Turkish Neurosurgery
Which is better Stainless Steel or Titanium alloy?
Sibel Akyol1, Hakan Bozkus2, Suzan Adin Cinar3, Mehmet Murat Hanci4
1University of Istanbul, Physiology, Istanbul,
2American Hospital, Neurosurgery, Istanbul,
3University of Istanbul, Institute of Experimental Medicine, Istanbul,
4University of Istanbul, Neurosurgery, Istanbul,
DOI: 10.5137/1019-5149.JTN.19061-17.1

Aim:To investigate immunologic reactions after implantation of stainless steel (SS) alloy and titanium (Ti) alloy in a rat model. Macrophage and cytokine responses have been reported after the in vivo and in vitro application of different biomaterials. Material and Methods:Wistar albino rats after an exploration of the thoracolumbar paravertebral muscle tissue of the subjects, group I underwent a sham surgery, and groups II and III were implanted Ti alloy and SS alloy rods respectively. The CD4, CD8, CD25 (IL-2R) (lymphocyte and CD4 gate), CD4+CD8+ and CD4+CD25+Foxp3+ (Tregs), IL-4, IL-10, IL-6, IL-17A, TGF-β, TNF-α in the blood were analyzed.Results:CD4, CD25 (IL-2R), CD4+CD8+ and Tregs levels were lower in the Group III compared to the sham and Group IIs. IL-6, IL-17A, TGF-β and TNF-α levels in the G III showed a significant increase on all days in comparison with the sham and Group II. IL-4 and IL-10 levels, were lower in the Group III than those in the Group II; and a significant decrease was observed in the IL-10 level. While there was a reduction in IL-6 and IL-17A levels in the Group II as opposed to the sham group.Conclusion:As opposed to SS alloy, Ti alloy suppresses the development of inflammations by inhibiting proinflammatory response; strengthens the humoral immune system by intensifying the antibody-dependent immune response; triggers the development of immune tolerance by regulating the immune response; and activates the mechanism that prevents immune response-related damage from occurring.

Corresponding author : Sibel Akyol