In vitro activation of human leukocytes in response to contact with synthetic hernia meshes

ObjectivesEvaluation of an in vitro chemiluminescent screen to predict leukocyte ROS in response to surgical materials.Design and methods6 surgical meshes; manufacture and knitting variations of polypropylene (PP), polyester terephtalate (PET) and polyglycolic acid (PGA) trialled healthy human blood (n = 5). Materials and blood were incubated with pholasin. Pholasin emits photons in the presence of reactive oxygen species; secreted by activated leukocytes.ResultsMultifilament-PGA mesh stimulated the greatest ROS response from blood derived human leukocytes. Multifilament-PET light weight and multifilament-PP meshes stimulated similar levels of ROS production which were greater than monofilament-PP light, monofilament-PP and monofilament-PET light meshes. Data demonstrated statistical variations in trans-donor response to the materials.ConclusionsAn in vitro chemiluminescent assay can be used to assess leukocyte respiratory burst response to biomaterials. PGA mesh elicited the greatest ROS response. PP and PET monofilament meshes induce less ROS than multifilament equivalents. In vitro results correlate with previously published clinical responses to these materials.

► This study characterised an in vitro approach to predict acute inflammation.
► We demonstrated differences in the leukocyte/material ROS response.
► The extent of these responses varied between individuals.
► This may translate to a pre-clinical screen to maximise patient material compliance.