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Tissue remodeling macrophages morphologically dominate at the interface of polypropylene surgical meshes in the human abdomen

A. Dievernich Orcid Logo, P. Achenbach, Luke Davies Orcid Logo, U. Klinge

Hernia, Volume: 24, Issue: 6, Pages: 1175 - 1189

Swansea University Author: Luke Davies Orcid Logo

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DOI (Published version): 10.1007/s10029-020-02315-2

Abstract

BackgroundMesh implants are widely used to reinforce the abdominal wall, although the inevitable inflammatory foreign body reaction (FBR) at the interface leads to complications. Macrophages are suspected to regulate the subsequent scar formation, but it is still unclear whether adequate fibrous sca...

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Published in: Hernia
ISSN: 1265-4906 1248-9204
Published: Springer Science and Business Media LLC 2020
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URI: https://cronfa.swan.ac.uk/Record/cronfa61680
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spelling 2022-11-07T15:42:27.4263606 v2 61680 2022-10-31 Tissue remodeling macrophages morphologically dominate at the interface of polypropylene surgical meshes in the human abdomen ff080296775381560053d5e3a6e81745 0000-0001-7767-4060 Luke Davies Luke Davies true false 2022-10-31 BMS BackgroundMesh implants are widely used to reinforce the abdominal wall, although the inevitable inflammatory foreign body reaction (FBR) at the interface leads to complications. Macrophages are suspected to regulate the subsequent scar formation, but it is still unclear whether adequate fibrous scar formation with collagen deposition depends mainly on the presence of M1 or M2 macrophages.MethodsThis study investigated the FBR to seven human polypropylene meshes, which were removed after a median incorporation time of 1 year due to the primary complaint of recurrence. Using immunofluorescence, the FBR was examined in six regional zones with increasing distance from the mesh fibers up to 350 µm, based on the cell densities, macrophage M1 (CD86) and M2 (CD163, CD206) phenotypes, deposition of collagen-I and -III, and expression of matrix metalloproteinase-2 (MMP-2) and -8 as indicator of collagen degradation.ResultsAll mesh–tissue complexes demonstrated a decrease in cell density and macrophages with distance to the mesh fibers. Overall, about 60% of the macrophages presented an M2 phenotype, whereas only 6% an M1 phenotype. Over 70% of macrophages showed co-expression with collagen-I or -III and over 50% with MMP-2.ConclusionsThe chronic FBR to polypropylene meshes is associated with an M2 macrophage response, which is accompanied by collagen deposition and MMP-2 expression. These findings challenge the idea that mainly M1 macrophages are related to inflammation and highlights that iatrogenic attempts to polarize these cells towards the M2 phenotype may not be a solution to ameliorate the long-term foreign body reaction. Journal Article Hernia 24 6 1175 1189 Springer Science and Business Media LLC 1265-4906 1248-9204 Foreign body reaction; Macrophage; Collagen; Mesh; Fluorescence microscopy 1 12 2020 2020-12-01 10.1007/s10029-020-02315-2 COLLEGE NANME Biomedical Sciences COLLEGE CODE BMS Swansea University Open Access funding enabled and organized by Projekt DEAL.. Open Access funding enabled and organized by Projekt DEAL. The support by the Federal Ministry of Education and Research (FKZ 13GW0108B) enabled the acquisition of the TissueGnostics system. 2022-11-07T15:42:27.4263606 2022-10-31T11:58:32.6719653 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine A. Dievernich 0000-0001-6677-9801 1 P. Achenbach 2 Luke Davies 0000-0001-7767-4060 3 U. Klinge 4 61680__25682__4ae09a3e017f464981b2b81b8e298aa0.pdf 61680.pdf 2022-11-07T15:40:50.5658671 Output 4412539 application/pdf Version of Record true © The Author(s) 2020. This article is licensed under a Creative Commons Attribution 4.0 International License true eng http://creativecommons.org/licenses/by/4.0/
title Tissue remodeling macrophages morphologically dominate at the interface of polypropylene surgical meshes in the human abdomen
spellingShingle Tissue remodeling macrophages morphologically dominate at the interface of polypropylene surgical meshes in the human abdomen
Luke Davies
title_short Tissue remodeling macrophages morphologically dominate at the interface of polypropylene surgical meshes in the human abdomen
title_full Tissue remodeling macrophages morphologically dominate at the interface of polypropylene surgical meshes in the human abdomen
title_fullStr Tissue remodeling macrophages morphologically dominate at the interface of polypropylene surgical meshes in the human abdomen
title_full_unstemmed Tissue remodeling macrophages morphologically dominate at the interface of polypropylene surgical meshes in the human abdomen
title_sort Tissue remodeling macrophages morphologically dominate at the interface of polypropylene surgical meshes in the human abdomen
author_id_str_mv ff080296775381560053d5e3a6e81745
author_id_fullname_str_mv ff080296775381560053d5e3a6e81745_***_Luke Davies
author Luke Davies
author2 A. Dievernich
P. Achenbach
Luke Davies
U. Klinge
format Journal article
container_title Hernia
container_volume 24
container_issue 6
container_start_page 1175
publishDate 2020
institution Swansea University
issn 1265-4906
1248-9204
doi_str_mv 10.1007/s10029-020-02315-2
publisher Springer Science and Business Media LLC
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description BackgroundMesh implants are widely used to reinforce the abdominal wall, although the inevitable inflammatory foreign body reaction (FBR) at the interface leads to complications. Macrophages are suspected to regulate the subsequent scar formation, but it is still unclear whether adequate fibrous scar formation with collagen deposition depends mainly on the presence of M1 or M2 macrophages.MethodsThis study investigated the FBR to seven human polypropylene meshes, which were removed after a median incorporation time of 1 year due to the primary complaint of recurrence. Using immunofluorescence, the FBR was examined in six regional zones with increasing distance from the mesh fibers up to 350 µm, based on the cell densities, macrophage M1 (CD86) and M2 (CD163, CD206) phenotypes, deposition of collagen-I and -III, and expression of matrix metalloproteinase-2 (MMP-2) and -8 as indicator of collagen degradation.ResultsAll mesh–tissue complexes demonstrated a decrease in cell density and macrophages with distance to the mesh fibers. Overall, about 60% of the macrophages presented an M2 phenotype, whereas only 6% an M1 phenotype. Over 70% of macrophages showed co-expression with collagen-I or -III and over 50% with MMP-2.ConclusionsThe chronic FBR to polypropylene meshes is associated with an M2 macrophage response, which is accompanied by collagen deposition and MMP-2 expression. These findings challenge the idea that mainly M1 macrophages are related to inflammation and highlights that iatrogenic attempts to polarize these cells towards the M2 phenotype may not be a solution to ameliorate the long-term foreign body reaction.
published_date 2020-12-01T04:20:40Z
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