Laparoscopy for the Treatment of Congenital Hernia: Use of Surgical Meshes and Mesenchymal Stem Cells in a Clinically Relevant Animal Model
More than a century has passed since the first surgical mesh for hernia repair was developed, and, to date, this is still the most widely used method despite the great number of complications it poses. The purpose of this study was to combine stem cell therapy and laparoscopy for the treatment of co...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-09-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fphar.2020.01332/full |
| _version_ | 1818047307410571264 |
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| author | Federica Marinaro Javier G. Casado Javier G. Casado Rebeca Blázquez Rebeca Blázquez Mauricio Veloso Brun Ricardo Marcos Marta Santos Francisco Javier Duque Esther López Verónica Álvarez Alejandra Usón Francisco Miguel Sánchez-Margallo Francisco Miguel Sánchez-Margallo |
| author_facet | Federica Marinaro Javier G. Casado Javier G. Casado Rebeca Blázquez Rebeca Blázquez Mauricio Veloso Brun Ricardo Marcos Marta Santos Francisco Javier Duque Esther López Verónica Álvarez Alejandra Usón Francisco Miguel Sánchez-Margallo Francisco Miguel Sánchez-Margallo |
| author_sort | Federica Marinaro |
| collection | DOAJ |
| description | More than a century has passed since the first surgical mesh for hernia repair was developed, and, to date, this is still the most widely used method despite the great number of complications it poses. The purpose of this study was to combine stem cell therapy and laparoscopy for the treatment of congenital hernia in a swine animal model. Porcine bone marrow-derived mesenchymal stem cells (MSCs) were seeded on polypropylene surgical meshes using a fibrin sealant solution as a vehicle. Meshes with (cell group) or without (control group) MSCs were implanted through laparoscopy in Large White pigs with congenital abdominal hernia after the approximation of hernia borders (implantation day). A successive laparoscopic biopsy of the mesh and its surrounding tissues was performed a week after implantation, and surgical meshes were excised a month after implantation. Ultrasonography was used to measure hernia sizes. Flow cytometry, histological, and gene expression analyses of the biopsy and necropsy samples were performed. The fibrin sealant solution was easy to prepare and preserved the viability of MSCs in the surgical meshes. Ultrasonography demonstrated a significant reduction in hernia size 1 week after implantation in the cell group relative to that on the day of implantation (p < 0.05). Flow cytometry of the mesh-infiltrated cells showed a non-significant increase of M2 macrophages when the cell group was compared with the control group 1 week after implantation. A significant decrease in the gene expression of VEGF and a significant increase in TNF expression were determined in the cell group 1 month after implantation compared with gene expressions in the control group (p < 0.05). Here, we propose an easy and feasible method to combine stem cell therapy and minimally invasive surgical techniques for hernia repair. In this study, stem cell therapy did not show a great immunomodulatory or regenerative effect in overcoming hernia-related complications. However, our clinically relevant animal model with congenital hernia closely resembles the clinical human condition. Further studies should be focused on this valuable animal model to evaluate stem cell therapies in hernia surgery. |
| first_indexed | 2024-12-10T10:03:43Z |
| format | Article |
| id | doaj.art-e20028a375034937a4baccfa47ec3876 |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-12-10T10:03:43Z |
| publishDate | 2020-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-e20028a375034937a4baccfa47ec38762022-12-22T01:53:18ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122020-09-011110.3389/fphar.2020.01332570889Laparoscopy for the Treatment of Congenital Hernia: Use of Surgical Meshes and Mesenchymal Stem Cells in a Clinically Relevant Animal ModelFederica Marinaro0Javier G. Casado1Javier G. Casado2Rebeca Blázquez3Rebeca Blázquez4Mauricio Veloso Brun5Ricardo Marcos6Marta Santos7Francisco Javier Duque8Esther López9Verónica Álvarez10Alejandra Usón11Francisco Miguel Sánchez-Margallo12Francisco Miguel Sánchez-Margallo13Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, Cáceres, SpainStem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, Cáceres, SpainCIBER de Enfermedades Cardiovasculares, Madrid, SpainStem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, Cáceres, SpainCIBER de Enfermedades Cardiovasculares, Madrid, SpainDepartment of Small Animal Clinics, Center of Rural Science, Federal University of Santa Maria (UFSM), Santa Maria, BrazilLaboratory of Histology and