Differential Oxylipin Profile in the Peri-prosthetic Tissue of Breast Implant Illness Patients
Year: 2023
Type: article
Study design: Observational Study
Abstract: INTRODUCTION: Breast implant illness (BII) is a systemic complication associated with breast implants. BII is poorly understood, and the etiology is unknown. The surgical injury at the implant site initiates a local inflammation, creates a multitude of factors that impacts adipose tissue (increased inflammation, decreased adipose-derived hormone expression). These acute stress responses activate pathways that are involved in lipid peroxidation generating oxylipins, that are involved in inflammatory, nociceptive, and vascular responses to injury. Here we report the changes in oxylipin profile in the BII patients and the correlations of these changes with Breast Implant Illness. MATERIALS & METHODS: The study comprised of 120 subjects across three cohorts consented via protocol approved by IRB. Cohort-I comprised of BII subjects who went through explantation of breast implants (N=46). Cohort-II (non-BII) included patients (N=29) with breast implants without BII symptoms but went through explantation. Cohort-III (N=45, normal) was comprised of women without an implant, whose breast tissue was removed as an unrelated clinically indicated surgical procedures. Metabolite profiling of 14 oxylipins using targeted liquid chromatography mass spectrometry (LC-MS/MS) from the peri-prosthetic breast adipose tissue was performed. Identification of the metabolite was mediated by deuterated internal standard (heavy isotope). Concentrations in pg/mg of tissue were obtained by normalizing by the weight of the sample. RESULTS: Kruskal Wallis test with Dunn’s correction showed increased abundance of four oxylipins in the BII cohort compared to the non-BII or normal cohort (p<0.05). The four oxylipins comprised of 9(10)-Di HOME, 9-HODE, 12-HETE and 13-HODE. The oxylipins also exhibited a positive correlation with the duration of implant when compared between the implant cohort (BII and non-BII) and non-implant cohort (normal). Relative abundance of these oxylipins was also positively associated to the common manifestation exhibited by the BII patients (viz. fatigue, myalgia and brain fog) obtained as part of the patient reported outcome. DISCUSSION: This study demonstrates that BII subjects exhibit an altered oxylipin profile. As oxylipins are known to be immunogenic in nature, this could be a possible underlying etiology that could lead to or exacerbate the systemic manifestations associated with BII. Further research in this direction is required to elucidate the mechanistic pathway(s) involved in the process.
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,195
OpenAlex ID: W4387738514