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Camicia A, Foppiani JA, Raska O, Hernandez Alvarez A, Lee D, Taritsa IC, Schuster KA, Wan R, Neradová S, Lin GJ, Lee TC, Molitor M, Zikan M, Lin SJ. From Case Reports to Molecular Insight: Examining the Outcomes and Underlying Mechanisms of Squamous Cell Carcinoma in Breast Implant Patients-A Systematic Review. Int J Mol Sci 2024; 25:2872. [PMID: 38474119 DOI: 10.3390/ijms25052872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
There is extensive coverage in the existing literature on implant-associated lymphomas like anaplastic large-cell lymphoma, but breast implant-associated squamous cell carcinoma (BIA-SCC) has received limited scholarly attention since its first case in 1992. Thus, this study aims to conduct a qualitative synthesis focused on the underexplored association between breast implants and BIA-SCC. A systematic review was conducted utilizing the PubMed, Web of Science, and Cochrane databases to identify all currently reported cases of BIA-SCC. Additionally, a literature review was performed to identify potential biochemical mechanisms that could lead to BIA-SCC. Studies were vetted for quality using the NIH quality assessment tool. From an initial pool of 246 papers, 11 met the quality criteria for inclusion, examining a total of 14 patients aged between 40 and 81 years. BIA-SCC was found in a diverse range of implants, including those with smooth and textured surfaces, as well as those filled with saline and silicone. The condition notably manifested a proclivity for aggressive clinical progression, as evidenced by a mortality rate approximating 21.4% within a post-diagnostic interval of six months. Our literature review reveals that chronic inflammation, driven by various external factors such as pathogens and implants, can initiate carcinogenesis through epigenetic modifications and immune system alterations. This includes effects from exosomes and macrophage polarization, showcasing potential pathways for the pathogenesis of BIA-SCC. The study highlights the pressing need for further investigation into BIA-SCC, a subject hitherto inadequately addressed in the academic sphere. This necessitates the urgency for early screening and intervention to improve postoperative outcomes. While the review is confined by its reliance on case reports and series, it serves as a valuable reference for future research endeavors.
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Affiliation(s)
- Alexandra Camicia
- Faculty of Medicine and Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy
| | - Jose A Foppiani
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
- Institute of Pathological Physiology, First Faculty of Medicine, Charles University, 12108 Praha, Czech Republic
| | - Otakar Raska
- Institute of Pathological Physiology, First Faculty of Medicine, Charles University, 12108 Praha, Czech Republic
| | - Angelica Hernandez Alvarez
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Daniela Lee
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Iulianna C Taritsa
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Kirsten A Schuster
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Rou Wan
- Mayo Clinic, Rochester, MN 55902, USA
| | - Sylva Neradová
- Institute of Pathological Physiology, First Faculty of Medicine, Charles University, 12108 Praha, Czech Republic
| | - Gavin J Lin
- Nobles and Greenough School, Dedham, MA 02026, USA
| | | | - Martin Molitor
- Institute of Pathological Physiology, First Faculty of Medicine, Charles University, 12108 Praha, Czech Republic
- Department of Plastic Surgery, Bulovka University Hospital, 46401 Praha, Czech Republic
| | - Michal Zikan
- Institute of Pathological Physiology, First Faculty of Medicine, Charles University, 12108 Praha, Czech Republic
- Department of Obstetrics and Gynecology, Bulovka University Hospital, 46401 Praha, Czech Republic
| | - Samuel J Lin
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
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Lian L, Sun Z, Zhang J, Gu S, Xia C, Gan K. Preparation, characterization and biocompatibility of calcium peroxide-loaded polycaprolactone microparticles. Zhejiang Da Xue Xue Bao Yi Xue Ban 2023; 52:296-305. [PMID: 37476941 PMCID: PMC10409898 DOI: 10.3724/zdxbyxb-2022-0696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 05/31/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVES To explore the physicochemical characteristics and biocompatibility of calcium peroxide (CPO)-loaded polycaprolactone (PCL) microparticle. METHODS The CPO/PCL particles were prepared. The morphology and elemental distribution of CPO, PCL and CPO/PCL particles were observed with scanning electron microscopy and energy dispersive spectroscopy, respectively. Rat adipose mesenchymal stem cells were isolated and treated with different concentrations (0.10%, 0.25%, 0.50%, 1.00%) of CPO or CPO/PCL particles. The mesenchymal stem cells were cultured in normal media