Abstract

Abstract The repair of abdominal hernias with prosthetic mesh can significantly reduce the risk of hernia recurrence. A new type of hernia implants combines monofilaments, Polypropylene (PP) and a biobased and natural slowly bioabsorbable polymer, Poly-L-Lactic Acid (PLLA). The partially (60%) resorbable PLLA/PP and PP meshes manufactured by COUSIN Surgery are 4DVentral® and Biomesh P1®. The contribution of PLLA in regulated inflammatory response and in enhancing abdominal repair remains unknown. Inflammation has a functional role during tissue regeneration process. An abnormal macrophage response characterized by an uncontrolled release of pro-inflammatory cytokines, chemokines, and tissue-degrading enzymes has been shown to be responsible for postoperative complications. In contrast, the angiogenic and tissue remodeling activities of the alternative anti-inflammatory M2 macrophages have potential use in tissue regenerative. Here, the characterization of the inflammatory response of human macrophages in vitro regarding 4DVentral® compared to Biomesh P1® was performed. Human monocytic THP-1 cells were differentiated into macrophages and polarized in M1 macrophages by incubation with IFN-γ and LPS or not (M0 macrophages). We found that 4DVentral® induced higher secretion of anti-inflammatory cytokines (IL-10 and Il1-RA) compared to PP Mesh in M0 macrophages. Interestingly, the secretion of pro-inflammatory cytokine IL-6 in M1 macrophages was dramatically reduced in the presence of 4DVentral® mesh compared to PP Biomesh P1®. However, the secretion of IL-10 was significantly increased with 4DVentral®. The composite PLLA/PP monofilament 4DVentral® positively drives human macrophages to an anti-inflammatory profile, resolving inflammation and promoting tissue repair.

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