Skip to main content
Erschienen in: Aesthetic Plastic Surgery 1/2008

01.01.2008 | Original Article

Pirfenidone Prevents Capsular Contracture After Mammary Implantation

verfasst von: Matias Gancedo, Luis Ruiz-Corro, Adriana Salazar-Montes, Ana Rosa Rincón, Juan Armendáriz-Borunda

Erschienen in: Aesthetic Plastic Surgery | Ausgabe 1/2008

Einloggen, um Zugang zu erhalten

Abstract

Background

Pirfenidone (PFD), a new antifibrotic and antiinflammatory agent, prevents and resolves fibrous tissue. This study evaluated the effect of PFD on adverse events in mammary implants using an animal model. Mammary implantation, the most frequent aesthetic surgery, may present several complications after surgery such as swelling, capsule contracture, hardness, and pain.

Methods

Wistar rats underwent submammary implantation with either smooth or textured silicone gel implants and were administrated 200 mg/kg of PFD daily. The control group received saline. The animals were killed at 8 weeks. The capsular tissue of both implants was removed for histologic and molecular analyses.

Results

Typical postaugmentation periimplant capsules with opacity on adjacent tissues developed 8 weeks after silicone implantation. No significant differences were observed between the textured and smooth implants in any analyzed parameter. Clearly, PFD reduced capsule thickness around submmamary tissue, fibroblast-like cell proliferation, and recruitment of inflammatory cells. The total cell numbers per field were reduced as well. In contrast, the control group presented abundant mononuclear cell infiltration and fibroblast-like cell proliferation. The total content of collagen in the PFD group was 50% less than in the control group. Fibroblast cells displayed 45% less activated phenotype in the PFD group than in the control group, as determined by immunohistochemistry techniques. In the PFD animals, transforming growth factor-β (TGF-β) decreased 85% and collagen 1 gene expression 60%, compared with the control group.

