Effects of Singulair (Montelukast) Treatment for Capsular Contracture

Huang, Catherine K.; Handel, Neal

doi:10.1177/1090820x10374724

Cited by 61 publications

(37 citation statements)

References 17 publications

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“…This suggests that montelukast had a prophylactic effect against capsular contracture. This finding is supported by a study in breast augmentation patients which similarly showed that montelukast significantly reduced post‐operative capsular contracture formation . The capsule cut measurements also demonstrated 9°more extension of the operative limb over the rats in CTL.…”

Section: Discussionsupporting

confidence: 64%

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An evaluation of prophylactic treatments to prevent post traumatic joint stiffness

Efird

Kellam

Yeazell

et al. 2014

Journal Orthopaedic Research

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Arthrofibrosis is a major obstacle to restoring joint function after trauma. The objective of this study was to evaluate montelukast, forskolin, and triamcinolone as possible means of prophylaxis against the formation of arthrofibrosis. Forty-eight rats underwent surgical knee trauma with post-operative immobilization in full flexion. The treatment groups were: control (CTL), oral montelukast (3.75 mg/kg/day) (MLK), intra-articular forskolin injections (0.6 mg/kg) (FSK), and intra-articular triamcinolone injections (0.68 mg/kg) (STR). Rats were sacrificed after 14 days and femorotibial contracture angles were measured with the posterior capsule intact and with the posterior capsule cut. A 0.015Nm extension moment was applied to the knee. All treatment groups had significant reductions in contracture angle compared to the control. Mean contractures with the posterior capsule intact were 32˚(CTL), 20˚(MLK), 22˚(FSK), and 7˚(STR). Contractures with the posterior capsule cut were 28˚(CTL), 19˚(MLK), 20˚(FSK), and 5˚(STR). The STR group was significantly better than FSK and MLK. Triamcinolone injections provided dramatic reductions in stiffness. Both forskolin and montelukast provided significant, though lesser, reductions in stiffness. While the triamcinolone contracture angles were significantly better, the novel treatments of forskolin and montelukast provided encouraging results and should be studied further. ß

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Section: Discussionsupporting

confidence: 64%

“…Being a leukotriene receptor antagonist, montelukast can inhibit the inflammatory cascade and might prevent fibrosis. It has been shown that prophylactic use of montelukast decreased capsular contracture in patients following breast augmentation …”

mentioning

confidence: 99%

An evaluation of prophylactic treatments to prevent post traumatic joint stiffness

Efird

Kellam

Yeazell

et al. 2014

Journal Orthopaedic Research

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“…65–67 Other research groups modulated the effects of the inflammatory pathway to reduce fibrosis and contracture using pirfenidone that inhibits TGFβ synthesis, enalapril that negates the fibrotic and inflammatory effects of angiotensin II, tumor necrosis factor–stimulated gene 6 overexpression (which provides an anti-inflammatory effect via modulation of hyaluronan), and the anti-inflammatory medications zafirlukast and montelukast. 20,44,68–70 Although these studies have been performed using only small numbers of animals, they strongly suggest a link between inflammation and capsular contracture.…”

Section: Discussionmentioning

confidence: 99%

Follistatin and the Breast Implant Capsule

Frenkiel

Temple-Smith

Kretser³

et al. 2017

Plastic and Reconstructive Surgery - Global Open

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“…Montelukast, which was used to reduce the occurrence of capsular contracture [9], is a leukotriene antagonist which binds to leukotriene receptors. Thus, by inhibiting the activation of leukotriene, it plays a role in reducing the occurrence of inflammatory responses.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Montelukast and Antiadhesion Barrier Solution on the Capsule Formation after Insertion of Silicone Implants in a White Rat Model

et al. 2013

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Background and Purposes: Capsular contracture is one of the most severe complications that can occur in breast surgery following silicone implant insertion. The purpose of this study was to investigate the effect of montelukast and antiadhesion barrier solution (AABS) on reducing capsular formation and their possible synergism. Materials andMethods: This study was approved by the Animal Ethics Committee (Reference No. KNU 2012-33) and was conducted in accordance with the Kyungpook National University - Institutional Animal Care and Use Committee, Animal Ethics Committee. The experiments in this study were conducted in vivo in 4 groups of 24 rats. Following silicone implant insertion, the pocket was injected with different agents. Group I (control group) was given normal saline injections into the pocket and fed with pure water. Group II was given injections of AABS and fed with pure water. Group III was given injections of normal saline and the medication montelukast during the experimental period. Group IV was given injections of AABS and montelukast as postoperative medication. Peri-implant capsules were excised after 8 weeks and were evaluated for transparency, inflammatory cell content, capsule thickness, collagen pattern and TGF-β expression. Results: The capsules in the experimental groups (i.e., groups II-IV) were significantly more transparent than those in group I (controls; p < 0.05, Student's t test). The mean capsule thickness of the experimental groups II (296 ± 14.76 μm), III (280 ± 14.77 μm) and IV (276 ± 39.28 μm) was smaller than that of the control group I (361 ± 35.43 μm). Compared to the control group, the histologic findings in the experimental groups suggested a decreased inflammatory response occurring in the peri-implant capsules as they exhibited minor vascularization and a reduced number of mast cells and macrophages. The collagen patterns in the experimental groups were of a lower density than in the control group with the former showing a loose, tidy collagen pattern. The amounts of TGF-β and collagen I were higher in the control group than in the experimental groups. Group IV (the synergic effect group) had a more pronounced effect on all the parameters examined than that in groups II and III with separate drug administration. Conclusions: Montelukast and AABS reduced the thickness, the inflammatory cell infiltrate and the myofibroblast content of the peri-implant capsules around silicone implants in this white rat model. They lowered the expression of the fibrotic mediator, TGF-β, and inhibited the peri-implant capsular fibrosis. Therefore, montelukast and AABS are effective in the reduction of silicone-induced peri-implant capsular formation.

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Effects of Singulair (Montelukast) Treatment for Capsular Contracture

Cited by 61 publications

References 17 publications

An evaluation of prophylactic treatments to prevent post traumatic joint stiffness

An evaluation of prophylactic treatments to prevent post traumatic joint stiffness

Follistatin and the Breast Implant Capsule

The Effect of Montelukast and Antiadhesion Barrier Solution on the Capsule Formation after Insertion of Silicone Implants in a White Rat Model

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