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Human monocyte activation by biologic and biodegradable meshes in vitro

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Abstract

Background

Inflammation and wound healing play critical roles in the integration of biologic and biodegradable meshes (BMs) at hernia repair sites. Monocytes/macrophages (M/MØs) are key cells controlling inflammation and wound healing. These cells release inflammatory cytokines and growth factors such as interleukin (IL)-1β, IL-6, IL-8, and vascular endothelial growth factor (VEGF) upon activation. Although BMs have been increasingly used in hernia repairs worldwide, to date, investigations of inflammatory responses to various BMs have been limited.

Methods

Mesh samples of three acellular human dermis-derived biologic meshes (AlloDerm, AlloMax, FlexHD) and one biodegradable synthetic mesh (Bio-A) were placed in 96-well plates. Human peripheral blood mononuclear cells (PBMCs) were isolated from six healthy subjects, added to each well, and incubated for 7 days. Culture supernatants were assayed for IL-1β, IL-6, IL-8, and VEGF levels using a multiplex bead-base immunoassay system (Bio-Plex).

Results

All four meshes induced cytokine expression from activated M/MØs to varying degrees in vitro. FlexHD induced significantly more IL-1β (2,591 pg/ml) than AlloMax (517 pg/ml), AlloDerm (48 pg/ml), or Bio-A (28 pg/ml) (p < 0.001). AlloMax stimulated a significantly greater quantity of IL-6 (38,343 pg/ml) than FlexHD (19,317 pg/ml), Bio-A (191 pg/ml), or AlloDerm (103 pg/ml) (p < 0.05). Interleukin-8 and VEGF displayed trends similar to that of IL-6. There were no significant differences in cytokine production between AlloDerm and Bio-A.

Conclusion

This study demonstrated that human macrophages are activated by human dermis-derived biologic and biodegradable meshes in vitro. A wide range of cytokine and growth factor induction was seen among the different mesh products. These differences in M/MØ activation may be related to the proprietary processing technologies of the studied meshes. The study results raise the possibility that these differences in M/MØ activation could indicate varying intensities of inflammation that control integration of different biologic meshes at the sites of hernia repair.

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Acknowledgment

This study was funded in part by institutional support from the University of Connecticut Health Center.

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Authors and Affiliations

  1. Department of Surgery, Connecticut Comprehensive Center for Hernia Repair, University of Connecticut Health Center, 263 Farmington Avenue–MC 3955, Farmington, CT, 06030, USA

    Sean B. Orenstein, Ulrike Klueh, Don L. Kreutzer & Yuri W. Novitsky

  2. Department of Surgery, Center for Molecular Tissue Engineering, University of Connecticut School of Medicine, Farmington, CT, USA

    Yi Qiao, Manjot Kaur, Ulrike Klueh & Don L. Kreutzer

Authors
  1. Sean B. Orenstein
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  2. Yi Qiao
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  3. Manjot Kaur
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  4. Ulrike Klueh
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  5. Don L. Kreutzer
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  6. Yuri W. Novitsky
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Correspondence to Yuri W. Novitsky.

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Orenstein, S.B., Qiao, Y., Kaur, M. et al. Human monocyte activation by biologic and biodegradable meshes in vitro. Surg Endosc 24, 805–811 (2010). https://doi.org/10.1007/s00464-009-0664-3

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  • DOI: https://doi.org/10.1007/s00464-009-0664-3

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