Conclusion

The findings show a positive effect of PFD on mammary contracture in 10 rats. Despite the small number of animals, the differences found in 10 control rats encourage the authors to propose a larger study later and to suggest PFD as a potential preventive strategy in human mammary implantation surgery.
Literatur
1.
Zurück zum Zitat Burckhardt BR (1988) Capsular contracture: Hard breasts, soft data. Clin Plast Surg 15:521 Burckhardt BR (1988) Capsular contracture: Hard breasts, soft data. Clin Plast Surg 15:521
2.
Zurück zum Zitat Collis N, Coleman D, Foo ITH, Sharpe DT (2000) Ten years of a prospective randomised controlled trial of textured versus smooth subglandular silicone gel breast implants. Plast Reconstr Surg 106:786–791PubMedCrossRef Collis N, Coleman D, Foo ITH, Sharpe DT (2000) Ten years of a prospective randomised controlled trial of textured versus smooth subglandular silicone gel breast implants. Plast Reconstr Surg 106:786–791PubMedCrossRef
3.
Zurück zum Zitat Vistnes LM, Ksander GA, Kosek J (1978) Study of encapsulation of silicone rubber implants in animals: A foreign body reaction. Plast Reconstr Surg 62:580–588PubMed Vistnes LM, Ksander GA, Kosek J (1978) Study of encapsulation of silicone rubber implants in animals: A foreign body reaction. Plast Reconstr Surg 62:580–588PubMed
4.
Zurück zum Zitat Coleman DJ, Foo ITH, Sharpe DT (1991) Textured or smooth implants for breast augmentation? A prospective controlled trial. Br J Plast Surg 44:444– 448PubMedCrossRef Coleman DJ, Foo ITH, Sharpe DT (1991) Textured or smooth implants for breast augmentation? A prospective controlled trial. Br J Plast Surg 44:444– 448PubMedCrossRef
5.
Zurück zum Zitat Lossing C, Hanson HA (1981) Peptide growth factors and myofibroblast in capsules around human breast implants. Plast Reconstr Surg 91:1277–1286 Lossing C, Hanson HA (1981) Peptide growth factors and myofibroblast in capsules around human breast implants. Plast Reconstr Surg 91:1277–1286
6.
Zurück zum Zitat Vistnes LM, Ksander GA, Isaacs G, Rozner L (1981) Elevated glycosaminoglycans and chondroitin 4–sulfate and other properties of contracted human prosthesis capsules. Ann Plast Surg 7:195–203PubMedCrossRef Vistnes LM, Ksander GA, Isaacs G, Rozner L (1981) Elevated glycosaminoglycans and chondroitin 4–sulfate and other properties of contracted human prosthesis capsules. Ann Plast Surg 7:195–203PubMedCrossRef
7.
Zurück zum Zitat Kuhn A, Sing S, Smith PD (2000) Periprosthetic breast capsules contain the fibrogenic cytokines TGF-β1 and TGF-β2, suggesting possible new treatment approaches. Ann Plast Surg 44:387–391PubMedCrossRef Kuhn A, Sing S, Smith PD (2000) Periprosthetic breast capsules contain the fibrogenic cytokines TGF-β1 and TGF-β2, suggesting possible new treatment approaches. Ann Plast Surg 44:387–391PubMedCrossRef
8.
Zurück zum Zitat Brohim RM, Foresman PA, Hildebrandt PK (1992) Early tissue reaction to textured breast implant surfaces. Ann Plast Surg 28:354PubMedCrossRef Brohim RM, Foresman PA, Hildebrandt PK (1992) Early tissue reaction to textured breast implant surfaces. Ann Plast Surg 28:354PubMedCrossRef
9.
Zurück zum Zitat Lossing C, Hansson HA (1993) Peptide growth factors and myofibroblasts in capsules around human breast implants. Plast Reconstr Surg 91:1277–1286PubMedCrossRef Lossing C, Hansson HA (1993) Peptide growth factors and myofibroblasts in capsules around human breast implants. Plast Reconstr Surg 91:1277–1286PubMedCrossRef
10.
Zurück zum Zitat Ajmal N, Riordan CL, Cardwell N, Nanney LB, Shack RB (2003) The effectiveness of sodium 2–mercaptoethane sulfonate (mesna) in reducing capsular formation around implants in a rabbit model. Plast Reconstr Surg 112:1455–1461PubMedCrossRef Ajmal N, Riordan CL, Cardwell N, Nanney LB, Shack RB (2003) The effectiveness of sodium 2–mercaptoethane sulfonate (mesna) in reducing capsular formation around implants in a rabbit model. Plast Reconstr Surg 112:1455–1461PubMedCrossRef
