title: Innate immunity activation on biomaterial surfaces: a mechanistic model and coping strategies.
abstract: When an artificial biomaterial (e.g., a stent or implantable pump) is exposed to blood, plasma proteins immediately adhere to the surface, creating a new interface between the biomaterial and the blood. The recognition proteins within the complement and contact activation/coagulation cascade systems of the blood will be bound to, or inserted into, this protein film and generate different mediators that will activate polymorphonuclear leukocytes and monocytes, as well as platelets. Under clinical conditions, the ultimate outcome of these processes may be thrombotic and inflammatory reactions, and consequently the composition and conformation of the proteins in the initial layer formed on the surface will to a large extent determine the outcome of a treatment involving the biomaterial, affecting both the functionality of the material and the patient's life quality. This review presents models of biomaterial-induced activation processes and describes various strategies to attenuate potential adverse reactions by conjugating bioactive molecules to surfaces or by introducing nanostructures.
authors.affiliation: Dept of Immunology, Genetics and Pathology (IGP), Rudbeck Laboratory C5:3, Uppsala University, SE-751 85 Uppsala, Sweden. Kristina.Nilsson_Ekdahl@igp.uu.se
authors.forename: Kristina N
authors.initials: KN
authors.lastname: Ekdahl
authors.forename: John D
authors.initials: JD
authors.lastname: Lambris
authors.forename: Hans
authors.initials: H
authors.lastname: Elwing
authors.forename: Daniel
authors.initials: D
authors.lastname: Ricklin
authors.forename: Per H
authors.initials: PH
authors.lastname: Nilsson
authors.forename: Yuji
authors.initials: Y
authors.lastname: Teramura
authors.forename: Ian A
authors.initials: IA
authors.lastname: Nicholls
authors.forename: Bo
authors.initials: B
authors.lastname: Nilsson
mesh_terms: D000818:Animals; D001672:Biocompatible Materials / Q000009:adverse effects / Q000494:pharmacology*; D003167:Complement Activation / Q000187:drug effects / Q000276:immunology*; D006801:Humans; D007113:Immunity, Innate / Q000187:drug effects / Q000276:immunology*; D018796:Immunoconjugates / Q000008:administration & dosage* / Q000276:immunology*; D018448:Models, Immunological; D049329:Nanostructures / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D001672:Biocompatible Materials; D018796:Immunoconjugates