Barbora Jíšová, Matyáš Ebel, Andrew de Beaux, Barbora East
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引用次数: 0
Abstract
Purpose: Surgical mesh, often made from polypropylene, is commonly recommended to enhance hernia repair outcomes in adults. Concerns about polypropylene, as a cause of allergy and/or autoimmune disease prompted this study to evaluate immunological parameters in patients with mesh and healthy controls.
Methodology: A case-control cohort study was conducted at a university hospital. Electronic patient records of hernia repairs using polypropylene mesh (January 2018-April 2022) were analysed. Blood samples from patients and healthy controls were assessed using various methods, including enzyme-linked immunosorbent assay (ELISA), immunofluorescence, immunoblotting, and flow cytometry.
Results: The database search identified 1544 participants. After applying the exclusion criteria 33 patients remained in the polypropylene mesh group. Patients with mesh had lower median IgG3 levels (p = 0.02) and Rheumatoid factor (RF) IgM (p = 0.018) compared to the control group. Although both IgG3 and RF IgM levels were in the normal reference range. In addition, 5 patients in the mesh group tested positive for serum ANCA levels compared to none in the control group (p = 0.053). No other differences in immunoglobulins, autoantibodies, complement, or immune cell subtypes were observed.
Conclusion: Patients with polypropylene mesh exhibited median IgG3 and RF IgM serum levels that were within the normal reference range but slightly lower compared to the control group. Among patients with polypropylene mesh, five displayed positive serum ANCA levels without autoimmune-related symptoms. Overall, no definitive signs of autoimmunity caused by polypropylene mesh. A larger, prospective study is warranted to further explore potential immune responses to polypropylene mesh.
期刊介绍：
Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery.
Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.
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