RESUMO
Glutaraldehyde-stabilized bovine pericardium is used for clinical application since 1970s because of its desirable features such as less immunogenicity and acceptable durability. However, a propensity for calcification is reported on account of glutaraldehyde treatment. In this study, commercially available glutaraldehyde cross-linked bovine pericardium was evaluated for its in vitro cytotoxic effect, macrophage activation, and in vivo toxic response in comparison to decellularized bovine pericardium. Glutaraldehyde-treated bovine pericardium and its extract were observed to be cytotoxic and it also caused significant inflammatory cytokine release from activated macrophages. Significant antibody response, calcification response, necrotic, and inflammatory response were noticed in glutaraldehyde-treated bovine pericardium in comparison to decellularized bovine pericardium in a rat subcutaneous implantation model. Glutaraldehyde-treated bovine pericardium also failed in acute systemic toxicity testing and intracutaneous irritation testing as per ISO 10993. With respect to healing and implant remodeling, total lack of host tissue incorporation and angiogenesis was noticed in glutaraldehyde-treated bovine pericardium compared to excellent host fibroblast incorporation and angiogenesis within the implant in decellularized bovine pericardium. In conclusion, using in vitro and in vivo techniques, this study has demonstrated that glutaraldehyde-treated bovine pericardium elicits toxic response compared to decellularized bovine pericardium which is not congenial for long-term implant performance.
RESUMO
El uso de las prótesis mecánicas y biológicas surgió de la necesidad de reemplazar quirúrgicamente la falta o la falla de un órgano. Las bioprótesis están hechas a partir de tejido autólogo, homólogo y heterólogo. La bioprótesis de pericardio bovino tratada con glutaraldehído es la más estudiada y se utiliza principalmente como bioprótesis cardiaca. Debido a su fácil preparación y uso, este material se ha empleado para reparar defectos hemiarios de la pared abdominal, la pared torácica, de diafragma y para sustituir vasos y tráquea; sin embargo, causa reacción de rechazo y tipo cuerpo extraño, los que han sido estudiados ampliamente para evitarlos. Presentamos una revisión de la literatura sobre el uso y estudio de la bioprótesis de pericardio bovino tratado con glutaraldehído.
The use of biological and mechanical prostheses arose from the need to replace a failing organ or function. Bioprostheses can be manufactured from autologous, homologus or heterologus tissue; glutaraldehyde treated bovine pericardium bioprostheses have been used extensively to repair diaphragmatic, abdominal and chest wall defects and to replace heart valves, blood vessels and tracheal segments, but the implanted tissue can elicit rejection or foreign body reaction; these have been extensively studied in order to avoid them. We review the literature regarding glutaraldehyde treated bovine pericardium bioprostheses.
