Publication: Sıçan modelinde periprostetik meme kapsülü oluşumunu azaltmak için profilaktik sitagliptin tedavisi uygulaması
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Authors
Şahin, Mehmet Ali
Advisor
Akın, Selçuk
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Bursa Uludağ Üniversitesi
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Abstract
Amaç: Meme implantlarının estetik ve rekonstrüktif cerrahide kullanım sıklığı arttıkça komplikasyonlar, özellikle kapsül kontraktürü görülme sıklığı artmaktadır. Kapsül kontraktürü patogenezinde kapsül çevresinde gelişen fibroblastlar önemli rol oynamaktadır. Önceki çalışmalarda, kapsül dokusunda CD26 pozitif fibroblastların yoğun olduğu ve bunların inhibisyonunun kapsül kontraktürünü engelleyebileceği gösterilmiştir. Bu çalışmada, CD26/DPP4 inhibitörü, antifibrotik ve antioksidan özellikleri bulunan, tip 2 diyabet tedavisinde kullanılan FDA onaylı Sitagliptin’in etkisi araştırıldı. Gereç ve Yöntem: Çalışma sıçan modeli olarak tasarlandı. Çalışmada 20 adet Wistar - Albino cinsi dişi sıçan kullanıldı. Her grup rastgele 10 sıçan içerecek şekilde planlanarak 2 grup oluşturuldu. Sıçanların sırt bölgesine panniculus carnosus altına silikon mini implantlar yerleştirildi. Kontrol grubuna ilaç verilmedi. Diğer gruba oral gavaj yoluyla 10 mg/kg/gün dozunda Sitagiliptin verildi. Sekiz hafta sonunda histopatolojik incelemelerle kapsül kalınlığı, Jansen skoru (kapsül yüzeyi, inflamasyon, hücre katları, doku organizasyonu) değerlendirildi. Bulgular: Kontrol grubunda kapsül kalınlığı ortalaması 15,3±11,8 iken, deney grubunda ortalama 9,1±3,8 olarak bulundu, iki grup arasında anlamlı bir fark olmadığı gözlemlendi (p-değeri 0,315). Çalışmada Jansen skoru alt bileşenleri olan kapsül yüzeyi hücresel dağılım, doku organizasyonu, doku sınırındaki hücre katları ve inflamatuvar yanıt açısından iki grup karşılaştırıldı; anlamlı bir fark olmadığını görüldü (p-değeri > 0,05). Özellikle toplam skor kontrol grubunda 8,9 ± 2,2 iken, deney grubunda 9,3 ± 2,0 olarak saptanmış ve bu fark istatistiksel olarak anlamlı bulunmamıştır (p = 0,696). Sonuç: Bu çalışmanın sonucunda göre kapsül kalınlığı ve Jansen skorlaması alt bileşenleri olan kapsül yüzey skoru, inflamatuvar yanıt, doku içerisindeki hücre katları ve doku organizasyonu açısından iki grup arasında anlamlı bir fark saptanmamıştır.
Aim: As the use of breast implants in aesthetic and reconstructive surgery increases, complications, particularly capsular contracture, also rise. Fibroblasts developing around the capsule play an important role in the pathogenesis of capsular contracture. Previous studies have shown a high concentration of CD26-positive fibroblasts in capsule tissue, and inhibiting these cells could potentially prevent capsular contracture. This study aimed to investigate the effect of Sitagliptin, an FDA-approved drug with antifibrotic and antioxidant properties used in type 2 diabetes treatment, which acts as a CD26/DPP4 receptor inhibitor, on reducing capsular contraction around breast implants. Materials and Methods: The study was designed as a rat model. 20 female Wistar-Albino rats were used in the study, divided into two groups, each containing 10 randomly assigned rats. Mini implants made from silicone blocks were placed beneath the panniculus carnosus in the dorsal region of the rats. No medication was given to the control group. The experimental group received 10 mg/kg/day of sitagliptin via oral gavage. After an 8-week follow up, the rats were euthanized. Histopathological evaluations were conducted to assess capsule thickness and parameters of Jansen scoring, including capsule surface score, inflammatory response, cell layers within the tissue, and tissue organization. Results: In this study, capsule thickness was compared between the control and experimental groups. The mean capsule thickness was found to be 15.3±11.8 in the control group and 9.1±3.8 in the experimental group. Statistical analysis (p = 0.315) indicated no significant difference between the two groups. Additionally, comparisons were made between the control and experimental groups regarding Jansen score components: cellular distribution on the capsule surface, tissue organization, cell layers at the tissue boundary, and inflammatory response. Results showed no statistically significant difference between the groups (p > 0.05). Specifically, the total score was 8.9 ± 2.2 in the control group and 9.3 ± 2.0 in the experimental group, with no statistically significant difference observed (p = 0.696). Conclusion: Based on the results of this study, no significant difference was detected between the two groups in terms of capsule thickness and the Jansen scoring subcomponents: capsule surface score, inflammatory response, cell layers within the tissue, and tissue organization.
Aim: As the use of breast implants in aesthetic and reconstructive surgery increases, complications, particularly capsular contracture, also rise. Fibroblasts developing around the capsule play an important role in the pathogenesis of capsular contracture. Previous studies have shown a high concentration of CD26-positive fibroblasts in capsule tissue, and inhibiting these cells could potentially prevent capsular contracture. This study aimed to investigate the effect of Sitagliptin, an FDA-approved drug with antifibrotic and antioxidant properties used in type 2 diabetes treatment, which acts as a CD26/DPP4 receptor inhibitor, on reducing capsular contraction around breast implants. Materials and Methods: The study was designed as a rat model. 20 female Wistar-Albino rats were used in the study, divided into two groups, each containing 10 randomly assigned rats. Mini implants made from silicone blocks were placed beneath the panniculus carnosus in the dorsal region of the rats. No medication was given to the control group. The experimental group received 10 mg/kg/day of sitagliptin via oral gavage. After an 8-week follow up, the rats were euthanized. Histopathological evaluations were conducted to assess capsule thickness and parameters of Jansen scoring, including capsule surface score, inflammatory response, cell layers within the tissue, and tissue organization. Results: In this study, capsule thickness was compared between the control and experimental groups. The mean capsule thickness was found to be 15.3±11.8 in the control group and 9.1±3.8 in the experimental group. Statistical analysis (p = 0.315) indicated no significant difference between the two groups. Additionally, comparisons were made between the control and experimental groups regarding Jansen score components: cellular distribution on the capsule surface, tissue organization, cell layers at the tissue boundary, and inflammatory response. Results showed no statistically significant difference between the groups (p > 0.05). Specifically, the total score was 8.9 ± 2.2 in the control group and 9.3 ± 2.0 in the experimental group, with no statistically significant difference observed (p = 0.696). Conclusion: Based on the results of this study, no significant difference was detected between the two groups in terms of capsule thickness and the Jansen scoring subcomponents: capsule surface score, inflammatory response, cell layers within the tissue, and tissue organization.
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Keywords
Kapsül kontraktürü, Sitagliptin, Fibrozis, Capsular contracture, Fibrosis