INTRODUCTION The synthesis of the periprosthetic capsule during implant-based breast reconstruction is the result of a coordinate cascade of inflammatory events ending in a fibrous tissue deposition around the expander or implant. Although the development of small volumes of fluid is one of the complications of prosthetic-based breast reconstruction, the characterization of the periprosthetic effusions coupled with the micro-textured devices, that have been recently introduced after the recall of macro-textured ones, is still lacking. The investigation of these periprosthetic effusions and paired capsules in terms of immunological content were the primary and secondary aims of the present study, respectively. METHODS For this, 68 women, 41 of whom had periprosthetic effusions at the time of expander replacement with implant, were recruited. For each case, capsule and healthy dermal tissues were taken and for women with periprosthetic effusion, peripheral blood was also collected. Periprosthetic effusions and peripheral blood were characterized by cytometry while capsules and dermal tissues by immunohistochemistry and Nanostring analysis. RESULTS The results showed an increase of Th1, Th2 lymphocytes and a HLA-DR+bright CD16+ cells (likely representing monocytes-derived macrophages) in periprosthetic effusions in respect to peripheral blood. These pro-inflammatory cells were counterbalanced by the gain of suppressive CD4 Treg cells. In the corresponding capsules, immunohistochemistry revealed the absence of Th1 cells and the presence of tissutal FOXP3 Treg. No significant difference in expression of inflammatory-related genes between capsules and dermal tissues was present. CONCLUSIONS These results suggest the presence of a Treg-controlled inflammation in both periprosthetic effusions and capsules.

中文翻译：

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扩胸器周围假体周围积液：流式细胞术、免疫组织化学和分子表征。

引言 基于植入物的乳房重建过程中假体周围囊的合成是炎症事件协调级联的结果，最终导致扩张器或植入物周围的纤维组织沉积。尽管少量液体的产生是基于假体的乳房重建的并发症之一，但在召回宏观纹理装置后最近引入的微纹理装置，对假体周围积液的表征仍然是一个难题。不足。对这些假体周围积液和配对胶囊的免疫学内容的研究分别是本研究的主要和次要目的。方法 为此，招募了 68 名女性，其中 41 名在用植入物替换扩张器时出现假体周围积液。对于每个病例，均采集胶囊和健康真皮组织，对于假体周围积液的女性，还采集外周血。通过细胞术对假体周围积液和外周血进行表征，而通过免疫组织化学和纳米线分析对胶囊和真皮组织进行表征。结果 结果显示，外周血假体周围积液中 Th1、Th2 淋巴细胞和 HLA-DR+bright CD16+ 细胞（可能代表单核细胞衍生的巨噬细胞）增加。这些促炎细胞被抑制性 CD4 Treg 细胞的增加所抵消。在相应的胶囊中，免疫组织化学显示不存在 Th1 细胞，但存在组织 FOXP3 Treg。胶囊和真皮组织之间炎症相关基因的表达不存在显着差异。结论 这些结果表明假体周围积液和被膜中都存在 Treg 控制的炎症。