Biostimulating fillers and induction of inflammatory pathways: A preclinical investigation of macrophage response to calcium hydroxylapatite and poly-L lactic acid.

INTRODUCTION: Initial macrophage response to biostimulatory substances is key in determining the subsequent behavior of fibroblasts and the organization of newly synthesized collagen. Though histological studies suggest that calcium hydroxylapatite (CaHA) filler initiates a regenerative healing response with collagen and elastin deposition similar to natural, healthy tissue rather than an inflammatory response with fibrosis, the relative activity of macrophages stimulated by CaHA, as well as how this activity compares to that induced by other biostimulatory fillers, has not been explored. The aim of the study is to characterize the in vitro macrophage response to two biostimulory fillers, CaHA and PLLA (poly-L lactic acid), and to evaluate their inflammatory potential. METHODS: Primary human macrophages were incubated with two dilutions (1:50 and 1:100) of commercially available CaHA or PLLA. After 24 h incubation, an inflammation array was used to screen for the expression of 40 cytokines, released by macrophages. ELISA was used to confirm array results. RESULTS: Four cytokines were significantly upregulated in M1 macrophages incubated with PLLA compared to both unstimulated controls and CaHA: CCL1 (p < 0.001), TNFRII (p < 0.01), MIP-1α (p < 0.05), and IL-8 (p < 0.001). In M2 macrophages, MIP-1α (p < 0.01) and MIP-1ß (p < 0.01) were significantly upregulated by PLLA compared to CaHA and unstimulated controls. CONCLUSION: Together, these findings indicate that the CaHA mode of action is a non-inflammatory response while PLLA initiates expression of several cytokines known to play a role in inflammation. Our study supports the concept that these two "biostimulatory" fillers follow distinct pathways and should be considered individually with regard to mechanism of action.

Contaminação bacteriológica de águas subterrâneas da região oeste de Santa Catarina, Brasil / Bacteriological contamination of groundwater of the western area of Santa Catarina, Brazil

O objetivo do estudo foi avaliar a qualidade bacteriológica de águas subterrâneas da região oeste do Estado de Santa Catarina, onde é comum a utilização de poços comunitários ou particulares. As amostras foram avaliadas pela técnica de fermentação em tubos múltiplos de acordo com a metodologia descrita no American Public Health Association e segundo a instrução normativa 62 de 26 de agosto de 2003, do Ministério da Agricultura Pecuária e Abastecimento. Além disso, foi realizado levantamento de dados por meio de um questionário, cujas questões foram respondidas pelo responsável pelo respectivo poço. Das 212 amostras de água analisadas, 161 (75,94%) estavam impróprias para o consumo humano, conforme a Portaria 518/2004 do Ministério da Saúde. Apesar dos altos índices de contaminação bacteriológica nas amostras avaliadas, a maioria dos consumidores julga essa água de boa qualidade e por isso, apenas 10% dos usuários costumam filtrar e 8% fervem a água antes do consumo. Portanto, torna-se necessário a adoção de medidas preventivas e o tratamento das águas já comprometidas.