title: Simvastatin Reduces Capsular Fibrosis around Silicone Implants.
abstract: Capsular fibrosis and contracture occurs in most breast reconstruction patients who undergo radiotherapy, and there is no definitive solution for its prevention. Simvastatin was effective at reducing fibrosis in various models. Peri-implant capsular formation is the result of tissue fibrosis development in irradiated breasts. The purpose of this study was to examine the effect of simvastatin on peri-implant fibrosis in rats. Eighteen male Sprague-Dawley rats were allocated to an experimental group (9 rats, 18 implants) or a control group (9 rats, 18 implants). Two hemispherical silicone implants, 10 mm in diameter, were inserted in subpanniculus pockets in each rat. The next day, 10-Gy of radiation from a clinical accelerator was targeted at the implants. Simvastatin (15 mg/kg/day) was administered by oral gavage in the experimental group, while animals in the control group received water. At 12 weeks post-implantation, peri-implant capsules were harvested and examined histologically and by real-time polymerase chain reaction. The average capsular thickness was 371.2 μm in the simvastatin group and 491.2 μm in the control group. The fibrosis ratio was significantly different, with 32.33% in the simvastatin group and 58.44% in the control group (P < 0.001). Connective tissue growth factor (CTGF) and transforming growth factor (TGF)-β1 gene expression decreased significantly in the simvastatin group compared to the control group (P < 0.001). This study shows that simvastatin reduces radiation-induced capsular fibrosis around silicone implants in rats. This finding offers an alternative therapeutic strategy for reducing capsular fibrosis and contracture after implant-based breast reconstruction.
authors.affiliation: Department of Plastic and Reconstructive Surgery, College of Medicine, Yeungnam University, Daegu, Korea .
authors.forename: Kyu Jin
authors.identifier: http://orcid.org/0000-0001-6335-1818
authors.initials: KJ
authors.lastname: Chung
authors.affiliation: RED Plastic Surgery, Changwon, Korea .
authors.forename: Ki Rin
authors.identifier: http://orcid.org/0000-0001-5582-5083
authors.initials: KR
authors.lastname: Park
authors.affiliation: Department of Plastic and Reconstructive Surgery, College of Medicine, Yeungnam University, Daegu, Korea .
authors.forename: Jun Ho
authors.identifier: http://orcid.org/0000-0002-0062-6420
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Plastic and Reconstructive Surgery, College of Medicine, Yeungnam University, Daegu, Korea .
authors.forename: Tae Gon
authors.identifier: http://orcid.org/0000-0002-6738-4630
authors.initials: TG
authors.lastname: Kim
authors.affiliation: Department of Plastic and Reconstructive Surgery, College of Medicine, Yeungnam University, Daegu, Korea .
authors.forename: Yong-Ha
authors.identifier: http://orcid.org/0000-0002-1804-9086
authors.initials: YH
authors.lastname: Kim
mesh_terms: D000284:Administration, Oral; D000818:Animals; D001940:Breast / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology / Q000528:radiation effects; D018427:Breast Implants; D055513:Connective Tissue Growth Factor / Q000235:genetics / Q000378:metabolism; D005355:Fibrosis; D005720:Gamma Rays; D008297:Male; D051381:Rats; D017207:Rats, Sprague-Dawley; D060888:Real-Time Polymerase Chain Reaction; D020034:Silicone Gels / Q000737:chemistry*; D019821:Simvastatin / Q000494:pharmacology*; D053773:Transforming Growth Factor beta1 / Q000378:metabolism
chemical_list: D020034:Silicone Gels; D053773:Transforming Growth Factor beta1; D055513:Connective Tissue Growth Factor; D019821:Simvastatin
keywords: Fibrosis; Implant Capsular Contracture; Simvastatin