179. Altered Foreign Body Response at the Posterior Surface Compared to the Anterior Surface of Human Silicone Breast Implants
Notice bibliographique
Résumé
PURPOSE: Dysregulation of the foreign body reaction (FBR) and chronic peri-prosthetic inflammation of the breast implant-tissue interface is linked to several pathologies including capsular contracture, breast implant associated-anaplastic large cell lymphoma (BIA-ALCL) and squamous cell carcinoma (SCC). The FBR and resulting capsule have long been assumed to be uniform. However, the implant is asymmetric and placed in a non-uniform implant pocket with differential anterior and posterior mechanical factors, which have been shown to alter the FBR. Currently, little is known about how these spatial factors influence capsule physiology, how they progress over time, and their impact on the implant itself. The purpose of our study was to: 1) compare inflammatory and fibrotic phenotypes of anterior and posterior human breast implant capsule 2) determine how duration of implantation alters these phenotypes, and 3) investigate whether there are corresponding oxidative changes to the device surface. METHODS: We collected human breast implant capsule and removed implants from reconstructive patients undergoing secondary surgery at McGill University Health Center hospital (September 2020 and April 2022). Within each breast, both anterior (N = 31) and posterior (N = 31) capsule were collected. Specimens were assessed histologically for capsular thickness and collagen organization. Capsular cell populations were measured by immunohistochemistry for fibroblasts (vimentin), myofibroblasts (α-smooth muscle actin), total macrophages (CD68), M1 macrophages (iNOS) and M2 macrophages (CD206). Expression of proinflammatory cytokines (IL-1β, IL-6), extracellular matrix (Col1, Col3) and profibrotic growth factor TGF-β were measured with RT-PCR. Samples of anterior (N = 17) and posterior (N=17) breast implant surface were assessed for oxidation with XPS analysis. Statistical analyses included paired t-tests and simple linear regression. RESULTS: We demonstrate that posterior capsule displays several features of a dysregulated FBR compared to anterior capsule. These features include: 1) significantly increased capsule thickness (p <.05), 2) abnormal extracellular matrix remodeling characterized by disorganized collagen organization (p <.05) and increased immature type 3 collagen expression (p <.05), and 3) increased infiltration of macrophages (p <.05). We also show that posterior capsule becomes more dysregulated over time as evidenced by a significant positive relationship between pro-inflammatory cytokines IL-1 β and IL-6 and implant duration (p <.05). Finally, posterior device surface was significantly more oxidized than that anterior device surface (p <.05) suggesting that corresponding changes occur at the level of the implant that may ultimately compromise the integrity of the device. CONCLUSIONS: Collectively, our data demonstrate significant spatiotemporal inflammatory and fibrotic differences in human capsule tissue surrounding breast implants, and corresponding oxidative changes to the breast implant surface. Notably, we show that the posterior surface of the implant adopts an increasingly inflammatory phenotype over time and corresponds with increased oxidation of the breast implant surface. This chronic inflammatory environment could contribute to pathologic sequelae such as development of capsular contracture, BIA-ALCL and SCC. The corresponding increased device oxidation could increase risk of implant rupture or gel bleed. This knowledge could be applied to target the posterior peri-prosthetic environment to reduce patient morbidity associated with breast implant surgery.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».