The link between surgical mesh implants and auto immune diseases needs studying, says leading Canadian professor

Professor Jan Willem Cohen Tervaert

Professor Jan Willem Cohen Tervaert - Credit: Archant

A leading professor from Canada is calling for large scale studies into the link between mesh and autoimmune diseases.

People are frustrated because doctors say there is no evidence that their symptoms are due to their implanted mesh, so this problem should be scientifically studied, he said.

Jan Willem Cohen Tervaert, director of rheumatology at the University of Alberta, Canada and professor of medicine and immunology in the Netherlands, said: “Many patients who have had mesh for hernia or gynaecological repair are convinced that their mesh has caused them to make them ill, yet in medical literature there’s no large scale studies to prove it.

“Doctors say it’s a chance occurrence and generally believe there’s not much that can be done for these patients, yet many suffer terribly.”

Professor Cohen Tervaert was the first to report the link between mesh implants and autoimmune disease when he spoke at the 11th International Conference on Autoimmunity in Lisbon this year.

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He reported a study in 40 patients with mesh that developed symptoms such as chronic fatigue, cognitive impairment known as “brain fog”, muscle and joint pain “fibromyalgia”, feverish temperature, and dry eyes and dry mouth.

In addition, 45 per cent of the patients developed an autoimmune disease.

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He postulates that the mesh acts as an adjuvant, a substance that accelerates or enhances an immune response.

He said: “If you have a genetic pre disposition to develop an autoimmune disease then an implant like mesh will increase your risk.

“For example if you were likely to get an autoimmune disease at the age of 100, having any bio material implant would cause that you get the disease at an earlier age, for instance at the age of 40 “.

“The disease may also be more pronounced, more severe. But there is always a genetic factor in the first place.”

“It’s a similar situation as with the breast implants where we and others have performed large scale studies to prove the relation between implants and the increased risk to develop an autoimmune disease“ he said.

“If you implant a foreign body in a human you get an inflammatory reaction with leukocytes, giant cells, and fibrosis,” he said.

“This inflammatory reaction has been proven in animal models to cause an adjuvant response.”

In his study of patients with autoimmune diseases that developed after mesh implantation, Professor Tervaert found that eight out of ten patients had allergies before mesh was implanted.

So, people with allergies to things like house dust, pets, nickel or hay fever, are at significantly higher risk to develop symptoms after a mesh implantation, he says, so should be warned before having a mesh implant.

Also many patients had abdominal pain or IBS, his study finds.

“In a previous study in breast implant patients we found that people with implants are three times more likely to have symptoms like fatigue, fibromyalgia and brain fog than in the general population. Whether this is also true for mesh implants is, however, not yet studied “.

Professor Cohen Tervaert added that the mesh may be oxidised once permanently placed in the body resulting in a decrease in mechanical properties of the mesh.

“If you have an inflammatory response, that means those inflammatory cells “produce” oxygen and attack the plastic!“

How doctors perceive patients with mesh related problems may change in the nearby future.

He said: “It’s the same as with smoking. It’s now OK to say smoking is bad for you, where once it wasn’t. Same with mesh. Right now many do not believe that it can trigger autoimmune disease, but as more studies are published I believe that the situation will change.”

• Professor Jan Willem Cohen Tervaert is a professor at the University of Alberta in Canada. He is a founding member of the Autoimmunity Consortium and a former chairman of the scientific advisory board of the Dutch Arthritis Foundation and a former advisor to the Dutch Minister of Health. His fields of interest are inflammation and autoimmunity disorders such as vasculitis.

• The aim in patients with mesh related disease is to regulate the immune system. High dose vitamin D may help. Also, certain foods can help the immune system to be better regulated, he said. Reducing salt is important. Also foods known for their anti inflammatory properties may be beneficial. Such foods include spicy foods like peppers. Other foods which may work to reduce inflammation are fish oil high in Omega 3, turmeric, chocolate, blueberries and grape skin.


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