title: Attachment of Primary Vaginal Fibroblasts to Absorbable and Nonabsorbable Implant Materials Coated With Platelet-Rich Plasma: Potential Application in Pelvic Organ Prolapse Surgery.
abstract: OBJECTIVE
  Pelvic organ prolapse (POP) is a common condition in women. The lifetime risk of undergoing surgery to correct POP is 11%, with 30% recurrence rate. Various types of vaginal implants, absorbable and nonabsorbable, that have been introduced in pelvic floor reconstructive surgeries have numerous serious adverse effects. Platelet-rich plasma (PRP) is an autologous product that accelerates tissue healing and regeneration. We hypothesized that autologous PRP will promote human vaginal fibroblast (HVF) attachment to vaginal implants and increase their healing potential.
  
  
  METHODS
  Vaginal tissue biopsies were collected from postmenopausal patients with POP (n = 10) and asymptomatic control subjects (n = 4) during vaginal hysterectomy or repair. Primary cells were isolated and characterized by immunocytochemistry. Cell attachment and proliferation were compared between POP HVFs and control HVFs (n = 4/group). Twelve weeks after the surgery, blood samples were collected from 6 POP patients to obtain autologous PRP. Two meshes, absorbable (Vicryl) and nonabsorbable (Restorelle), were coated in PRP or control media; autologous POP HVFs (n = 6) were seeded on meshes for 2 hours. Cells attached to the meshes were fixed, stained with DAPI (4,6-diamidino-2-phenylindole dihydrochloride), and counted.
  
  
  RESULTS
  Pelvic organ prolapse HVFs were similar to control HVFs in attachment to different matrix substrates and in proliferation rate. Attachment of POP HVFs to both meshes was significantly increased after coating with PRP versus Dulbecco modified Eagle medium (Vicryl: 9875 vs. 1006 cells/cm, Restorelle: 3724 vs. 649 cells/cm; P < 0.001 for both).
  
  
  CONCLUSIONS
  In vitro, primary POP HVFs show better attachment to implant materials when treated with PRP, which may lead to reduced mesh-related complications in vivo, indicating its great potential for urogynecologic surgeries.
authors.affiliation: From the *Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics & Gynecology, and †Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital; and ‡Department of Obstetrics & Gynecology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Medel
authors.forename: May
authors.initials: M
authors.lastname: Alarab
authors.forename: Hala
authors.initials: H
authors.lastname: Kufaishi
authors.forename: Harold
authors.initials: H
authors.lastname: Drutz
authors.forename: Oksana
authors.initials: O
authors.lastname: Shynlova
mesh_terms: D020341:Absorbable Implants; D000368:Aged; D002448:Cell Adhesion; D020099:Coated Materials, Biocompatible; D005260:Female; D005347:Fibroblasts / Q000166:cytology*; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D053657:Platelet-Rich Plasma; D013526:Surgical Mesh; D014182:Transplantation, Autologous; D014621:Vagina / Q000166:cytology*; D014746:Vimentin / Q000378:metabolism
chemical_list: D020099:Coated Materials, Biocompatible; D014746:Vimentin