title: The effect of botulinum neurotoxin type A on capsule formation around silicone implants: the in vivo and in vitro study.
abstract: This study confirms that botulinum neurotoxin type A (BoNT-A) decreases capsular contracture and elucidates a possible mechanism. Silicone blocks were implanted subcutaneously in 20 mice. The experimental groups received BoNT-A (1, 2·5 or 5 U) instilled into the subcutaneous pocket. After 30 days, periprosthetic capsules were harvested and evaluated. The effect of BoNT-A on the differentiation of human dermal fibroblasts to myofibroblasts in culture was examined by Western blot analysis. Changes in transforming growth factor-beta1 (TGF-β1) expression in cultured fibroblasts were determined by enzyme-linked immunosorbent assay (ELISA). In in vivo study, the thickness of capsules (P < 0·05) and the number of alpha-smooth muscle actin (α-SMA)(+) cells in capsules (P < 0·05) were significantly decreased in the experimental groups. TGF-β1 was significantly underexpressed in the experimental groups (P < 0·05). In in vitro study, BoNT-A did not significantly affect fibroblast viability. Western blot analysis showed that α-SMA protein levels were significantly decreased in the experimental groups (P < 0·05). Based on ELISA, the amount of TGF-β1 was significantly decreased in the experimental groups (P < 0·05), especially cells treated with a high dose of BoNT-A (P < 0·001). This study confirms that BoNT-A prevents capsular formation around silicone implants, possibly by blocking TGF-β1 signalling and interrupting the differentiation of fibroblasts to myofibroblasts.
authors.affiliation: Department of Physiology, College of Medicine, Chungnam National University, Daejeon, Korea.|Research Institute for Medical Sciences, College of Medicine, Chungnam National University, Daejeon, Korea.
authors.forename: Sang D
authors.initials: SD
authors.lastname: Lee
authors.affiliation: Department of Dermatology, College of Medicine, Chungnam National University, Daejeon, Korea.
authors.forename: Min-Hee
authors.initials: MH
authors.lastname: Yi
authors.affiliation: Department of Dermatology, College of Medicine, Chungnam National University, Daejeon, Korea.
authors.forename: Dong W
authors.initials: DW
authors.lastname: Kim
authors.affiliation: Department of Plastic Surgery, Sanggye Piak Hospital, School of Medicine, Inje University, Seoul, Korea.
authors.forename: Young
authors.initials: Y
authors.lastname: Lee
authors.affiliation: Department of Plastic Surgery, College of Medicine, Chungnam National University, Daejeon, Korea.
authors.forename: YoungWoong
authors.initials: Y
authors.lastname: Choi
authors.affiliation: Research Institute for Medical Sciences, College of Medicine, Chungnam National University, Daejeon, Korea.|Department of Anatomy, College of Medicine, Chungnam National University, Daejeon, Korea.|BiO & J Inc., Daejeon, Korea.
authors.forename: Sang-Ha
authors.initials: SH
authors.lastname: Oh
mesh_terms: D000199:Actins / Q000378:metabolism; D000818:Animals; D015153:Blotting, Western; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D018427:Breast Implants; D002454:Cell Differentiation / Q000187:drug effects; D002470:Cell Survival / Q000187:drug effects; D003286:Contracture / Q000517:prevention & control*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005347:Fibroblasts / Q000187:drug effects / Q000378:metabolism; D051379:Mice; D023421:Models, Animal; D058628:Myofibroblasts / Q000187:drug effects; D009498:Neurotoxins / Q000008:administration & dosage*; D020034:Silicone Gels; D053773:Transforming Growth Factor beta1 / Q000378:metabolism
chemical_list: D000199:Actins; D009498:Neurotoxins; D020034:Silicone Gels; D053773:Transforming Growth Factor beta1; C544013:alpha-smooth muscle actin, mouse; D019274:Botulinum Toxins, Type A
keywords: Botulinum neurotoxin type A; Capsule; Myofibroblast; TGF-β1