11.
Zurück zum Zitat Frangou J, Kanellaki M (2001) The effect of local application of mitomycin C on the development of capsule around silicone implants in the breast: An experimental study in mice. Aesth Plast Surg 25:118–128CrossRef Frangou J, Kanellaki M (2001) The effect of local application of mitomycin C on the development of capsule around silicone implants in the breast: An experimental study in mice. Aesth Plast Surg 25:118–128CrossRef
12.
Zurück zum Zitat Eltze E, Bettendorf O, Rody A, Jackisch C, Herchenroder F, Bocker W, Pfleiderer B (2003) Influence of local complications on capsule formation around model implants in a rat model. J Biomed Mater Res 64A:12–19CrossRef Eltze E, Bettendorf O, Rody A, Jackisch C, Herchenroder F, Bocker W, Pfleiderer B (2003) Influence of local complications on capsule formation around model implants in a rat model. J Biomed Mater Res 64A:12–19CrossRef
13.
Zurück zum Zitat Minami E, Jun Koh I, Ronche JC, Ferreira J, Logullo AF, Waitzberg A, Chifferi V, Fortoul-Rosewick T, Domínguez-Pereira M, Nascimento PH, Saldiva P, Poli de Figueiredo LF (2006) The composition and behavior of capsules around smooth and textured breast implants in pigs. Plast Reconstr Surg 118:874–884PubMedCrossRef Minami E, Jun Koh I, Ronche JC, Ferreira J, Logullo AF, Waitzberg A, Chifferi V, Fortoul-Rosewick T, Domínguez-Pereira M, Nascimento PH, Saldiva P, Poli de Figueiredo LF (2006) The composition and behavior of capsules around smooth and textured breast implants in pigs. Plast Reconstr Surg 118:874–884PubMedCrossRef
14.
Zurück zum Zitat Eltze E, Schafer U, Bettendorf O, Rody A, Herchenroder F, Chiwritsch T, Jackisch C, Pfleiderer B (2006) Radiation-induced capsule tissue reactions around textured breast implants in a rat model. Breast 15:331–338PubMedCrossRef Eltze E, Schafer U, Bettendorf O, Rody A, Herchenroder F, Chiwritsch T, Jackisch C, Pfleiderer B (2006) Radiation-induced capsule tissue reactions around textured breast implants in a rat model. Breast 15:331–338PubMedCrossRef
15.
Zurück zum Zitat Adams WP, Haydon MS, Raniere J, Trott S, Marques M, Feliciano M, Robinson JB, Tang L, Brown SA (2006) A rabbit model for capsular contracture: development and clinical implications. Plast Reconstr Surg 117:1214–1219PubMedCrossRef Adams WP, Haydon MS, Raniere J, Trott S, Marques M, Feliciano M, Robinson JB, Tang L, Brown SA (2006) A rabbit model for capsular contracture: development and clinical implications. Plast Reconstr Surg 117:1214–1219PubMedCrossRef
16.
Zurück zum Zitat Cardenas-Camarena L, Paillet JC, Briseño R: Electrostimulation (2005) Uses and applications for periprosthetic capsular contracture: Experimental model. Aesth Plast Surg 29:410–414CrossRef Cardenas-Camarena L, Paillet JC, Briseño R: Electrostimulation (2005) Uses and applications for periprosthetic capsular contracture: Experimental model. Aesth Plast Surg 29:410–414CrossRef
17.
Zurück zum Zitat Peterson HD, Burt GB Jr (1974) The role of steroid in prevention of circumferential capsular scarring in augmentation mammaplasty. Plast Reconstr Surg 54:28PubMedCrossRef Peterson HD, Burt GB Jr (1974) The role of steroid in prevention of circumferential capsular scarring in augmentation mammaplasty. Plast Reconstr Surg 54:28PubMedCrossRef
18.
Zurück zum Zitat Perrin ER (1976) The use of soluble steroid within inflatable breast prostheses. Plast Reconstr Surg 57:163PubMedCrossRef Perrin ER (1976) The use of soluble steroid within inflatable breast prostheses. Plast Reconstr Surg 57:163PubMedCrossRef
19.
