Ting-Mao Chou, Chin-Hao Hsu, Tai-I Hsu, Leo Shaw, Wen-Ching Wang, Chao-Ming Hung, I-Ming Jou, Yao-Lung Kuo
Introduction: Breast reconstruction using silicone implants is a widespread choice, however, breast capsular contracture (BCC), a response of the immune system to foreign materials, is the most affliction and frustration fibrosis complications after silicone implantation. Chronic inflammation-associated fibrosis is regarded as a main cause of BCC. Hyaluronic acid (HA) is an effective anti-adhesive and anti-fibrotic agent. Furthermore, 1,4-butanediol diglycidyl ether-cross-linked hyaluronan hydrogel (cHA) is a non-resorbable cross-linked hyaluronan-derived polymer with no cytotoxicity and high stability. This study aims to evaluate the potential of cHA on preventing BCC in breast surgery using silicone implants.
Methods: The effect of cHA on BCC will be examined in breast BCC rat model.
Results: Our study showed that cHA decreased fibrosis-regulated factors transforming growth factor beta 1 (TGF-β1) and tissue inhibitor of metalloproteinase (TIMP) expressions and increased metalloproteinase (MMP) MMP-9 expression in capsule tissue. cHA significantly decreased inflammatory mediators tumor necrosis factoralpha (TNF-α), interleukin IL-6, nitric oxide (NO), as well as inducible nitric oxide synthase (iNOS) expressions. In addition, cHA significantly decreased transcription factor nuclear factor kappa B (NF-κB) activation in silicone surrounded tissue.
Conclusions: cHA showed prevention in BCC formation through inhibiting NF-κB -associated inflammation in rats with silicone implantation.