Expression of NF-κB-p65 and α-SMA in the Study of Capsules formed by Surface Textured Implants Versus Foam Covered
Rafael Dib Possiedi1,2, Lee Seng Khoo1,3, Francesco Mazzarone1
1Department of Plastic & Reconstructive Surgery, Hospital Santa Casa de Misericórdia do Rio de Janeiro, 38th Infirmary Professor Ivo Pitanguy's Service, Rio de Janeiro, Brazil.
Background:
We aimed to compare inflammatory and intercellular transcription responses induced by surface textured (ST) implants versus foam covered (FC) silicone implants placed on the dorsal aspect of rats.
Methods:
We utilized 80 female rats of the Wistar lineage. The rats were divided into four subgroups of 20 with one type of implant placed in the dorsum per rat. Analysis was carried out on peri-implant capsules at 90 d and at 180 d post-surgery with microscopic evaluation of inflammatory and immuno-histochemical response of NF-κB-p65 and α-SMA in fibroblasts. This study was carried out at the Evangelical Faculty of Parana and at the Ivo Pitanguy Institute, Brazil in 2015.
Results:
The FC exhibited higher levels of acute and chronic inflammation on evaluation in both time frames. The capsule surrounding the ST implants was significantly thicker with well-organized collagen fibres. NFκB-p65 expression in the capsule surrounding the FC implant was more pronounced. There was higher and more significant α-SMA expression in the capsules of the surface textured (ST) silicone implants compared to the foam-covered (FC) silicone implants.
Conclusion:
Activation of NFκB-p65 plays a key role in the evolution of capsule formation and maintenance of inflammation by regulating the healing process. Similarly, higher and more prolonged levels of inflammation (increased NF-κB-p65 results in increased inflammation) and lower α-SMA (higher α-SMA is protective against capsular contracture) did not directly translate to a thicker capsule and ultimately, capsular contracture in foam covered silicone implants.
