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Int Urol Nephrol. 2017 Apr;49(4):597-605. doi: 10.1007/s11255-017-1520-3. Epub 2017 Feb 8.

Nitric oxide coating polypropylene mesh increases angiogenesis and reduces inflammatory response and apoptosis.

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School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil.
, 4405, Engenheiro Anysio da Rocha Compasso st, Porto Velho, Rondônia, 76821-331, Brazil.
Institute of Biology, University of Campinas, Campinas, São Paulo, Brazil.
Pontifical Catholic University of Campinas (PUC-Campinas), Campinas, São Paulo, Brazil.
School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil.



To evaluate the effect of implanted S-nitrosoglutathione (GSNO) coating polypropylene mesh in foreign-body response of rats.


Thirty female rats underwent to subcutaneous implant of five polypropylene (PP) fragments: uncoated PP (control); PP polyvinylalcohol (PVA) coated and PP PVA + GSNO (1, 10 and 70 mMol) coated. After euthanasia (4 and 30 days), eight slides were prepared from each animal: hematoxylin-eosin (inflammatory response); unstained (birefringence collagen evaluation); TUNEL technique (apoptosis); and five for immunohistochemical processing: CD-31 (angiogenesis), IL-1 and TNF-α (proinflammatory cytokynes), iNOS (NO synthesis) and MMP-2 (collagen metabolism). The inflammation area, birefringence index, apoptotic index, immunoreactivity and vessel density were objectively measured.


Inflammatory reaction area at 4 days was 11.3, 15.2, 25.1, 17.1 and 19.3% of pure PP, PVA, GSNO 1, 10 and 70 mM, respectively, p = 0.0006 (PP × Others). At 30 days lower inflammatory area was observed in GSNO 10 and 70 mM compared to pure PP (5.3, 5.2 and 11.1%, respectively, p = 0.0001). Vessel density was higher for GSNO 1 mM (25.5%) compared to pure PP (19.6%) at 30 days only, p = 0.0081. Apoptotic index at 4 days was lower for GSNO 1 mM (49.3%) than pure PVA (60.6%), p = 0.0124. GSNO 10 and 70 mM reduced their apoptotic index at 30 days compared to 4 days (49.9 vs. 36.9 and 59.1 vs. 47.5%, respectively, p = 0.0397). Birefringence index, IL-1, TNF, MMP-2 and iNOS were not different.


Depending on concentrations, GSNO can increase angiogenesis, reduce inflammation and apoptosis compared to pure PP, without impact on cytokine, collagen organization/metabolism and endogenous NO synthesis.


Host versus graft reaction; Nitric oxide; Pelvic organ prolapse; Polypropylenes; Surgical mesh

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