Bacterial Biofilms Associated with Breast Implant Illness

The ASERF Scientific Research Committee and Board of Directors are pleased to announce the following grant award: Researcher: Mithun Sinha , PhD Grant Award: ASERF Interim Grant Amount Awarded: $23,110 Project Name: Bacterial Biofilms Associated with Breast Implant Illness Project Summary: More than 330,000 women in US undergo breast implant augmentation surgeries every year. In recent years, a number of patients have self-described a constellation of symptoms that they believe are related to their breast implants. These patients have given this constellation of symptoms they believe to be directly related to their implants the name Breast Implant Illness (BII). The symptoms described are numerous but generally include symptoms typical of fibromyalgia, chronic fatigue and a host of other symptoms often associated with autoimmune illnesses. Generally, the causation of these symptoms are ascribed to the implants. An ever-increasing number of patients are seeking to have their implants removed.   These conditions have been attributed to the type and material of the implant. The FDA has conducted multiple studies and have found silicone implants to be safe. Still, the patient reported symptoms are on the rise. Recently, in March 2019, the FDA held a panel hearing specifically to address the rising concerns for reast implant associated illness. It is to be noted that bacterial biofilms have been reported around breast implants. Bacterial biofilms are resistant to the host immune system due to the presence of extra polymeric substance (EPS). The low level of inflammation by bacterial biofilms have been implicated to cause cancer (gastric cancer by Helicobacter pylori). We propose that occult peri-implant Pseudomonas biofilms present around the capsule secrete an enzyme acting on the adipose tissue to form oxylipins. Since the introduction of silicone breast implants in the nineteen sixties several issues have been raised regarding their safety. Silicone as a biomaterial is inert but time and again studies have been conducted to determine their long term effects. Bacterial biofilms associated with implants have not been well studied in context of implant associated illness. Gram negative Pseudomonas aeruginosa is a commonly identified pathogen associated with breast implant infection(1). The species is also one of the most robust biofilm formers(2). Pseudomonas aeruginosa (PA) interacts with host biomolecules and such interactions are critical toward the formation of biofilm(3). Breast parenchyma is comprised of both glandular and adipose tissue; breast adipose is rich in oleic acids. Oleic acids oxidized derivatives have been recently reported to facilitate the formation of biofilms in vitro(4).  Pseudomonas expresses fatty acid di-oxygenase (DOX) enzyme. DOX catalyzes oleic acid to oxylipins, 10-HOME and 7,10-DiHOME(4)