Nitric oxide coating polypropylene mesh increases angiogenesis and reduces inflammatory response and apoptosis
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To evaluate the effect of implanted S-nitrosoglutathione (GSNO) coating polypropylene mesh in foreign-body response of rats.
Thirty female rats underwent to subcutaneous implant of five polypropylene (PP) fragments: uncoated PP (control); PP polyvinylalcohol (PVA) coated and PP PVA + GSNO (1, 10 and 70 mMol) coated. After euthanasia (4 and 30 days), eight slides were prepared from each animal: hematoxylin–eosin (inflammatory response); unstained (birefringence collagen evaluation); TUNEL technique (apoptosis); and five for immunohistochemical processing: CD-31 (angiogenesis), IL-1 and TNF-α (proinflammatory cytokynes), iNOS (NO synthesis) and MMP-2 (collagen metabolism). The inflammation area, birefringence index, apoptotic index, immunoreactivity and vessel density were objectively measured.
Inflammatory reaction area at 4 days was 11.3, 15.2, 25.1, 17.1 and 19.3% of pure PP, PVA, GSNO 1, 10 and 70 mM, respectively, p = 0.0006 (PP × Others). At 30 days lower inflammatory area was observed in GSNO 10 and 70 mM compared to pure PP (5.3, 5.2 and 11.1%, respectively, p = 0.0001). Vessel density was higher for GSNO 1 mM (25.5%) compared to pure PP (19.6%) at 30 days only, p = 0.0081. Apoptotic index at 4 days was lower for GSNO 1 mM (49.3%) than pure PVA (60.6%), p = 0.0124. GSNO 10 and 70 mM reduced their apoptotic index at 30 days compared to 4 days (49.9 vs. 36.9 and 59.1 vs. 47.5%, respectively, p = 0.0397). Birefringence index, IL-1, TNF, MMP-2 and iNOS were not different.
Depending on concentrations, GSNO can increase angiogenesis, reduce inflammation and apoptosis compared to pure PP, without impact on cytokine, collagen organization/metabolism and endogenous NO synthesis.
KeywordsHost versus graft reaction Nitric oxide Pelvic organ prolapse Polypropylenes Surgical mesh
This study was funded by Sao Paulo Research Foundation (Grant: 2011/11522-2).
AP contributed to conception and design, acquisition of data, analysis and interpretation of data, drafting of the manuscript, critical revision of the manuscript, statistical analysis, obtaining funding and technical support. WJF contributed to conception and design, acquisition of data, analysis and interpretation of data, critical revision of the manuscript and technical and material support. LOR contributed to conception and design, analysis and interpretation of data, drafting of the manuscript and critical revision of the manuscript. CLZR contributed to conception and design, acquisition of data, analysis and interpretation of data, drafting of the manuscript, critical revision of the manuscript, statistical analysis, obtaining funding, technical support and supervision.
Compliance with ethical standards
Conflict of interest
All applicable international, national and/or institutional guidelines for the care and use of animals were followed. This study has received approval by the Ethics Committee for Animal Experiments (CEEA-IB-UNICAMP) of the University of Campinas (Protocol: 2400-1).