Embryology, Department of Microscopy, Abel Salazar Institute of Biomedical Sciences, University of Porto, Porto, PortugalLaboratory of Histology and Embryology, Department of Microscopy, Abel Salazar Institute of Biomedical Sciences, University of Porto, Porto, PortugalAnimal Medicine Department, Faculty of Veterinary Medicine, University of Extremadura, Cáceres, SpainStem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, Cáceres, SpainStem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, Cáceres, SpainStem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, Cáceres, SpainCIBER de Enfermedades Cardiovasculares, Madrid, SpainScientific Direction, Jesús Usón Minimally Invasive Surgery Centre, Cáceres, SpainMore than a century has passed since the first surgical mesh for hernia repair was developed, and, to date, this is still the most widely used method despite the great number of complications it poses. The purpose of this study was to combine stem cell therapy and laparoscopy for the treatment of congenital hernia in a swine animal model. Porcine bone marrow-derived mesenchymal stem cells (MSCs) were seeded on polypropylene surgical meshes using a fibrin sealant solution as a vehicle. Meshes with (cell group) or without (control group) MSCs were implanted through laparoscopy in Large White pigs with congenital abdominal hernia after the approximation of hernia borders (implantation day). A successive laparoscopic biopsy of the mesh and its surrounding tissues was performed a week after implantation, and surgical meshes were excised a month after implantation. Ultrasonography was used to measure hernia sizes. Flow cytometry, histological, and gene expression analyses of the biopsy and necropsy samples were performed. The fibrin sealant solution was easy to prepare and preserved the viability of MSCs in the surgical meshes. Ultrasonography demonstrated a significant reduction in hernia size 1 week after implantation in the cell group relative to that on the day of implantation (p < 0.05). Flow cytometry of the mesh-infiltrated cells showed a non-significant increase of M2 macrophages when the cell group was compared with the control group 1 week after implantation. A significant decrease in the gene expression of VEGF and a significant increase in TNF expression were determined in the cell group 1 month after implantation compared with gene expressions in the control group (p < 0.05). Here, we propose an easy and feasible method to combine stem cell therapy and minimally invasive surgical techniques for hernia repair. In this study, stem cell therapy did not show a great immunomodulatory or regenerative effect in overcoming hernia-related complications. However, our clinically relevant animal model with congenital hernia closely resembles the clinical human condition. Further studies should be focused on this valuable animal model to evaluate stem cell therapies in hernia surgery.https://www.frontiersin.org/article/10.3389/fphar.2020.01332/fullmeshcongenital herniamesenchymal stem cellsanimal modelhernia repairstem cell therapy |
| spellingShingle | Federica Marinaro Javier G. Casado Javier G. Casado Rebeca Blázquez Rebeca Blázquez Mauricio Veloso Brun Ricardo Marcos Marta Santos Francisco Javier Duque Esther López Verónica Álvarez Alejandra Usón Francisco Miguel Sánchez-Margallo Francisco Miguel Sánchez-Margallo Laparoscopy for the Treatment of Congenital Hernia: Use of Surgical Meshes and Mesenchymal Stem Cells in a Clinically Relevant Animal Model Frontiers in Pharmacology mesh congenital hernia mesenchymal stem cells animal model hernia repair stem cell therapy |
| title | Laparoscopy for the Treatment of Congenital Hernia: Use of Surgical Meshes and Mesenchymal Stem Cells in a Clinically Relevant Animal Model |
| title_full | Laparoscopy for the Treatment of Congenital Hernia: Use of Surgical Meshes and Mesenchymal Stem Cells in a Clinically Relevant Animal Model |
| title_fullStr | Laparoscopy for the Treatment of Congenital Hernia: Use of Surgical Meshes and Mesenchymal Stem Cells in a Clinically Relevant Animal Model |
| title_full_unstemmed | Laparoscopy for the Treatment of Congenital Hernia: Use of Surgical Meshes and Mesenchymal Stem Cells in a Clinically Relevant Animal Model |
| title_short | Laparoscopy for the Treatment of Congenital Hernia: Use of Surgical Meshes and Mesenchymal Stem Cells in a Clinically Relevant Animal Model |
| title_sort | laparoscopy for the treatment of congenital hernia use of surgical meshes and mesenchymal stem cells in a clinically relevant animal model |
| topic | mesh congenital hernia mesenchymal stem cells animal model hernia repair stem cell therapy |
| url | https://www.frontiersin.org/article/10.3389/fphar.2020.01332/full |
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