Official websites use. Share sensitive information only on official, secure websites. Corresponding Author: James M. Anderson, M. The foreign body reaction composed of macrophages and foreign body giant cells is the end-stage response of the inflammatory and wound healing responses following implantation of a medical device, prosthesis, or biomaterial. A brief, focused overview of events leading to the foreign body reaction is presented. The major focus of this review is on factors that modulate the interaction of macrophages and foreign body giant cells on synthetic surfaces where the chemical, physical, and morphological characteristics of the synthetic surface are considered to play a role in modulating cellular events.
An understanding of the foreign body reaction is important as the foreign body reaction may impact the biocompatibility safety of the medical device, prosthesis, or implanted biomaterial and may significantly impact short- and long-term tissue responses with tissue-engineered constructs containing proteins, cells, and other biological components for use in tissue engineering and regenerative medicine.
Our perspective has been on the inflammatory and wound healing response to implanted materials, devices, and tissue-engineered constructs. The incorporation of biological components of allogeneic or xenogeneic origin as well as stem cells into tissue-engineered or regenerative approaches opens up a myriad of other challenges.
An in depth understanding of how the immune system interacts with these cells and how biomaterials or tissue-engineered constructs influences these interactions may prove pivotal to the safety, biocompatibility, and function of the device or system under consideration. 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 that 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.
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Obviously, protein adsorption and fibrin-predominant provisional matrix formation are intimately linked in their mechanistic responses. The injury to vascularized connective tissue not only initiates the inflammatory responses innate immunity , it also leads to thrombus formation involving activation of the extrinsic and intrinsic coagulation systems, the complement system, the fibrinolytic system, the kinin-generating system, and platelets. These protein cascades may be intimately involved in the dynamic phenomenon of protein adsorption and desorption that is known as the Vroman Effect.
