Turkish Neurosurgery 2018 , Vol 28 , Num 4
Which is Better: Stainless Steel or Titanium Alloy?
Sibel AKYOL1,Hakan BOZKUS2,Suzan ADIN CINAR3,Mehmet Murat HANCI4,
1Istanbul University, Department of Physiology, Istanbul, Turkey
2Istanbul Bilim University, Department of Neurosurgery, Istanbul, Turkey
3Institute of Experimental Medicine, Istanbul, Turkey
4Istanbul University, Department of Neurosurgery, Istanbul, Turkey
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 in vivo and in vitro application of different biomaterials.

MATERIAL and METHODS: Wistar albino rats were used. After an exploration of the thoracolumbar paravertebral muscle tissue of the subjects, Group I underwent sham surgery, and Groups II and III underwent implantation of 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-?,TNF-? in the blood were analyzed.

RESULTS: CD4, CD25 (IL-2R), CD4+CD8+ and Tregs levels were lower in Group III compared to Group I (sham) and Group II. IL-6, IL-17A, TGF-? and TNF-? levels in Group III showed a significant increase on all days in comparison with Group I and Group II. IL-4 and IL-10 levels were lower in Group III than those in Group II; and a significant decrease was observed in the IL-10 level. There was a reduction in IL-6 and IL-17A levels in Group II as opposed to Group I.

CONCLUSION: As opposed to SS alloy, Ti alloy suppresses the development of inflammation by inhibiting the pro-inflammatory 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. Keywords : Immune system, Implant, Stainless steel, Titanium

Corresponding author : Sibel AKYOL, 2015sibelakyol@gmail.com