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The Effect of Doxycycline on the Fibrous Breast Capsule in a Mouse Model Following Subcutaneous Breast Implant

Jennifer E. Baker Mitchell Skinner Ryan M. Gobble
University of Cincinnati
2019-01-29

Presenter: Jennifer E. Baker

Affidavit:
Jennifer Baker

Director Name: Jeffrey Sussman

Author Category: Other Specialty Resident
Presentation Category: Basic Science Research
Abstract Category: Breast (Aesthetic and Recon.)

PURPOSE:
Acute infection occurs in approximately 4-10% of all implant-based breast reconstructions. Biofilm formation on the implant has been associated with capsular contracture. Doxycycline, a matrix metalloproteinase inhibitor, has been shown to reduce fibrosis in chronic wounds. We hypothesize that doxycycline-coated breast implants will lead to decreased fibrosis after infection in a silicone breast implant murine model.

METHODS: Silicone breast implants were coated with doxycycline using a novel method and placed into a subcutaneous pocket on a mouse. Methicillin-resistant Staphylococcus aureus (MRSA) or normal saline was injected into the pocket. Implants were incubated for 3 or 7 days and then harvested placed into formalin and ultimately embedded in paraffin. Immunohistochemistry was performed for vimentin, elastin, tubulin, and α-smooth muscle actin (α-sma). ELISA analysis for matrix metalloproteinase 9 (MMP9) and tissue inhibitors of metalloproteinase 1 (TIMP1) was performed on 7-day samples

RESULTS: A reduction in tubulin and vimentin formation in implant capsules of doxycycline treated mice at 3 days was found; no difference was observed in α-sma or elastin composition in the capsule. At 7 days, reductions in all proteins were observed. Overall capsule thickness and neutrophils were decreased in doxycycline-implant mice at both time points. An increase in MMP9 and decreased in TIMP1 was demonstrated in the MRSA/ETOH-implant mice at 7 days.

CONCLUSION: Doxycycline-coated implants reduce fibrosis in a murine implant model. Future studies with a longer time point will aid in delineating the long-term effects of doxycycline-coated implants on capsular formation.

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