AUTHOR=Schoberleitner Ines , Faserl Klaus , Tripp Christoph H. , Pechriggl Elisabeth Judith , Sigl Stephan , Brunner Andrea , Zelger Bettina , Hermann-Kleiter Natascha , Baier Leoni , Steinkellner Theresia , Sarg Bettina , Egle Daniel , Brunner Christine , Wolfram Dolores TITLE=Silicone implant surface microtopography modulates inflammation and tissue repair in capsular fibrosis JOURNAL=Frontiers in Immunology VOLUME=15 YEAR=2024 URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2024.1342895 DOI=10.3389/fimmu.2024.1342895 ISSN=1664-3224 ABSTRACT=

Excessive fibrous capsule formation around silicone mammary implants (SMI) involves immune reactions to silicone. Capsular fibrosis, a common SMI complication linked to host responses, worsens with specific implant topographies. Our study with 10 patients investigated intra- and inter-individually, reduced surface roughness effects on disease progression, wound responses, chronic inflammation, and capsular composition. The results illuminate the significant impact of surface roughness on acute inflammatory responses, fibrinogen accumulation, and the subsequent fibrotic cascade. The reduction of surface roughness to an average roughness of 4 μm emerges as a promising approach for mitigating detrimental immune reactions, promoting healthy wound healing, and curbing excessive fibrosis. The identified proteins adhering to rougher surfaces shed light on potential mediators of pro-inflammatory and pro-fibrotic processes, further emphasizing the need for meticulous consideration of surface design. The composition of the implant capsule and the discovery of intracapsular HSP60 expression highlight the intricate web of stress responses and immune activation that can impact long-term tissue outcomes.