Host Biologic Response to Acellular Dermal Matrices of Human and Porcine Origin

Abstract Background Acellular dermal matrices (ADMs) originate from various tissues and are manufactured by different processes, which can influence material properties that affect host response upon implantation. Objectives The aim of the study was to compare material properties and host responses to ADMs derived from human or porcine dermis. Methods The morphology of commercially available ADMs (human-derived AlloDerm [hADM], porcine-derived Strattice Pliable [pADM-S], and porcine-derived Artia [pADM-A]) was evaluated through bright-field and scanning electron microscopy and compared with unprocessed human and porcine dermis. Collagen melting temperatures were assessed through differential scanning calorimetry. Host responses to ADMs were assessed in rat (pADM-A and pADM-S) and nonhuman primate (NHP) models (pADM-A, pADM-S, and hADM). Histologic responses were evaluated for inflammation, fibroblast infiltration, and revascularization. Results Morphologically, the extracellular matrix structures of hADM, pADM-A, and native human dermis were similarly loose, whereas the structures of pADM-S and native porcine dermis were tighter. Collagen melting temperatures were similar across all samples. Following 20 h exposure to collagenase enzyme, hADM retained the most undigested collagen, followed by pADM-A, then pADM-S. Following 2 and 4 weeks of implantation in the rodent and NHP models, pADM-A yielded the most favorable host response with ample cell infiltration, vascularization, and minimal inflammation vs other implanted ADMs. Minimal-to-moderate inflammatory responses were observed for all materials; hADM and pADM-A demonstrated the lowest responses. Conclusions In both short-term preclinical implantation models, comparable morphologies and biochemistry of pADM-A and hADM allowed for similarly favorable host responses vs pADM-S. All ADMs assessed demonstrated responses consistent with a favorable regenerative mechanism of action. Level of Evidence: 4 (Therapeutic)