Zurück zum Zitat Vinnik CA (1976) Spherical contracture of fibrous capsules around breast implants: Prevention and treatment. Plast Reconstr Surg 58:555PubMedCrossRef Vinnik CA (1976) Spherical contracture of fibrous capsules around breast implants: Prevention and treatment. Plast Reconstr Surg 58:555PubMedCrossRef
20.
Zurück zum Zitat Ellemberg AH (1977) Marked thinning of the breast skin flaps after the insertion of implants containing triamcinolone. Plast Reconstr Surg 60:755 Ellemberg AH (1977) Marked thinning of the breast skin flaps after the insertion of implants containing triamcinolone. Plast Reconstr Surg 60:755
21.
Zurück zum Zitat Carrico TJ, Cohen IK (1979) Capsular contracture and steroid-related complication after augmentation mammaplasty: A preliminary study. Plast Reconstr Surg 64:377PubMedCrossRef Carrico TJ, Cohen IK (1979) Capsular contracture and steroid-related complication after augmentation mammaplasty: A preliminary study. Plast Reconstr Surg 64:377PubMedCrossRef
22.
Zurück zum Zitat Baker JL Jr (1981) The effectiveness of alpha-tocopherol (vitamin E) in reducing the incidence of spherical contracture around breast implants. Plast Reconstr Surg 68:696PubMed Baker JL Jr (1981) The effectiveness of alpha-tocopherol (vitamin E) in reducing the incidence of spherical contracture around breast implants. Plast Reconstr Surg 68:696PubMed
23.
Zurück zum Zitat Cucin RL, Guthrie RH, Graham M (1982) Rate of diffusion of Solu-Medrol across the silastic membranes of breast prostheses: An in vivo study. Ann Plast Surg 9:228PubMedCrossRef Cucin RL, Guthrie RH, Graham M (1982) Rate of diffusion of Solu-Medrol across the silastic membranes of breast prostheses: An in vivo study. Ann Plast Surg 9:228PubMedCrossRef
24.
Zurück zum Zitat Cafee HH (1984) The effects of intraprosthetic methylprednisolone on implants capsules and surrounding soft tissue. Ann Plast Surg 12:348CrossRef Cafee HH (1984) The effects of intraprosthetic methylprednisolone on implants capsules and surrounding soft tissue. Ann Plast Surg 12:348CrossRef
25.
Zurück zum Zitat Gayou R, Rudolph R (1979) Capsular contraction around silicone mammary prostheses. Ann Plast Surg 2:62PubMedCrossRef Gayou R, Rudolph R (1979) Capsular contraction around silicone mammary prostheses. Ann Plast Surg 2:62PubMedCrossRef
26.
Zurück zum Zitat Iyer SN, Wild JS, Schiedt MJ, Hyde DM, Margolin SB, Giri SN (1995) Dietary intake of pirfenidone ameliorates bleomycin-induced lung fibrosis in hamsters. J Lab Clin Med 125:779–785PubMed Iyer SN, Wild JS, Schiedt MJ, Hyde DM, Margolin SB, Giri SN (1995) Dietary intake of pirfenidone ameliorates bleomycin-induced lung fibrosis in hamsters. J Lab Clin Med 125:779–785PubMed
27.
Zurück zum Zitat Al-Took S, Murray C, Tulandi T (1998) Effects of pirfenidone and dermoid cyst fluid on adhesion formation. Fertil Steril 69:341–342PubMedCrossRef Al-Took S, Murray C, Tulandi T (1998) Effects of pirfenidone and dermoid cyst fluid on adhesion formation. Fertil Steril 69:341–342PubMedCrossRef
28.
Zurück zum Zitat García L, Hernandez I, Sandoval A, Salazar, Garcia J, Vera J, Grijalva G, Muriel P, Margolin S, Armendariz-Borunda J (2002) Pirfenidone affectively reverses experimental liver fibrosis. J Hepatol 32:797–805 García L, Hernandez I, Sandoval A, Salazar, Garcia J, Vera J, Grijalva G, Muriel P, Margolin S, Armendariz-Borunda J (2002) Pirfenidone affectively reverses experimental liver fibrosis. J Hepatol 32:797–805
29.
Zurück zum Zitat Armendáriz-Borunda J, Islas-Carbajal MC, Meza-García E, Rincón AR, Sandoval AS, Salazar A, Berumen J, Alvarez A, Alvarez A, Covarrubias A, Aréchiga G, García L (2006) A pilot study in cirrhotic patients using a new antiinflammatory and antifibrotic agent, pirfenidone. Gut 55:1663–1665PubMedCrossRef Armendáriz-Borunda J, Islas-Carbajal MC, Meza-García E, Rincón AR, Sandoval AS, Salazar A, Berumen J, Alvarez A, Alvarez A, Covarrubias A, Aréchiga G, García L (2006) A pilot study in cirrhotic patients using a new antiinflammatory and antifibrotic agent, pirfenidone. Gut 55:1663–1665PubMedCrossRef
