Effect of zafirlukast on capsular contracture around silicone implants in rats

Abstract

PURPOSE:To evaluate the effect of zafirlukast on capsular contracture around silicone implants by measuring the pressure within the implant, using a rat experimental model. METHODS: Forty adult female Wistar rats were used. Each one received two silicone implants, one with smooth-surface and the other with textured-surface. They were randomly divided into four groups (n=10). The rats of control group I were sacrificed after the implants. The remaining animals were subjected to a daily regimen of intra-peritoneal injection for a period of 90 days and they were distributed as follows: control group II received 0.9% physiological saline solution; experimental group I received zafirlukast 1.25 mg/kg; and experimental group II received zafirlukast 5 mg/kg. The measurement of intra-implant pressure of control group I was determined on the surgery day and in other groups on the ninetieth day, after being sacrificed. RESULTS: In the evaluation of textured implants there was an increase of internal pressure in the control group II, and there was no increase in the experimental groups. Compared to the controls there were not significant differences in smooth implants. CONCLUSION: Zafirlukast reduced the risk of developing capsular contracture around silicone implants with textured surface. Key words: Breast Implants. Implant Capsular Contracture. Leukotriene Antagonists. Rats. RESUMO OBJETIVO: Avaliar o efeito do zafirlukast na contratura capsular ao redor de implantes de silicone, através da aferição da pressão intra-implante, utilizando-se um modelo experimental de ratos. MÉTODOS: Quarenta ratos fêmeas Wistar foram utilizados. Cada um recebeu dois implantes de silicone, sendo um com superfície lisa e outro texturizada. Foram divididos aleatoriamente em quatro grupos (n=10). Os ratos do grupo controle I foram sacrificados após o implante. O restante dos animais foi submetido a um regime diário de injeção intraperitoneal por um período de 90 dias e foram distribuídos: grupo controle II recebeu solução salina fisiológica 0,9%, grupo experimental I recebeu zafirlukast 1,25 mg/kg, e grupo experimental II recebeu zafirlukast 5 mg/kg. O grupo controle II recebeu solução salina; grupo experimental I, 1,25 mg/kg/dia de zafirlukast; grupo experimental II, 5mg/kg/dia de zafirlukast. A aferição da pressão intra-implante do grupo controle I foi averiguada no dia do ato operatório, e nos outros grupos no nonagésimo dia, após serem sacrificados. RESULTADOS: Na avaliação dos implantes texturizados houve aumento da pressão interna no grupo controle II e, não se observou aumento nos grupos experimentais. Na comparação com os controles não foram observadas diferenças significativas nos implantes lisos. CONCLUSÃO: O Zafirlukast reduziu o risco de desenvolver contratura capsular em torno de implantes de silicone com superfície texturizada. Descritores: Implantes de Mama. Contratura Capsular em Implantes. Antagonistas de Leucotrienos. Ratos.

Capsular Contracture after Breast Augmentation: An Update for Clinical Practice

“…The leukotriene antagonist, Zafirlukast (AstroZeneca) has been used off label to investigate whether it has an effect on the development of contracture. Animal studies have found that when 5 mg/kg per day of Zafirlukast was injected around textured silicone implants, the capsules are thinner and more vascular with a lower collagen density [ 75 76 ], indicating that the drug may be able to prevent capsular contracture from developing in the first place. A number of studies have also been carried out in women who have undergone implant based surgery.…”

Asiaticoside Combined With Carbon Ion Implantation to Improve the Biocompatibility of Silicone Rubber and to Reduce the Risk of Capsule Contracture

“…Animal studies revealed that when 5 mg/kg leukotriene antagonist zarlukast is injected daily around the rough silicone rubber material, the capsule around the silicone rubber is thinner, the vascularization of the capsule is more abundant, and the collagen density is lower, indicating that this drug can prevent capsule contracture ( Hinz et al, 2001 ; Mazzocchi et al, 2012 ). A study involving 60 patients with mild and severe capsular contracture evaluated monthly up to a year after the initiation of a 6-months treatment with zarlukast revealed that during active treatment, the Baker score of the contracture decreased, after the patient stopped treatment, the score began to increase ( Bastos et al, 2012 ). This result suggests that to obtain long-term effects, long-term treatment is necessary.…”

The Effects of Colchicine-Impregnated Oxidized Regenerated Cellulose on Capsular Contracture

“…18 There are numerous theories regarding the cause of capsular contracture, such as implant-related factors, different implant insertion planes, foreign body reaction, hematoma, bacterial contamination, and subclinical infection. 4,19,20 Despite various hypotheses, capsular contracture formation is accepted to be multifactorial having inflammation as a common denominator. 6,21 Systemic and local response of the body to implants is still being debated, and increasing biocompatibility is an area of ongoing research.…”