Stem cell augmented mesh materials: an in vitro and in vivo study
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Introduction and hypothesis
To test in vitro and in vivo the capability of mesh materials to act as scaffolds for rat-derived mesenchymal stem cells (rMSCs) and to compare inflammatory response and collagen characteristics of implant materials, either seeded or not with rMSCs.
rMSCs isolated from rat bone marrow were seeded and cultured in vitro on four different implant materials. Implants showing the best rMSC proliferation rate were selected for the in vivo experiment. Forty-eight adult female Sprague–Dawley rats were randomly divided into two treatment groups. The implant of interest—either seeded or not with rMSCs—was laid and fixed over the muscular abdominal wall. Main outcome measures were: in vitro, proliferation of rMSCs on selected materials; in vivo, the occurrence of topical complications, the evaluation of systemic and local inflammatory response and examination of the biomechanical properties of explants.
Surgisis and Pelvitex displayed the best cell growth in vitro. At 90 days in the rat model, rMSCs were related to a lower count of neutrophil cells for Pelvitex and a greater organisation and collagen amount for Surgisis. At 7 days Surgisis samples seeded with rMSCs displayed higher breaking force and stiffness.
The presence of rMSCs reduced the systemic inflammatory response on synthetic implants and improved collagen characteristics at the interface between biological grafts and native tissues. rMSCs enhanced the stripping force on biological explants.
KeywordsMesh Stem cells Graft-related complications
Maximum force before the separation of the mesh from the abdominal wall
Foreign body giant cells
Mesenchymal stem cells
Pelvitex without rMSCs
Pelvic organ prolapse
Pelvitex with rMSCs
Rat-derived mesenchymal stem cells
Secant modulus at 30 % elongation
Secant modulus at 50 % elongation
Small intestine submucosa
Small intestine submucosa without rMSCs
Small intestine submucosa with rMSCs
Maximum elongation before the separation of the mesh from the abdominal wall
Conflicts of interest
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- 30.Urogynecologic surgical mesh: update on the safety and effectiveness of transvaginal placement for pelvic organ prolapse. July 2011 http://www.fda.gov/downloads/MedicalDevices/Safety/AlertsandNotices/UCM262760.pdf