Activation of human mononuclear cells by porcine biologic meshes in vitro
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While porcine-based biologic meshes are increasingly used for hernia repair, little data exist on tissue responses to such products. Host foreign body reaction, local inflammation, and wound healing are principally controlled by monocytes/macrophages (M/MØs). Exaggerated activation of M/MØs may deleteriously influence mesh integration and remodeling. We hypothesized that common porcine meshes induce the differential activation of M/MØs in vitro.
Materials and methods
Samples of four acellular porcine-derived meshes, CollaMend™ (CM; C.R. Bard/Davol), Permacol™ (PC; TSL/Covidien), Strattice™ (ST; LifeCell), and Surgisis® (SS; Cook Biotech), were exposed to mononuclear cells derived from the peripheral blood of six healthy subjects. Following a 7-day incubation period, supernatants were assayed for interleukin-1beta (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), and vascular endothelial growth factor (VEGF) using a multiplex bead-based immunoassay system. The four groups were compared using analysis of variance (ANOVA) and Student’s t-test.
Each mesh type induced differential mononuclear cell activation in vitro. The mean IL-1β expressions for CM (7,195 pg/ml) and PC (4,215 pg/ml) were significantly higher compared to ST and SS (123 and 998 pg/ml, respectively; P < 0.05). Similar trends were also seen for IL-6 (range 445–70,729 pg/ml), IL-8 (range 11,640–1,045,938 pg/ml), and VEGF (range 686–7,133 pg/ml).
For the first time, we demonstrated that porcine meshes induce M/MØ activation in vitro. CM and PC (chemically crosslinked dermis) induced significantly higher cytokine expression compared to ST (non-crosslinked dermis) and SS (small intestine submucosa). These differences are likely related to proprietary processing methods and/or the extent of collagen crosslinking. Further understanding of immunologic effects of porcine-derived biologic meshes will not only allow for a comparison between existing products, but it may also lead to mesh modifications and improvement of their clinical performance.
KeywordsBiologic mesh Porcine Dermis Small intestine submucosa Peripheral blood mononuclear cells (PBMCs) Monocytes Cytokine Interleukin-1beta (IL-1β) Interleukin-6 (IL-6) Interleukin-8 (IL-8) Vascular endothelial cell growth factor (VEGF) In vitro
- 5.Milburn ML, Holton LH, Chung TL, Li EN, Bochicchio GV, Goldberg NH, Silverman RP (2008) Acellular dermal matrix compared with synthetic implant material for repair of ventral hernia in the setting of peri-operative Staphylococcus aureus implant contamination: a rabbit model. Surg Infect (Larchmt) 9:433–442CrossRefGoogle Scholar
- 20.Orenstein SB, Qiao Y, Kaur M, Klueh U, Kreutzer DL, Novitsky YW (2009) Human monocyte activation by biologic and biodegradable meshes in vitro. Surg Endosc (in press)Google Scholar
- 25.Kaback LA, Smith TJ (1999) Expression of hyaluronan synthase messenger ribonucleic acids and their induction by interleukin-1beta in human orbital fibroblasts: potential insight into the molecular pathogenesis of thyroid-associated ophthalmopathy. J Clin Endocrinol Metab 84:4079–4084CrossRefPubMedGoogle Scholar
- 35.Mosser DM, Zhang X (2008) Activation of murine macrophages. Curr Protoc Immunol Chapter 14: Unit 14.2Google Scholar
- 36.Zhang X, Goncalves R, Mosser DM (2008) The isolation and characterization of murine macrophages. Curr Protoc Immunol Chapter 14: Unit 14.1Google Scholar
- 40.Ansaloni L, Catena F, Coccolini F, Gazzotti F, D’Alessandro L, Pinna AD (2009) Inguinal hernia repair with porcine small intestine submucosa: 3-year follow-up results of a randomized controlled trial of Lichtenstein’s repair with polypropylene mesh versus surgisis inguinal hernia matrix. Am J Surg 198:303–312CrossRefPubMedGoogle Scholar
- 41.Franklin ME Jr, Treviño JM, Portillo G, Vela I, Glass JL, González JJ (2008) The use of porcine small intestinal submucosa as a prosthetic material for laparoscopic hernia repair in infected and potentially contaminated fields: long-term follow-up. Surg Endosc 22:1941–1946CrossRefPubMedGoogle Scholar
- 44.Trabuco EC, Zobitz ME, Klingele CJ, Gebhart JB (2007) Effect of host response (incorporation, encapsulation, mixed incorporation and encapsulation, or resorption) on the tensile strength of graft-reinforced repair in the rat ventral hernia model. Am J Obstet Gynecol 197:638.e1–638.e6CrossRefGoogle Scholar
- 45.Xu H, Wan H, Zuo W, Sun W, Owens RT, Harper JR, Ayares DL, McQuillan DJ (2009) A porcine-derived acellular dermal scaffold that supports soft tissue regeneration: removal of terminal galactose-alpha-(1,3)-galactose and retention of matrix structure. Tissue Eng Part A 15:1807–1819CrossRefPubMedGoogle Scholar