Release of metal elements from the Essure implant: A prospective cohort study.

OBJECTIVE(S): The causal mechanistic relationships between Essure® and adverse effects are unclear, but corrosion in the in-vivo environment with release of metal ions may be suspected. Here we evaluated the concentrations of nickel (Ni), chromium (Cr) and tin (Sn) in the peritoneal fluid (PF) and in the fallopian tube (FT) during laparoscopic Essure® removal compared to a control group. STUDY DESIGN: Ni, Cr and Sn concentrations were determined in the PF and FT from two groups(group A: symptomatic patients with Essure®) vs group B (control group without Essure®) by Inductively Coupled Plasma Mass Spectrometry analysis. Correlation between metal elements concentrations and reported pre-operative symptoms was also investigated. RESULTS: There were 131 patients in group A vs 92 control patients in group B. The concentrations of Cr and Ni in PF between both groups were significantly different (p < 0.0001) while there was no statistical difference for Sn (p = 0.58). There was also a significantly higher concentration in the FT for the 3 metal elements in group A than in group B (p < 0.0001). There were differential dynamics of the levels of metal elements based on the length of time between the placement and removal of Essure®. CONCLUSIONS: There was a chronic exposure to metal elements in symptomatic patients with Essure® raising the question of the relationship between adverse effects and these potential toxic metals.

Characterization and Cellular Uptake of Peptides Derived from In Vitro Digestion of Meat Analogues Produced by a Sustainable Extrusion Process.

Whether proteins in meat analogues (MAs) have the ability to provide equivalent nutrition as those in animal meat remains unknown. Herein, a MA was produced by high-moisture extrusion using soy and wheat proteins. The physicochemical properties, in vitro digestion, and cellular uptake of the released peptides were systematically compared between the MA and the chicken breast (CB). The MA showed a higher hardness but a lower degree of texturization than the CB. After simulated digestion, soluble peptides in the MA had a higher molecular weight and higher hydrophobicity. No observable cytotoxicity or inflammatory response to Caco-2 cells was found for both MA and CB digests. The former exhibited less permeability of peptides across Caco-2 cells. Liquid chromatography with tandem mass spectrometry found that the identified peptides in MA and CB digests contained 7-30 and 7-20 amino acid residues, respectively, and they became shorter after cellular transportation. The amino acid composition showed fewer essential and non-essential amino acids in the MA permeate than in the CB permeate.

Potential release of toxic metal elements from Essure® device in symptomatic patients: First results of the French Ablimco cohort.

OBJECTIVE: Many patients with Essure® devices request the removal of these implants due to persistent adverse effects. The pathophysiology remains unknown, but a corrosion of the implants in the in-vivo environment leading to metal ion release may be suspected. The implants consist of polyester fibers, nickel-titanium alloy and other metals including chromium. The purpose of this study is to deliver the first results on the concentrations of nickel and chromium (two potential toxic metal elements) in peritoneal fluid and in the fallopian tube tissue during laparoscopic removal of Essure®. STUDY DESIGN: In this prospective observational study conducted in a French academic research hospital (University hospital of Lyon), nickel and chromium concentrations were determined in the fallopian tube tissue and peritoneal liquid from symptomatic patients with Essure® by Inductively Coupled Plasma Mass Spectrometry (ICP-MS) analysis in a PerkinElmer NexION 350. RESULTS: Significant metal element concentrations were showed in the peritoneal fluid. There was also a differential concentration in the fallopian tube tissue with higher concentration close to the implant then lower at a distance from this implant. There was a correlation between the concentrations of the two metals. CONCLUSION: The presence of nickel and chromium in the fallopian tube tissue and the peritoneal fluid raises the question of a possible relationship between the symptoms attributed to Essure® implants and the dissemination of potential toxic metals due to galvanic corrosion of the devices.