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Related Experiment Videos

Inflammatory intermediates produced by tissues encasing silicone breast prostheses

E A Mena1, N Kossovsky, C Chu

  • 1Department of Pathology and Laboratory Medicine, School of Medicine, University of California, Los Angeles 90024-1732, USA.

Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research
|January 1, 1995
PubMed
Summary

Silicone breast implants cause inflammation, with periprosthetic tissues producing higher levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha). Macrophage presence correlates with TNF-alpha, but mediator levels do not predict patient symptoms.

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Area of Science:

  • Biomedical Engineering
  • Immunology
  • Materials Science

Background:

  • Silicone breast prostheses elicit inflammatory responses in soft tissues.
  • Previous studies observed inflammatory mediator production by individual cells in response to silicone.
  • This study investigates inflammatory mediator production by periprosthetic tissues as a whole organ response.

Purpose of the Study:

  • To measure inflammatory mediator production by periprosthetic tissues surrounding silicone breast implants.
  • To correlate mediator levels with histopathology of periprosthetic capsules and patient clinical symptoms.
  • To compare mediator levels in periprosthetic tissues with control tissues.

Main Methods:

  • Periprosthetic tissues from ten women with silicone breast implants were cultured in vitro.

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  • Control tissues included skin scars from augmentation mammaplasty and knee synovium from arthritis patients.
  • Mediators [interleukin-2 (IL-2), tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), and prostaglandin E2 (PGE2)] were measured using enzyme linked immunosorbent assay (ELISA).

    • Main Results:

    • Periprosthetic tissues showed substantially greater levels of IL-6 and TNF-alpha compared to controls; IL-2 and PGE2 levels were lower.
    • Mediator levels varied significantly between patients, with IL-6 ranging from 100 to 1,000,000 pg/ml per 10 g tissue.
    • Elevated TNF-alpha production correlated with increased macrophage numbers and overall tissue cellularity (p < .05).

    Conclusions:

    • Periprosthetic capsule cellularity, particularly macrophages, may drive TNF-alpha production.
    • Cytokine production by periprosthetic tissues alone is not a reliable predictor of clinical symptoms in patients with silicone breast prostheses.
    • Further research is needed to understand the complex interplay between implant materials, host response, and clinical outcomes.