title: Multinucleated giant cells in the implant bed of bone substitutes are foreign body giant cells-New insights into the material-mediated healing process.
abstract: In addition to macrophages, multinucleated giant cells (MNGCs) are involved in the tissue reaction to a variety of biomaterials. Especially in the case of bone substitute materials it has been assumed that the MNGCs are osteoclasts, based on the chemical and physical similarity of many materials to the calcified matrix and the bony environment in which they are used. However, many studies indicate that these cells belong to the cell line of the foreign body giant cells (FBGCs), which are of "inflammatory origin", although they have been shown to possess both a pro- and also anti-inflammatory phenotype. Moreover, no information is available about their role in the tissue reaction to bone substitute materials. The present study was conducted to analyze the origin of MNGCs in the implant beds of a synthetic and a xenogeneic bone substitute and focused on the application of immunohistochemical methods. Two antibodies against integrin molecules specific for osteoclasts (β-3 integrin) or FBGCs (β-2 integrin) were used to distinguish both giant cell types. The results of the present study indicate that the MNGCs induced by both kinds of bone substitutes are FBGCs, as they express only β-2 integrin in contrast to the osteoclasts outside of the immediate implantation areas, which only demonstrate β-3 integrin expression. These data give new insight into the tissue reaction to both xenogeneic and synthetic bone substitutes. Based on this new knowledge further research concerning the proteomic profile of the FBGCs especially based on the different physicochemical properties of bone substitutes is necessary. This may show that specific characteristics of bone substitutes may exhibit a substantial influence on the regeneration process via the expression of anti-inflammatory molecules by FBGCs. Based on this information it may be possible to formulate and choose bone substitutes that can guide the process of bone tissue regeneration on the molecular level. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 1105-1111, 2017.
authors.affiliation: Private office, Berlin, Germany.
authors.forename: Mike
authors.identifier: 0000-0002-3001-1347
authors.initials: M
authors.lastname: Barbeck
authors.affiliation: Clinic for Oro-Maxillofacial and Plastic Surgery, FORM-Lab, University Medical Center of the Goethe University, Frankfurt, Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Booms
authors.affiliation: Institute of Pathology, Repair-Lab, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
authors.forename: Ronald
authors.initials: R
authors.lastname: Unger
authors.affiliation: Clinic for Oro-Maxillofacial and Plastic Surgery, FORM-Lab, University Medical Center of the Goethe University, Frankfurt, Germany.
authors.forename: Verena
authors.initials: V
authors.lastname: Hoffmann
authors.affiliation: Clinic for Oro-Maxillofacial and Plastic Surgery, FORM-Lab, University Medical Center of the Goethe University, Frankfurt, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Sader
authors.affiliation: Clinic for Oro-Maxillofacial and Plastic Surgery, FORM-Lab, University Medical Center of the Goethe University, Frankfurt, Germany.
authors.forename: Charles James
authors.initials: CJ
authors.lastname: Kirkpatrick
authors.affiliation: Clinic for Oro-Maxillofacial and Plastic Surgery, FORM-Lab, University Medical Center of the Goethe University, Frankfurt, Germany.
authors.forename: Shahram
authors.initials: S
authors.lastname: Ghanaati
mesh_terms: D018786:Bone Substitutes / Q000009:adverse effects*; D015921:Dental Implants / Q000009:adverse effects*; D015743:Giant Cells, Foreign-Body / Q000378:metabolism* / Q000473:pathology*; D006801:Humans
chemical_list: D018786:Bone Substitutes; D015921:Dental Implants
keywords: bone substitutes; foreign body giant cell; inflammation; tissue reaction; tissue regeneration