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Plast Reconstr Surg ; 120(7): 2025-2033, 2007 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-18090769

RESUMEN

BACKGROUND: Late capsular contraction around breast implants is one of the most difficult complications to prevent or resolve. The authors studied the mechanisms that control the fibrotic process in an animal model. Using angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonist, the authors previously described a significant reduction in fibrosis in different experimental models. METHODS: Four groups of six rats each had a mini breast implant, 12 with a smooth surface and 12 with a textured surface. In two groups, the angiotensin-converting enzyme inhibitor enalapril was administered in drinking water, ad libitum, to determine its effect on both implant types. Two control groups were given plain drinking water. Three months postoperatively, all of the rats were killed and the capsule sections were cut and stained with hematoxylin and eosin and Masson's trichrome. Immunolabeling of collagen III and transforming growth factor (TGF)-beta1 was performed using monoclonal antibodies. RESULTS: Significant differences were found between smooth and textured implants, with a uniformly low inflammatory response found on textured implants. For both surfaces, the enalapril-treated group had a significant reduction of the inflammatory process that was especially marked in the textured implants. Immunostaining for collagen III and TGF-beta1 showed a consistent reduction in both fibrous tissue and cytokine mediator. CONCLUSIONS: Enalapril lowers the expression of fibrotic mediators, TGF-beta1, inflammatory markers, anti-ED1, anti-collagen III monoclonals, and the periprosthetic fibrosis process. The reduction of TGF-beta1 indicates that the probable main cytokine mediator of the fibrotic cascade is attenuated. This hypothesis may provide the basis for a safe and cheap therapeutic strategy with which to modify the capsular contracture that sometimes affects women with mammary implants.


Asunto(s)
Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Implantes de Mama , Enalapril/uso terapéutico , Implantes Experimentales , Complicaciones Posoperatorias/prevención & control , Inhibidores de la Enzima Convertidora de Angiotensina/farmacología , Animales , Colágeno Tipo III/biosíntesis , Colágeno Tipo III/genética , Regulación hacia Abajo/efectos de los fármacos , Evaluación Preclínica de Medicamentos , Enalapril/farmacología , Diseño de Equipo , Femenino , Fibrosis/etiología , Fibrosis/prevención & control , Granuloma de Cuerpo Extraño/etiología , Granuloma de Cuerpo Extraño/patología , Granuloma de Cuerpo Extraño/prevención & control , Glándulas Mamarias Animales/patología , Glándulas Mamarias Animales/cirugía , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/patología , Distribución Aleatoria , Ratas , Ratas Sprague-Dawley , Factor de Crecimiento Transformador beta1/biosíntesis , Factor de Crecimiento Transformador beta1/genética
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