Does the Immune Reactivity of Bacteria Biofilms Cause Vaginal Mesh (Polypropylene) Erosion?---A Ultrastructural, Microbiological and Immunohistochemical Analysis

  • Wang, Alex Cheng (PI)
  • Chen, Min-Chi (CoPI)
  • Chiu, Cherng-Hsun (CoPI)
  • Ko, Yu-Shien (CoPI)
  • Lin, Cheng Tao (CoPI)
  • Lu, Tsia Shu (CoPI)

Project: National Science and Technology CouncilNational Science and Technology Council Academic Grants

Project Details


Aging, birth trauma and extensive pelvic surgery are the causes known to cause advanced pelvic organ prolaspe, fecal as well as urinary incontinence. Surgical treatment is the last resort to manage the abovementioned clinical manifestations of pelvic floor disorders except the subject is too frail to receive operation. In order to facilitate the reconstructive pelvic surgery, reinforcement with synthetic mesh or biological material is the modern trend in pelvic repair. Unfortunately no prosthesis including synthetic or biological is ideal because vaginal erosion with mesh extrusion which is the subject of this proposal and other complications were reported continuously. As per the literature, the rate for mesh vaginal extrusion ranged between 2.4 and 17% when polypropylene which is the most popular synthetic material used for the midurethral sling or pelvic reconstructive surgery to date. The causes of this complication are still controversial which include rejection, poor quality of tissue, surgical artifact, material of mesh and etc. A prospective controlled study for the investigation of the cause for mesh vaginal erosion was conducted and the results revealed evidences of immune reactivity after mesh implantation, albeit the evidence was not solid. As per the pilot study initially done by us to determine the biofilmrelatedinfection, we have found bacterial biofilm could adhere to surfaces and interfaces, i.e. bacteria located in the cells just beneath the contacting surfaces in the electron microscopic (EM) analyses. In addition, soon after bacteria infection, proteins in biofilm undergo conformational changes, making them immunogenic and triggers a typical inflammatory response leading to activation of the complement system. Thus, we plan to use CD (clusters of differentiation) antigens – 4, 8, 20, 25, 40, 68 and quantitative analysis of FoxP3 to determine the function of regulatory T cells in the immune response. In addition, bacterial culture and subuquent EM analysis for the bacteria biofilm will be performed.

Project IDs

Project ID:PC9706-1019
External Project ID:NSC96-2314-B182-015-MY2
Effective start/end date01/08/0831/07/09


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