title: In vivo characterisation of the inflammatory reaction following mesh implantation in transgenic mice models.
abstract: BACKGROUND
  Hernia repair with prosthetic meshes represents one of the most common surgical procedures in the field of surgery. This intervention is always associated with an ensuing inflammatory response, angiogenesis and fibrotic encapsulation forming a foreign body granuloma (FBG) around the mesh fibres. Several studies have described this inflammatory reaction by characterising inflammatory cell infiltrate around the FBG after mesh explantation. However, very little is known about the real-time progression of such an inflammatory response. The aim of this study was to investigate the feasibility of monitoring the ongoing inflammatory response to mesh implantation using bioluminescence in vivo.
  
  
  METHODS
  Three luciferase transgenic mice strains (FVB/N-Tg(Vegfr2-luc)-Xen, BALB/C-Tg(NFκB-RE-luc)-Xen and Tg(INS/EpRE-Luc)T20Rbl) were used. Mice were anaesthetized with 2 % isoflurane, and two incisions were made on the left and right sides of the abdomen of the mice. A 1-cm(2) propylene mesh was implanted subcutaneously in the right incision wound of each mouse, and the left wound served as control. Two hundred microliters of D-luciferin was injected into the mice, and bioluminescence measurements were done prior to the surgical intervention and subsequently every 3 days. After mesh explantation, histological analysis was done. Statistical analysis was done using prism GraphPad software.
  
  
  RESULTS
  Bioluminescence results revealed different time points of maximum signal for the different mice strains. VEGFR2 gene expression peaked on day 6, NFkB on day 12 and ARE on day 3 post mesh implantation. We also observed much higher bioluminescent signal around the FBG surrounding the mesh as compared to the control wound, with p < 0.05 for all the different mice strains.
  
  
  CONCLUSIONS
  Our results prove the possibility of monitoring the inflammatory reaction after mesh implantation in vivo using bioluminescence signal release. This provides a novel method of accessing and accurately describing the ongoing inflammatory response over a given period of time.
authors.affiliation: Department of General, Visceral- and Transplantation Surgery, University Hospital of the RWTH, Pauwelsstr. 30, 52074, Aachen, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Fet
authors.forename: P H
authors.initials: PH
authors.lastname: Alizai
authors.forename: A
authors.initials: A
authors.lastname: Fragoulis
authors.forename: C
authors.initials: C
authors.lastname: Wruck
authors.forename: T
authors.initials: T
authors.lastname: Pufe
authors.forename: R H
authors.initials: RH
authors.lastname: Tolba
authors.forename: U P
authors.initials: UP
authors.lastname: Neumann
authors.forename: U
authors.initials: U
authors.lastname: Klinge
mesh_terms: D000818:Animals; D052160:Benzothiazoles; D001707:Biopsy, Needle; D004195:Disease Models, Animal; D005549:Foreign-Body Reaction / Q000473:pathology*; D007150:Immunohistochemistry; D007249:Inflammation / Q000473:pathology; D018836:Inflammation Mediators / Q000097:blood; D051379:Mice; D008807:Mice, Inbred BALB C; D008822:Mice, Transgenic; D019919:Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D011897:Random Allocation; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D013526:Surgical Mesh / Q000009:adverse effects*; D014945:Wound Healing / Q000502:physiology
chemical_list: D052160:Benzothiazoles; C532924:D-luciferin; D018836:Inflammation Mediators
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