Losartan modifies mesh integration after abdominal wall repair: an experimental study

Purpose Angiotensin II (AT II) receptor blockers have previously shown to reduce inflammatory response in many settings. We aimed to assess the effects of ATII receptor blocker (Losartan) on mesh integration after abdominal wall repair in a rat model. Methods A total of 16 Wistar-Kyoto (WKY) and 16...

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Published in:	Hernia : the journal of hernias and abdominal wall surgery Vol. 26; no. 3; pp. 937 - 944
Main Authors:	Peña, M. E., Angeramo, C. A., Schlottmann, F., Sadava, E. E.
Format:	Journal Article
Language:	English
Published:	Paris Springer Paris 01-06-2022 Springer Nature B.V
Subjects:	Abdomen Abdominal Surgery Abdominal wall Abdominal Wall - surgery Angiotensin Angiotensin II Animal models Animals Blood pressure Experimental hernia surgery Hernia Herniorrhaphy Humans Hypertension Hypertension - drug therapy Inflammation Integration Losartan - pharmacology Medicine Medicine & Public Health Necropsy Original Article Polypropylene Prostheses and Implants Rats Rats, Inbred SHR Rats, Inbred WKY Surgery Surgical Mesh tissue engineering and biomaterial research in hernia repair Hernia Rat model Inflammatory response Losartan Angiotensin Mesh integration
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Summary:	Purpose Angiotensin II (AT II) receptor blockers have previously shown to reduce inflammatory response in many settings. We aimed to assess the effects of ATII receptor blocker (Losartan) on mesh integration after abdominal wall repair in a rat model. Methods A total of 16 Wistar-Kyoto (WKY) and 16 previously hypertensive (SHRSP) rats were isolated. An acute ventral hernia followed by a bridged repair with heavyweight polypropylene mesh was performed. Subjects received either normal saline (WKY-C n = 8 and SHRPS-C n = 8) or 40 mg/kg losartan (WKY-L n = 8) and SHRPS-L n = 8) in the postoperative period. Blood pressure was recorded preoperatively and weekly after surgery. Necropsy with en-bloc resection of the abdominal wall was performed at postoperative day 30. Macroscopic and microscopic evaluations of the specimens were conducted. H&E and Masson’s trichrome were used for histologic evaluation. Results Both groups receiving Losartan showed a significant reduction of blood pressure after surgery (WKY-L: 130/85 vs 116/81 mmHg, SHRPS-L: 176/137 vs 122/101 mmHg, p < 0.01). A significant reduction in mesh incorporation and adherence scores were also observed on macroscopic analysis in Losartan groups ( p < 0.01 and p = 0.02, respectively). Microscopically, higher immature fibroplasia was observed after Losartan, with a significant reduction in scar plate formation and inflammatory response on the prosthetic surface ( p = 0.04 and p = 0.02, respectively). Conclusion Losartan modifies the interaction between the host tissue and the prosthesis. An impairment in mesh integration and immature fibroplasia in both normotensive and hypertensive rats detected in our model warrants further research.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1265-4906 1248-9204
DOI:	10.1007/s10029-021-02444-2