The Preventive Effect of Topical Zafirlukast Instillation for Peri-Implant Capsule Formation in Rabbits

Kang, Shin Hyuk; Shin, Kee Cheol; Kim, Woo Seob; Bae, Tae Hui; Kim, Han Koo; Kim, Mi Kyung

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자료유형: 학술저널

저자정보: Kang, Shin Hyuk (Department of Plastic and Reconstructive Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine) Shin, Kee Cheol (Department of Plastic and Reconstructive Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine) Kim, Woo Seob (Department of Plastic and Reconstructive Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine) Bae, Tae Hui (Department of Plastic and Reconstructive Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine) Kim, Han Koo (Department of Plastic and Reconstructive Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine) Kim, Mi Kyung (Department of Pathology, Chung-Ang University Hospital, Chung-Ang University College of Medicine)

저널정보: 대한성형외과학회 Archives of plastic surgery : APS Archives of plastic surgery : APS 제42권 제2호

발행연도: 2015.1

수록면: 179 - 185 (7page)

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Background Capsular contracture is the most troublesome complication in breast implant surgery. Although capsule formation can be seen as a normal reaction to a foreign body, it can induce pain, hardness, deformity, and other pathologic problems. Surgical intervention is required in severe cases, but even surgery cannot guarantee a successful outcome without recurrence. This experimental study confirms that single topical administration of leukotriene antagonist zafirlukast (Accolate, Astrazeneca) reduces peri-implant capsule formation and prevents capsular contracture. Methods Twelve smooth-surfaced cohesive gel implants were implanted in New Zealand White rabbits. These miniature implants were designed to be identical to currently used products for breast augmentation. The rabbits were divided into 2 groups. In the experimental group (n=6), the implant and normal saline with zafirlukast were inserted in the submuscular pocket. In the control group (n=6), the implant and normal saline alone were used. Two months later, the implants with peri-implant capsule were excised. We evaluated capsule thickness and collagen pattern and performed immunohistochemical staining of myofibroblasts, transforming growth factor $(TGF)-{\beta}1$, 2. Results The thickness of the capsules in the experimental group was reduced in both dorsal and ventral directions. The collagen pattern showed parallel alignment with low density, and the number of myofibroblasts as well as the amounts of $TGF-{\beta}1$ and $TGF-{\beta}2$ were reduced in the experimental group. Conclusions We suggest that single topical administration of leukotriene antagonist zafirlukast can be helpful in reducing capsule formation and preventing capsular contracture via myofibroblast suppression, modulation of fibroblastic cytokines, and anti-inflammatory effect.

#Breast implants #Implant capsular contracture #Zafirlukast #Prevention

참고문헌 (25)

참고문헌 신청

Young VL. / 1998 / Guidelines and indications for breast implant capsulectomy / Plast Reconstr Surg 102:884~891

Hackshaw KV / 1992 / Urine leukotriene E4 levels are elevated in patients with active systemic lupus erythematosus / J Rheumatol 19:252~258

Scuderi N / 2006 / The effects of zafirlukast on capsular contracture: preliminary report / Aesthetic Plast Surg 30:513~520

Bastos EM / 2007 / Histologic analysis of zafirlukast’s effect on capsule formation around silicone implants / Aesthetic Plast Surg 31:559~565

Scuderi N / 2007 / Effects of zafirlukast on capsular contracture: controlled study measuring the mammary compliance / Int J Immunopathol Pharmacol 20:577~584

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