Abstract
The perspectives of regenerative medicine are still severely hampered by the host response to biomaterial implantation, despite the robustness of technologies that hold the promise to recover the functionality of damaged organs and tissues. In this scenario, the cellular and molecular events that decide on implant success and tissue regeneration are played at the interface between the foreign body and the host inflammation, determined by innate and adaptive immune responses. To avoid adverse events, rather than the use of inert scaffolds, current state of the art points to the use of immunomodulatory biomaterials and their knowledge-based use to reduce neutrophil activation, and optimize M1 to M2 macrophage polarization, Th1 to Th2 lymphocyte switch, and Treg induction. Despite the fact that the field is still evolving and much remains to be accomplished, recent research breakthroughs have provided a broader insight on the correct choice of biomaterial physicochemical modifications to tune the reaction of the host immune system to implanted biomaterial and to favor integration and healing.
Highlights
Biomaterials play a central role in a wide variety of healthcare issues and have fostered great improvements in different biomedical fields, such as tissue engineering, medical implants, drug delivery, and immunotherapies [1,2,3,4,5]
With regards to the pro-regenerative mechanisms, M2 macrophages displaying an anti-inflammatory/anti-fibrotic phenotype contribute to regeneration through crosstalk with a subpopulation of T cells defined as regulatory (Tregs), which play an important role in tissue immune homeostasis
The innate immune system capability to monitor, recognize, and clear foreign bodies activates a response that is unaware of the therapeutic potential of implanted biomaterials; on the other hand, biomaterial possesses characteristics that “irritate” the immune system
Summary
Biomaterials play a central role in a wide variety of healthcare issues and have fostered great improvements in different biomedical fields, such as tissue engineering, medical implants, drug delivery, and immunotherapies [1,2,3,4,5]. This wide applicative potential relies on the ability of these materials to provide biocompatible supports (i.e., scaffolds, devices), to encapsulate and protect biological active products (i.e., cells, chemicals, and proteins), and to allow easy modification of chemical and physicochemical properties [5,6,7,8,9,10]. We highlight how the specific features of the different biomaterials could be exploited to control the inflammatory-immune response to implanted biomaterials and to promote tissue regeneration
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