The Effects of Botulinum Toxin Type A on the Biological Behavior of Fibroblasts on Silicone Implants

Background: Capsular contracture is one of the most severe complications following breast augmentation surgery. It has been reported that botulinum toxin Type A (BTX-A) can inhibit capsular contracture, but the exact mechanisms remain unclear. Therefore, this study aims to explore the potential mechanisms behind BTX-A's inhibition of capsular contracture by observing its effects on the biological behavior of fibroblasts and its impact on the TGF-β/Smad signaling pathway.

Methods: In vitro experiments involved culturing fibroblasts on PDMS surfaces, subsequently treating them with various concentrations of BTX-A. Fibroblast proliferation activity was assessed using the CCK-8 assay, while the migration and cytoskeletal morphology of the fibroblasts were meticulously examined. ELISA was utilized to quantify the expression of fibrosis-related cytokines. Gene and protein expressions related to the TGF-β/Smad pathway were analyzed through real-time PCR and Western blotting techniques.

Results: BTX-A moderately enhanced the early proliferation and migration of fibroblasts on the surface of PDMS silicone sheets and reduced the synthesis of collagen types I and III. Furthermore, under the influence of BTX-A, the expression of TGF-βR2 and α-SMA in the TGF-β/Smad pathway was significantly inhibited.

Conclusions: This study demonstrates that BTX-A can inhibit fibroblast differentiation by downregulating the expression of TGF-βR2, thereby suppressing the TGF-β/Smad pathway. This suggests a possible mechanism through which BTX-A mitigates capsular contracture.

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