title: Biocompatibility of a sonicated silk gel for cervical injection during pregnancy: in vivo and in vitro study.
abstract: OBJECTIVE
  To evaluate the biocompatibility of silk gel for cervical injection.
  
  
  METHODS
  Silk gel was injected into the cervix of pregnant rats on day 13 (n = 11) and harvested at day 17. Histology of silk gel was compared with suture controls. Also, human cervical fibroblasts were cultured on silk gel and tissue culture plastic (TCP) in vitro. Cell viability, proliferation, metabolic activity, gene expression (COL1A1, COL3A1, and COX2), and release of proinflammatory mediators (interleukin [IL] 6 and IL-8) were evaluated.
  
  
  RESULTS
  In vivo, a mild foreign body response was seen surrounding the silk gel and suture controls. In vitro, cervical fibroblasts were viable, metabolically active, and proliferating at 72 hours. Release of IL-6 and IL-8 was similar on silk gel and TCP. Collagen and COX2 gene expression was similar or slightly decreased compared with TCP.
  
  
  CONCLUSIONS
  Silk gel was well tolerated in vivo and in vitro, which supports continuing efforts to develop silk gels as an alternative to cervical cerclage.
authors: Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Tufts Medical Center, Boston, MA, USA.
authors: Agatha S
authors: AS
authors: Critchfield
authors: Department of Biomedical Engineering, Tufts University, Medford, MA, USA.
authors: Reid
authors: R
authors: Mccabe
authors: Department of Biomedical Engineering, Tufts University, Medford, MA, USA.
authors: Nikolai
authors: N
authors: Klebanov
authors: Division of Laboratory Animal Medicine, Tufts University, Boston, MA, USA.
authors: Lauren
authors: L
authors: Richey
authors: Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, USA.
authors: Simona
authors: S
authors: Socrate
authors: Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Tufts Medical Center, Boston, MA, USA.
authors: Errol R
authors: ER
authors: Norwitz
authors: Department of Biomedical Engineering, Tufts University, Medford, MA, USA.
authors: David L
authors: DL
authors: Kaplan
authors: Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Tufts Medical Center, Boston, MA, USA mhouse@tuftsmedicalcenter.org.
authors: Michael
authors: M
authors: House
mesh_terms: D000282:Administration, Intravaginal; D000818:Animals; D001672:Biocompatible Materials / Q000008:administration & dosage* / Q000737:chemistry; D002470:Cell Survival / Q000187:drug effects / Q000502:physiology; D002478:Cells, Cultured; D023802:Cerclage, Cervical / Q000009:adverse effects / Q000379:methods; D002584:Cervix Uteri / Q000166:cytology / Q000187:drug effects* / Q000502:physiology; D005260:Female; D006801:Humans; D011247:Pregnancy; D051381:Rats; D047011:Silk / Q000008:administration & dosage* / Q000737:chemistry; D013010:Sonication / Q000379:methods
chemical_list: D001672:Biocompatible Materials; D047011:Silk
keywords: cerclage; cervix; injectable biomaterial; preterm birth; silk