title: Innate Immunity and Biomaterials at the Nexus: Friends or Foes.
abstract: Biomaterial implants are an established part of medical practice, encompassing a broad range of devices that widely differ in function and structural composition. However, one common property amongst biomaterials is the induction of the foreign body response: an acute sterile inflammatory reaction which overlaps with tissue vascularisation and remodelling and ultimately fibrotic encapsulation of the biomaterial to prevent further interaction with host tissue. Severity and clinical manifestation of the biomaterial-induced foreign body response are different for each biomaterial, with cases of incompatibility often associated with loss of function. However, unravelling the mechanisms that progress to the formation of the fibrotic capsule highlights the tightly intertwined nature of immunological responses to a seemingly noncanonical "antigen." In this review, we detail the pathways associated with the foreign body response and describe possible mechanisms of immune involvement that can be targeted. We also discuss methods of modulating the immune response by altering the physiochemical surface properties of the biomaterial prior to implantation. Developments in these areas are reliant on reproducible and effective animal models and may allow a "combined" immunomodulatory approach of adapting surface properties of biomaterials, as well as treating key immune pathways to ultimately reduce the negative consequences of biomaterial implantation.
authors.affiliation: Experimental Therapeutics Laboratory, Sansom Institute and Hanson Institute, School of Pharmacy and Medical Science, University of South Australia, Adelaide, SA 5000, Australia.
authors.forename: Susan N
authors.initials: SN
authors.lastname: Christo
authors.affiliation: Experimental Therapeutics Laboratory, Sansom Institute and Hanson Institute, School of Pharmacy and Medical Science, University of South Australia, Adelaide, SA 5000, Australia ; Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, SA 5005, Australia.
authors.forename: Kerrilyn R
authors.initials: KR
authors.lastname: Diener
authors.affiliation: Mawson Institute, University of South Australia, Adelaide, SA 5095, Australia.
authors.forename: Akash
authors.initials: A
authors.lastname: Bachhuka
authors.affiliation: Mawson Institute, University of South Australia, Adelaide, SA 5095, Australia.
authors.forename: Krasimir
authors.initials: K
authors.lastname: Vasilev
authors.affiliation: Experimental Therapeutics Laboratory, Sansom Institute and Hanson Institute, School of Pharmacy and Medical Science, University of South Australia, Adelaide, SA 5000, Australia ; School of Medicine, University of Adelaide, Adelaide, SA 5005, Australia.
authors.forename: John D
authors.initials: JD
authors.lastname: Hayball
mesh_terms: D000818:Animals; D001672:Biocompatible Materials / Q000009:adverse effects*; D005549:Foreign-Body Reaction / Q000209:etiology* / Q000276:immunology*; D006801:Humans; D007113:Immunity, Innate / Q000187:drug effects* / Q000276:immunology*; D018448:Models, Immunological; D019736:Prostheses and Implants / Q000009:adverse effects*
chemical_list: D001672:Biocompatible Materials