Department of Plastic, Aesthetic and Reconstructive Surgery, Clínica Universidad de Navarra, University of Navarra, Pío XII 36, Pamplona, Spain.
Aesthetic Plast Surg. 2010 Aug;34(4):430-7. doi: 10.1007/s00266-010-9475-0. Epub 2010 Feb 23.
Capsular contracture is the most common complication associated with silicone prostheses. It may take the form of anything from slight hardening to obvious deformity. The role of transforming growth factor beta (TGF-beta) in the scar physiopathology of any fibrotic process has been demonstrated. The effects of inhibition of TGF-beta have also been demonstrated in experimental models of fibrosis, which opens the way for new therapeutic alternatives in the treatment of capsular contracture. The aim of this study was to evaluate periprosthetic fibrosis with a newly synthesized TGF-beta peptide inhibitor (p144).
Three experimental groups were formed: Group I, subcutaneous and submuscular textured silicone prostheses were left untreated; Group 2, the prostheses were left after being immersed in the vehicle; Group 3, the same protocol was followed as in Group 2, but the solution contained the vehicle with the inhibitor peptide of TGF-beta, p144 (15 mg/prosthesis). The animals were sacrificed 24 weeks after implantation, and the capsules were assessed both macroscopically and histologically.
The results obtained showed that the inhibition of capsular thickness and soluble collagen content in pericapsular fibrosis did not significantly decrease in the group of animals treated with the TGF-beta inhibitor peptide in comparison with control cases.
We detected no statistically significant reduction in fibrosis in the periprosthetic capsule after treating the implants with the inhibitor peptide p144, but we feel that the influence of trauma around the prosthesis is critical in impeding the antifibrotic activity of the inhibitor peptide.
包膜挛缩是与硅树脂假体相关的最常见并发症。它可能表现为从轻微的硬化到明显的变形。转化生长因子-β（TGF-β）在任何纤维性过程的瘢痕病理生理学中的作用已经得到证实。TGF-β抑制作用的影响也在纤维化的实验模型中得到了证实，这为包膜挛缩治疗的新治疗选择开辟了道路。本研究的目的是评估新合成的 TGF-β肽抑制剂（p144）对假体周围纤维化的影响。
形成了三个实验组：I 组，未处理皮下和肌下纹理硅树脂假体；II 组，假体浸泡在载体后保留；III 组，遵循与 II 组相同的方案，但溶液中含有 TGF-β的抑制剂肽 p144（15mg/假体）。植入后 24 周处死动物，对包膜进行宏观和组织学评估。
结果表明，与对照组相比，用 TGF-β抑制剂肽处理的动物组，包膜厚度和囊周纤维化中可溶性胶原含量的抑制作用没有显著降低。
我们没有检测到用抑制剂肽 p144 处理植入物后假体周围胶囊纤维化的统计学显著减少，但我们认为假体周围创伤的影响对抑制抑制剂肽的抗纤维化活性至关重要。