30.
Zurück zum Zitat Lee B-S, Margolin SB, Nowak AR (1998) Pirfenidone: A novel pharmacological agent that inhibits leiomyoma cell proliferation and collagen production. J Clin Endocrinol Metab 83:219–223PubMedCrossRef Lee B-S, Margolin SB, Nowak AR (1998) Pirfenidone: A novel pharmacological agent that inhibits leiomyoma cell proliferation and collagen production. J Clin Endocrinol Metab 83:219–223PubMedCrossRef
31.
Zurück zum Zitat Shimizu T, Kuroda T, Hata S, Fukagawa M, Margolin SB, Kurokawa K (1998) Pirfenidone improves renal function and fibrosis in the postobstructed kidney. Kidney Int 54:99–109PubMedCrossRef Shimizu T, Kuroda T, Hata S, Fukagawa M, Margolin SB, Kurokawa K (1998) Pirfenidone improves renal function and fibrosis in the postobstructed kidney. Kidney Int 54:99–109PubMedCrossRef
32.
Zurück zum Zitat Shetlar MR, Shetlar DJ, Bloom RF, Shetlar CL, Margolin SB (1998) Involution of keloid implants in athymic mice treated with pirfenidone or with triamcinolone. J Lab Clin Med 132:491–496PubMedCrossRef Shetlar MR, Shetlar DJ, Bloom RF, Shetlar CL, Margolin SB (1998) Involution of keloid implants in athymic mice treated with pirfenidone or with triamcinolone. J Lab Clin Med 132:491–496PubMedCrossRef
33.
Zurück zum Zitat Callaway JK, Beart PM, Jarott B (1998) A reliable procedure for comparison of antioxidants in rat brain homogenates. J Pharmacol Toxicol Methods 39:155–162PubMedCrossRef Callaway JK, Beart PM, Jarott B (1998) A reliable procedure for comparison of antioxidants in rat brain homogenates. J Pharmacol Toxicol Methods 39:155–162PubMedCrossRef
34.
Zurück zum Zitat Chomczynski P, Sacchi N (1987) Single-step method of RNA isolation by acid guanidinium thiocyanate-phenol chloroform extraction. Anal Biochem 162:156–159PubMedCrossRef Chomczynski P, Sacchi N (1987) Single-step method of RNA isolation by acid guanidinium thiocyanate-phenol chloroform extraction. Anal Biochem 162:156–159PubMedCrossRef
36.
Zurück zum Zitat Fagrell D, Berggren A, Tarpila E (2001) Capsular contracture around saline-filled fine textured and smooth mammary implants: A prospective 7.5-year follow-up. Plast Reconstr Surg 108:2108PubMedCrossRef Fagrell D, Berggren A, Tarpila E (2001) Capsular contracture around saline-filled fine textured and smooth mammary implants: A prospective 7.5-year follow-up. Plast Reconstr Surg 108:2108PubMedCrossRef
37.
Zurück zum Zitat Lee B-S, Margolin SB, Nowak AR (1998) Pirfenidone: A novel pharmacological agent that inhibits leiomyoma cell proliferation and collagen production. J Clin Endocrinol Metab 83:219–223PubMedCrossRef Lee B-S, Margolin SB, Nowak AR (1998) Pirfenidone: A novel pharmacological agent that inhibits leiomyoma cell proliferation and collagen production. J Clin Endocrinol Metab 83:219–223PubMedCrossRef
38.
Zurück zum Zitat Musters S, Coughlan K, McFadden T, Mapple R, Mulvey T, Plaunt K (2004) Exogenous TGF-β1 promotes stromal development in the heifer mammary gland. J Dairy Sci 87:896–904PubMedCrossRef Musters S, Coughlan K, McFadden T, Mapple R, Mulvey T, Plaunt K (2004) Exogenous TGF-β1 promotes stromal development in the heifer mammary gland. J Dairy Sci 87:896–904PubMedCrossRef
Metadaten
Titel
Pirfenidone Prevents Capsular Contracture After Mammary Implantation
verfasst von
Matias Gancedo
Luis Ruiz-Corro
Adriana Salazar-Montes
Ana Rosa Rincón
Juan Armendáriz-Borunda
Publikationsdatum
01.01.2008
Verlag
Springer-Verlag
Erschienen in
Aesthetic Plastic Surgery / Ausgabe 1/2008
Print ISSN: 0364-216X
Elektronische ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-007-9051-4

Weitere Artikel der Ausgabe 1/2008

Aesthetic Plastic Surgery 1/2008 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.