ReviewForeign body reaction to biomaterials
Section snippets
Introduction: inflammatory response following material implantation
The perspective of this review originates from our long-standing clinical implant retrieval and evaluation program in the Department of Pathology at the University Hospitals of Cleveland. Simply put, our perspective is derived from surgical pathology and the identification of inflammatory and wound healing responses as opposed to an immunology perspective, which focuses on innate and adaptive immunity. The consistent diagnosis of the foreign body reaction with macrophages and foreign body giant
Adsorption of plasma proteins
Biomaterials and medical devices immediately and spontaneously acquire a layer of host proteins prior to interacting with host cells. Thus, it is highly probable that the types, levels, and surface conformations of the adsorbed proteins are critical determinants of the tissue reaction to such implants [10]. Conversely, the types, concentrations, and conformations of these surface-adsorbed proteins are dependent on biomaterial surface properties that dictate the adhesion and survival of cells,
Macrophage activation and cytokine secretion
Macrophages secrete an array of inflammatory mediators following activation. A resting macrophage becomes activated in response to microbial products, immune complexes, chemical mediators, certain extracellular matrix proteins, and T lymphocyte-derived cytokines. Activated macrophages are capable of secreting a wide range of cytokines such as IL-1, IL-6, IL-10, IL-12, IL-18, TNF-α, TGF-β, IL-8, MCP-1, and MIP-1α/β [101]. Adherent macrophages on biomaterials become activated in an attempt to
Conclusions
The development of novel biomaterials, biomedical devices, or tissue-engineered constructs necessitates a thorough understanding of the biological responses to implanted materials. Once a biomaterial is introduced into the body, a sequence of events occurs in the surrounding tissue and ultimately ends in the formation of foreign body giant cells at the tissue/material interface. The consequences of the reaction to the material surface can be devastating. Our laboratory has focused on gaining a
Acknowledgements
We acknowledge the support from the National Institute of Health and the National Institute of Biomedical Imaging and Bioengineering (EB-000275, EB-000282, and T32 GM07250).
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All authors contributed equally to the preparation of this review.