T regulatory cells: a key predictor of the host response in mesh - PowerPoint PPT Presentation

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T regulatory cells: a key predictor of the host response in mesh complications Amanda Artsen, Rui Liang, Leslie Meyn, Steve Abramowitch, Pamela Moalli University of Pittsburgh Medical Center, Magee-Womens Research Institute Disclosures

T regulatory cells: a key predictor of the host response in mesh complications Amanda Artsen, Rui Liang, Leslie Meyn, Steve Abramowitch, Pamela Moalli University of Pittsburgh Medical Center, Magee-Womens Research Institute
Disclosures Funding: NIH HD083383 (Moalli) Tobacco Grant Settlement, State of PA I have no other relevant financial relationships to disclose
350,000 urogynecologic mesh surgeries annually foreign body response mesh implantation mesh fiber T reg M1 healing M2 ? MMPs fibrosis M1 exposure pain M2 tissue degradation encapsulation T reg Jonsson et al 2012, 2013 tissue integration Brown et al 2015 Nolfi et al 2013
350,000 urogynecologic mesh surgeries annually PDGF-BB IGFPB-1 ? ? Fibroblasts AIM HYPOTHESIS fibrosis pain M2 MCP-1 encapsulation ? T reg tissue integration Jonsson et al 2012, 2013 Brown et al 2015 Nolfi et al 2013
Study design Patients undergoing mesh excision for pain or exposure Optional biopsy distant from mesh: autologous control No biopsy: biopsy from women undergoing prolapse/SUI surgery matched by age, obesity class and surgical indication = matched control Luminex kit to determine concentrations of MCP-1, PDGF-BB and IGFBP-1 Paired and unpaired t tests
Results Exposure (n=8) Pain (n=9) 5 autologous control biopsies 10 matched control biopsies § Age 51.9±12.0y § BMI 28.9±1.0 kg/m 2 § Median Parity 3 (IQR 2-4) § All factors were similar between pain and exposure
Results Mesh ( n =15) Control ( n =15) P value Factor (pg/mL) PDGF-BB 0.55±0.29 0.17±0.18 0.001 IGFBP-1 36.11±51.80 39.53±70.64 0.70 MCP-1 2.18±1.15 2.59±5.15 0.76 Elevated PDGF-BB in mesh tissue complexes compared to controls
Conclusions § Elevated PDGF in mesh-tissue complexes removed for pain or exposure supports a role of fibroblasts § Similar results in pain and exposure groups suggest same mechanistic pathway of dysregulated wound healing § Future studies: activated fibroblasts, therapeutic role of T cells
Acknowledgements Funding: NIH HD083383 (Moalli) Tobacco Grant Settlement, State of PA

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