Engineering biomaterials to integrate and heal: The biocompatibility paradigm shifts

• Published in: Biotechnology and bioengineering Vol. 109; no. 8; pp. 1898 - 1911
• Main Authors: Bryers, James D., Giachelli, Cecilia M., Ratner, Buddy D.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.08.2012; Wiley Subscription Services, Inc
• Subjects: Biocompatibility; Biocompatible Materials - chemistry; Bioengineering; Biomedical materials; Failure; foreign body response; Foreign-Body Reaction - prevention & control; macrophage phenotype; Prostheses and Implants; tissue regeneration; Wound healing
• ISSN: 0006-3592; 1097-0290
• DOI: 10.1002/bit.24559

This article focuses on one of the major failure routes of implanted medical devices, the foreign body reaction (FBR)—that is, the phagocytic attack and encapsulation by the body of the so‐called “biocompatible” biomaterials comprising the devices. We then review strategies currently under development that might lead to biomaterial constructs that will harmoniously heal and integrate into the body. We discuss in detail emerging strategies to inhibit the FBR by engineering biomaterials that elicit more biologically pertinent responses. Biotechnol. Bioeng. 2012; 109:1898–1911. © 2012 Wiley Periodicals, Inc. Porous templated scaffolds (PTSs) are polymer constructs where each pore is exactly the same size, and pore interconnects are also uniform in size; with both parameters being adjustable. Consistently, the 30–40 µm dia. pore size PTS shows excellent healing, regardless of polymer composition or implant site. Hypothetically, the large numbers of macrophage observed in the 35‐µm PTS are being directed toward the M2 (regenerative) phenotype. Growing circumstantial evidence suggests the controversial possibility that macrophage transdifferentiate into implant site‐specific tissue cells.