Acute inflammation triggered by two lightweight hernia meshes: a comparative in vitro and retrospective cohort study.

IF 2.4 2区医学 Q1 SURGERY

Hernia Pub Date : 2025-06-17 DOI:10.1007/s10029-025-03391-y

Martin Reichert, Bernadet Massambo, Anca-Laura Amati, Veronika Grau, Katrin Richter, Andreas Hecker

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引用次数: 0

Abstract

Purpose: Retro-muscular mesh augmentation is standard for repairing abdominal incisional or larger primary hernia. A wide variety of meshes with diverse properties are available. The knowledge on the immune-modulating effects of meshes is, however, insufficient. This study investigates the impact of two widely used lightweight meshes, ULTRAPRO^® and ProGrip™, on macrophage activation (in vitro), systemic inflammation (in vivo), patient perioperative and long-term outcomes.

Methods: Human THP-1 cell-derived macrophages were cultured in absence and presence of ULTRAPRO^® or ProGrip™ meshes. The release of pro-inflammatory cytokines, interleukin (IL)-1β and IL-6, was measured following inflammasome activation. In a retrospective study, systemic inflammation and postoperative outcomes after retro-muscular hernia repair using ULTRAPRO^® (321 patients) or ProGrip™ (161 patients) meshes were analyzed.

Results: In the presence of ULTRAPRO^®, IL-1β and IL-6 release by macrophages was increased, whereas ProGrip™ tended to reduce cytokine levels (p ≤ 0.05; n = 7). Baseline characteristics were comparable between both groups; systemic C-reactive protein levels were likewise higher in patients receiving ULTRAPRO^® compared to ProGrip™ (mean difference: 26.9 ± 7.5 mg/dl; p < 0.0001). No relevant differences were observed in perioperative morbidity or short-term outcomes, including complications and hospitalization after hernia repair, but hernia recurrence rates tended to be higher within three-year follow-up after ProGrip™ implantation compared to ULTRAPRO^® (p = 0.0630).

Conclusion: Meshes exhibit distinct immune-modulating effects on macrophages, leading to differential activation that may influence foreign-body reaction and systemic inflammation. These immune responses potentially impact clinical outcomes and recurrence after hernia repair. This study underscores the need for comparative prospective, randomized-controlled trials to further evaluate the clinical relevance of mesh-specific immunological effects.

Abstract Image

查看原文本刊更多论文

两种轻型疝补片引发的急性炎症：一项体外比较和回顾性队列研究。

目的：肌后补片术是修复腹部切口或较大原发性疝的标准术式。各种各样的网格具有不同的属性是可用的。然而，关于网状物免疫调节作用的知识是不够的。本研究探讨了两种广泛使用的轻质补片ULTRAPRO®和ProGrip™对巨噬细胞激活（体外）、全身炎症（体内）、患者围手术期和长期预后的影响。方法：人THP-1细胞来源的巨噬细胞在不含ULTRAPRO®或ProGrip™网的情况下培养。在炎性小体激活后，测量促炎细胞因子，白细胞介素(IL)-1β和IL-6的释放。在一项回顾性研究中，分析了使用ULTRAPRO®（321例患者）或ProGrip™（161例患者）补片修复后肌肉疝的全身炎症和术后结果。结果：在ULTRAPRO®存在下，巨噬细胞IL-1β和IL-6释放增加，而ProGrip™倾向于降低细胞因子水平(p≤0.05；n = 7)。两组的基线特征具有可比性；与ProGrip™相比，接受ULTRAPRO®治疗的患者全身c反应蛋白水平同样更高(平均差异：26.9±7.5 mg/dl；P （P = 0.0630）。结论：网状物对巨噬细胞具有明显的免疫调节作用，导致差异激活，可能影响异物反应和全身炎症。这些免疫反应可能影响临床结果和疝修补后的复发。这项研究强调需要比较前瞻性、随机对照试验来进一步评估网状特异性免疫效应的临床相关性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hernia SURGERY-

CiteScore

4.90

自引率

26.10%

发文量

171

审稿时长

4-8 weeks

期刊介绍： Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery. Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.