From the Department of Obstetrics and Gynecology, Duke University Medical Center.
Mechanical Engineering and Materials Science, Duke University, Durham.
Female Pelvic Med Reconstr Surg. 2021 Feb 1;27(2):e469-e475. doi: 10.1097/SPV.0000000000000964.
Polycarbonate urethane (PCU) is a new biomaterial, and its mechanical properties can be tailored to match that of vaginal tissue. We aimed to determine whether vaginal host immune and extracellular matrix responses differ after PCU versus lightweight polypropylene (PP) mesh implantation.
Hysterectomy and ovariectomy were performed on 24 Sprague-Dawley rats. Animals were divided into 3 groups: (1) PCU vaginal mesh, (2) PP vaginal mesh, and (3) sham controls. Vagina-mesh complexes or vaginas (controls) were excised 90 days after surgery. We quantified responses by comparing: (1) histomorphologic scoring of hematoxylin and eosin- and Masson trichrome-stained slides, (2) macrophage subsets (immunolabeling), (3) pro-inflammatory and anti-inflammatory cytokines (Luminex panel), (4) matrix metalloproteinase (MMP)-2 and -9 using an enzyme-linked immunosorbent assay, and (5) type I/III collagen using picrosirius red staining.
There was no difference in histomorphologic score between PCU and PP (P = 0.211). Although the histomorphologic response was low surrounding all mesh fibers, groups with PCU and PP mesh had a higher histomorphologic score than the control group (P < 0.005 and P < 0.002, respectively). There were no differences between groups in terms of macrophage subsets, pro-inflammatory cytokines, anti-inflammatory cytokines, MMP-2 and MMP-9, or collagen ratio.
Polycarbonate urethane, an elastomer with material properties similar to those of vaginal tissue, elicits minimal host inflammatory responses in a rat model. Because its implantation does not elicit more inflammation than currently used lightweight PP, using PCU for prolapse mesh warrants further investigation with larger animal models.
聚碳酸酯聚氨酯（PCU）是一种新型生物材料，其机械性能可以根据需要与阴道组织相匹配。我们旨在确定 PCU 与轻质聚丙烯（PP）网片植入后阴道宿主免疫和细胞外基质反应是否存在差异。
对 24 只 Sprague-Dawley 大鼠进行子宫切除术和卵巢切除术。动物分为 3 组：（1）PCU 阴道网片组，（2）PP 阴道网片组和（3）假手术对照组。术后 90 天切除阴道-网片复合物或阴道（对照组）。通过比较以下方面来量化反应：（1）苏木精和伊红及 Masson 三色染色载玻片的组织形态学评分，（2）巨噬细胞亚群（免疫标记），（3）促炎和抗炎细胞因子（Luminex 面板），（4）使用酶联免疫吸附试验测定基质金属蛋白酶（MMP）-2 和 -9，以及（5）使用苦味酸天狼星红染色测定 I/III 型胶原。
PCU 和 PP 的组织形态学评分无差异（P = 0.211）。尽管围绕所有网片纤维的组织形态反应较低，但 PCU 和 PP 网片组的组织形态学评分高于对照组（分别为 P < 0.005 和 P < 0.002）。各组间的巨噬细胞亚群、促炎细胞因子、抗炎细胞因子、MMP-2 和 MMP-9 或胶原比例无差异。
聚碳酸酯聚氨酯，一种与阴道组织相似的弹性体，在大鼠模型中引起的宿主炎症反应最小。由于其植入不会引起比目前使用的轻质 PP 更多的炎症，因此使用 PCU 进行脱垂网片值得进一步研究更大的动物模型。
