T regulatory cells and TGF-β1: Predictors of the host response in mesh complications.
T regulatory cells and TGF-β1: Predictors of the host response in mesh complications.
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T调节细胞和TGF-β1：网格并发症中宿主反应的预测指标。
DOI：
10.1016/j.actbio.2020.07.051
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发表时间：
2020-10-01
影响因子：
9.7
通讯作者：
Moalli PA
中科院分区：
文献类型：
--
作者：
Artsen AM;Liang R;Meyn L;Rytel M;Palcsey S;Abramowitch SD;Moalli PA
聚丙烯网经常用于泌尿妇科手术；然而，约 10% 的病例会出现疼痛和网状物暴露在阴道内的情况。 50% 的病例中，无论是否暴露，网片引起的疼痛在移除后仍持续存在。慢性疼痛史预示着网片去除反应不佳，但只有一小部分人有这种诊断。我们假设网片引起的疼痛与纤维化相关，并且无法通过增强的炎症和纤维化宿主反应来改善。接受网片去除的妇女可以参与网片生物储存库。入组时和取出后 6 个月完成标准化问卷，包括视觉模拟量表 (VAS) 骨盆疼痛评分。反应者被认为是 VAS 改善≥13 mm 的人。随机选择 30 个网状组织外植体进行分析。样品被标记为 CD8、CD4 (Th) 和 FoxP3 (Treg)。使用定制的半定量测定法测量纤维周围胶原沉积（纤维化）。通过免疫测定法测定组织中 TGF-b1、bFGF、MCP-1、PDGF-BB 和 IGFBP-1 的浓度，并通过途径分析与阴道对照活检进行比较。 VAS 疼痛评分与组织学纤维化程度相关。应答者拥有更多的 Treg（每 mm2 7.8 个 vs 0.3 个，p = 0.036），每增加一个 Treg/mm2，患者成为应答者的可能性就会增加 1.6 倍（p = 0.05）。在无反应者中促纤维化 TGF-β1 增加了一倍 (p = 0.032)。在通路分析中，bFGF 减少和 PDGF-BB 增加为 TGF-β1 上调提供了可能的机制。总之，纤维化是疼痛并发症的一种可能机制，适应性免疫反应可能有助于减轻/预防受影响患者的并发症和康复。
Polypropylene mesh is frequently used in urogynecology procedures; however, pain and mesh exposure into the vagina occur in ~10% of cases. Mesh-induced pain, which occurs with or without exposure, persists after removal in 50% of cases. Chronic pain history predicts poor response to mesh removal but only a fraction have this diagnosis. We hypothesize that mesh induced pain is correlated with fibrosis and failure to improve with a heightened inflammatory and fibrotic host response. Women undergoing mesh removal were offered participation in a mesh biorepository. Standardized questionnaires including visual analog scale (VAS) pelvic pain scores were completed at enrollment and 6 months after removal. Responders were considered those with ≥13 mm VAS improvement. 30 mesh-tissue explants were randomly selected for analysis. Samples were labeled for CD8, CD4 (Th) and FoxP3 (Tregs). Peri-fiber collagen deposition (fibrosis) was measured using a customized semi-quantitative assay. Concentrations of TGF-b1, bFGF, MCP-1, PDGF-BB, and IGFBP-1 in tissue were determined by immunoassay and compared to vaginal control biopsies with pathway analysis. VAS pain scores were correlated with degree of histologic fibrosis. Responders had more Tregs (7.8 vs 0.3 per mm2, p = 0.036) and patients were 1.6 times as likely to be a responder for every additional Treg/mm2 (p = 0.05). Pro-fibrotic TGF-β1 was doubled in nonresponders (p = 0.032). On pathway analysis, decreased bFGF and increased PDGF-BB provide a possible mechanism for upregulation of TGF-β1. In conclusion, fibrosis is a plausible mechanism of pain complications and the adaptive immune response likely contributes to mitigation/prevention of complications and recovery in affected patients.
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影响因子：
4.8
作者：
LYSIAK, JJ;HUSSAINI, IM;GONIAS, SL
通讯作者：
GONIAS, SL
影响因子：
2.2
作者：
Klinge, U;Klosterhalfen, B;Schumpelick, V
通讯作者：
Schumpelick, V
影响因子：
3.6
作者：
Adams, WP;Haydon, AS;Brown, SA
通讯作者：
Brown, SA
DOI：
10.1097/spv.0000000000000419
发表时间：
2017-11-01
影响因子：
1.6
作者：
Cardenas-Trowers, Olivia O.;Malekzadeh, Pouran;Hatch, Kenneth D.
通讯作者：
Hatch, Kenneth D.
DOI：
10.1016/j.bbrc.2007.06.121
发表时间：
2007-09-07
影响因子：
3.1
作者：
Meckmongkol, Teerin T.;Harmon, Robert;Van De Water, Livingston
通讯作者：
Van De Water, Livingston