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The effect of botulinum neurotoxin type A on capsule formation around silicone implants: the in vivo and in vitro study
Authors:Dong W Kim  Young Lee  YoungWoong Choi  Sang‐Ha Oh
Affiliation:1. Department of Dermatology, College of Medicine, Chungnam National University, Daejeon, Korea;2. Department of Plastic Surgery, Sanggye Piak Hospital, School of Medicine, Inje University, Seoul, Korea;3. Department of Plastic Surgery, College of Medicine, Chungnam National University, Daejeon, Korea;4. Department of Anatomy, College of Medicine, Chungnam National University, Daejeon, Korea;5. Research Institute for Medical Sciences, College of Medicine, Chungnam National University, Daejeon, Korea;6. BiO & J Inc., Daejeon, Korea
Abstract:This study confirms that botulinum neurotoxin type A (BoNT‐A) decreases capsular contracture and elucidates a possible mechanism. Silicone blocks were implanted subcutaneously in 20 mice. The experimental groups received BoNT‐A (1, 2·5 or 5 U) instilled into the subcutaneous pocket. After 30 days, periprosthetic capsules were harvested and evaluated. The effect of BoNT‐A on the differentiation of human dermal fibroblasts to myofibroblasts in culture was examined by Western blot analysis. Changes in transforming growth factor‐beta1 (TGF‐β1) expression in cultured fibroblasts were determined by enzyme‐linked immunosorbent assay (ELISA). In in vivo study, the thickness of capsules (P < 0·05) and the number of alpha‐smooth muscle actin (α‐SMA)+ cells in capsules (P < 0·05) were significantly decreased in the experimental groups. TGF‐β1 was significantly underexpressed in the experimental groups (P < 0·05). In in vitro study, BoNT‐A did not significantly affect fibroblast viability. Western blot analysis showed that α‐SMA protein levels were significantly decreased in the experimental groups (P < 0·05). Based on ELISA, the amount of TGF‐β1 was significantly decreased in the experimental groups (P < 0·05), especially cells treated with a high dose of BoNT‐A (P < 0·001). This study confirms that BoNT‐A prevents capsular formation around silicone implants, possibly by blocking TGF‐β1 signalling and interrupting the differentiation of fibroblasts to myofibroblasts.
Keywords:Botulinum neurotoxin type A  Capsule  Myofibroblast  TGF‐β  1
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