Connecticut Comprehensive Center for Hernia Repair, Department of Surgery, University of Connecticut Health Center, 263 Farmington Avenue--MC 3955, Farmington, CT 06030, USA.
Hernia. 2010 Aug;14(4):401-7. doi: 10.1007/s10029-010-0634-7. Epub 2010 Feb 10.
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.
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-1beta), 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-1beta 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.
虽然基于猪的生物补片越来越多地用于疝修补术，但关于这些产品对组织的反应的数据很少。宿主异物反应、局部炎症和伤口愈合主要由单核细胞/巨噬细胞（M/MØ）控制。M/MØ 的过度激活可能会对补片的整合和重塑产生有害影响。我们假设常见的猪源补片在体外诱导 M/MØ 的差异激活。
从 6 名健康受试者的外周血中分离单核细胞，暴露于四种去细胞猪源补片的样本，即 CollaMend（CM；C.R. Bard/Davol）、Permacol（PC；TSL/Covidien）、Strattice（ST；LifeCell）和 Surgisis（SS；Cook Biotech）。在 7 天的孵育期后，使用基于多色珠的免疫分析系统检测上清液中白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）和血管内皮生长因子（VEGF）的含量。使用方差分析（ANOVA）和学生 t 检验比较四组。
每种补片类型在体外均诱导单核细胞的差异激活。CM（7195 pg/ml）和 PC（4215 pg/ml）的平均 IL-1β 表达明显高于 ST 和 SS（分别为 123 和 998 pg/ml；P < 0.05）。IL-6（范围 445-70729 pg/ml）、IL-8（范围 11640-1045938 pg/ml）和 VEGF（范围 686-7133 pg/ml）也呈现出类似的趋势。
我们首次证明了猪补片在体外诱导 M/MØ 激活。CM 和 PC（化学交联真皮）诱导的细胞因子表达明显高于 ST（非交联真皮）和 SS（小肠黏膜下层）。这些差异可能与专有处理方法和/或胶原交联程度有关。进一步了解猪源生物补片的免疫效应不仅可以比较现有产品，还可能导致补片的修改和改善其临床性能。