or osteogenic differentiation media under the hypoxia/normoxia conditions, and the amount of released O2 and H2O2 after CPO/PCL treatment were detected. The gene expressions of alkaline phosphatase (ALP), Runt-associated transcription factor 2 (RUNX2), osteopontin (OPN) and osteocalcin (OCN) were detected by realtime RT-PCR. SD rats were subcutaneously injected with 1.00% CPO/PCL particles and the pathological changes and infiltration of immune cells were observed with HE staining and immunohistochemistry at day 7 and day 14 after injection. RESULTS Scanning electron microscope showed that CPO particles had a polygonal structure, PCL particles were in a small spherical plastic particle state, and CPO/PCL particles had a block-like crystal structure. Energy dispersive spectroscopy revealed that PCL particles showed no calcium mapping, while CPO/PCL particles showed obvious and uniform calcium mapping. The concentrations of O2 and H2O2 released by CPO/PCL particles were lower than those of CPO group, and the oxygen release time was longer. The expressions of Alp, Runx2, Ocn and Opn increased with the higher content of CPO/PCL particles under hypoxia in osteogenic differentiation culture and normal culture, and the induction was more obvious under osteogenic differentiation conditions (all P<0.05). HE staining results showed that the muscle tissue fibers around the injection site were scattered and disorderly distributed, with varying sizes and thicknesses at day 7 after particle injection. Significant vascular congestion, widened gaps, mild interstitial congestion, local edema, inflammatory cell infiltration, and large area vacuolization were observed in some tissues of rats. At day 14 after microparticle injection, the muscle tissue around the injection site and the tissue fibers at the microparticle implantation site were arranged neatly, and the gap size was not thickened, the vascular congestion, local inflammatory cell infiltration, and vacuolization were significantly improved compared with those at day 7. The immunohistochemical staining results showed that the expressions of CD3 and CD68 positive cells significantly increased in the surrounding muscle tissue, and were densely distributed in a large area at day 7 after particle injection. At day 14 of microparticle injection, the numbers of CD3 and CD68 positive cells in peripheral muscle tissue and tissue at the site of particle implantation were lower than those at day 7 (all P<0.01). CONCLUSIONS CPO/PCL particles have good oxygen release activity, low damage to tissue, and excellent biocompatibility.
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Affiliation(s)
- Leidong Lian
- Medical School of Ningbo University, Ningbo 315000, Zhejiang Province, China.
| | - Zechen Sun
- Department of Orthopedics, Yuyao Fourth People's Hospital, Ningbo 315400, Zhejiang Province, China
| | - Jinhao Zhang
- Medical School of Ningbo University, Ningbo 315000, Zhejiang Province, China
| | - Shirong Gu
- Department of Orthopedics, Li Huili Hospital Affiliated to Ningbo University, Ningbo 315046, Zhejiang Province, China
| | - Chenjie Xia
- Department of Orthopedics, Li Huili Hospital Affiliated to Ningbo University, Ningbo 315046, Zhejiang Province, China
| | - Kaifeng Gan
- Department of Orthopedics, Li Huili Hospital Affiliated to Ningbo University, Ningbo 315046, Zhejiang Province, China.
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ASIA (Shoenfeld's syndrome) due to hysteroscopic Essure sterilization. Autoimmun Rev 2021; 20:102979. [PMID: 34752966 DOI: 10.1016/j.autrev.2021.102979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 07/19/2021] [Indexed: 11/21/2022]
Abstract
Essure (TM, Bayer; Leverkusen, Germany) may act as a potential cause of autoimmune/inflammatory syndrome by adjuvants (ASIA). Essure is a device hysteroscopically inserted into the fallopian tubes to elicit a local inflammatory response for permanent sterilization. Patients with ASIA present with a constellation of symptoms including fatigue, cognitive impairment, and arthralgias. It is well known that ASIA is triggered by implantation of foreign material such as breast implants and mesh for hernia repair. In the current study, we present a retrospective cohort of 33 patients electing to remove Essure due to pelvic pain and systemic symptoms consistent with an ASIA diagnosis, and detail a case report of an Essure patient. Furthermore, we reviewed the existing literature on adverse events associated with Essure and studies assessing outcomes following explantation. The concept that Essure may trigger ASIA is further supported by both in vivo and in vitro studies demonstrating immunostimulatory effects of the material components of the device. We conclude that the existing evidence is sufficient to recommend screening of Essure recipients for ASIA symptoms, and where indicated, discussion of the risks and potential benefits of surgical removal.
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