Ji HaYeun, Sukarto Abby, Deegan Daniel, Fan Frank
Aziyo Biologics, Inc., Silver Spring, Md.
Plast Reconstr Surg Glob Open. 2021 Feb 16;9(2):e3420. doi: 10.1097/GOX.0000000000003420. eCollection 2021 Feb.
Human acellular dermal matrices (hADMs) are applied in various soft tissue reconstructive surgeries as scaffolds to support tissue remodeling and regeneration. To evaluate the clinical efficacy of hADM implants, it is integral that the hADM does not induce a host chronic inflammatory response leading to fibrotic encapsulation of the implant. In this study, we characterized the inflammatory and fibrosis-related tissue remodeling response of 2 commercial hADM products (SimpliDerm and AlloDerm RTU) in a nonhuman primate model using histology and gene expression profiling.
Eighteen African green monkeys with abdominal wall defects were applied to evaluate the performance of SimpliDerm and AlloDerm RTU implants (N = 3) at 2, 4, and 12-weeks post-implantation. Using histology and gene expression profiling, tissue responses such as implant integration, degradation, cell infiltration, immune response, neovascularization, and pro-fibrotic responses over time were evaluated.
SimpliDerm showed a lower initial inflammatory response and slower implant degradation rate than AlloDerm RTU evidenced by histomorphological analysis. These factors led to a more anti-inflammatory and pro-remodeling microenvironment within SimpliDerm, demonstrated by lower TNFα levels and lower expression levels of pro-fibrotic markers, and promoted tissue repair and regeneration by 3-months post-implantation.
Overall, histology and gene expression profiling analyses shown in this study demonstrated an effective model for analyzing hADM performance in terms of host inflammatory and fibrotic response. Further studies are warranted to fully evaluate the utility of this novel hADM in the clinical setting and verify the prognosis of our pre-clinical analysis model.
人脱细胞真皮基质(hADM)作为支架应用于各种软组织重建手术,以支持组织重塑和再生。为了评估hADM植入物的临床疗效,hADM不引发导致植入物纤维化包裹的宿主慢性炎症反应至关重要。在本研究中,我们使用组织学和基因表达谱分析,在非人类灵长类动物模型中对两种商用hADM产品(SimpliDerm和AlloDerm RTU)的炎症和纤维化相关组织重塑反应进行了表征。
将18只腹壁缺损的非洲绿猴用于评估SimpliDerm和AlloDerm RTU植入物(N = 3)在植入后2周、4周和12周的性能。使用组织学和基因表达谱分析,评估随时间变化的组织反应,如植入物整合、降解、细胞浸润、免疫反应、新血管形成和促纤维化反应。
组织形态学分析表明,SimpliDerm的初始炎症反应较低,植入物降解速率比AlloDerm RTU慢。这些因素导致SimpliDerm内形成更具抗炎性和促重塑的微环境,表现为较低的TNFα水平和促纤维化标志物的较低表达水平,并在植入后3个月促进了组织修复和再生。
总体而言,本研究中所示的组织学和基因表达谱分析证明了一种用于分析hADM在宿主炎症和纤维化反应方面性能的有效模型。有必要进行进一步研究,以全面评估这种新型hADM在临床环境中的效用,并验证我们临床前分析模型的预后。