The effect of human amniotic fluid cell culture medium on capsule formation around silicone prosthesis

Introduction: Silicone implants have been used for breast augmentation and breast reconstruction after mastectomy for the last fifty years. Capsular contracture is a phenomenon that occurs when the reactive capsule around the breast prosthesis thickens, tightens and causes tightness of the breast. This is one of the most common complications of aesthetic and reconstructive breast surgery. For this reason, the effects of many agents, methods such as allograft or tissue engineering on the formation of capsule around the prosthesis have been studied in the literature. In our study, we used both ACCM and ADSC for this purpose and compared their effects on the capsule formation around the silicone prosthesis. AmnioMAX TM C-100 (AmnioMAX TM C-100 and AmnioMAX TM II Complete Media,Life Technologies, 5791 Van Allen Way, Carlsbad, California 92008), a nutrient medium used for in vitro culture of amniotic fluid cells and chorionic villus cells, was used as ACCM. Materials and Methods: In the study, 26 female Sprague Dawley rats weighing between 250-300 g were used. 26 rats were randomly assigned to control, 3 study groups (ACCM only, only ADSC-adipose tissue derived mesenchymal stem cell, ACCM + ADSC) and two rats were used to obtain ADSC. A 1x1 cm pocket was prepared above the paravertebral muscles under the panniculus carnosus with a paravertebral incision in the rats. Before implant placement: 0.5 cc of normal saline was injected into the prepared pouch in Group 1 (Control). In Group 2 (ACCM), 0.5 cc ACCM was injected into the pouch. In Group 3 (ADSC) 0.5 cc ADSC was injected into the pouch. In group 4 (ACCM+ADSC), 0.5 cc ACCM and 0.5 cc ADSC were injected into the pouch. And then the implant was placed in the pouch. All rats were sacrificed at the end of the second month, and the periprosthetic capsules in the surgical area were excised. Morphological analysis was performed evaluating with capsule thickness. Tissue samples were taken for histopathological and biochemical examinations. The obtained data were evaluated statistically with the Shaphiro Wilk test. Results: TGFβ-1 and 2, IL-2, TAS, TOS and OSI parameter averages were found to be statistically significantly different between the groups (p<0.05). The mean of TGFβ-1and 2 (31.18±13.11 and 20.79±6.9), IL2 (14.4±2.34), TOS (0.24±0.06) and OSI (0,53±0,12) of the rats in the combined group were found to be significantly lower than other groups. The mean TAS (0.47±0.09) was found to be significantly higher in the combined group compared to the other groups. As a result of the comparison of the immunoreactivity intensities between the groups, all the subjects in the Control group had severe immunoreactivity (100%), while weak immunoreactivity was observed in the majority of the rats (66.7%) in the ACCM group and in all of the rats in the Combined group. Conclusion: According to the results obtained from the current parameters examined in our study, we think that the group in which ACCM and ADSC were applied combined was more resistant to oxidative stress, had a weaker immunoreactivity level, and reduced the capsule formation more by changing the behavior pattern of the fibroblasts responsible for periprosthetic capsule formation.