Abstract
The present study evaluated the tissue response toward a resorbable collagen membrane derived from bovine achilles tendon (test group) in comparison to physiological wound healing (control group). After subcutaneous implantation in Wistar rats over 30 days, histochemical and immunohistochemical methods elucidated the cellular inflammatory response, vascularization pattern, membrane protein and cell absorbance capacity. After 30 days, the test-group induced two different inflammatory patterns. On the membrane surface, multinucleated giant cells (MNGCs) were formed after the accumulation of CD-68-positive cells (macrophages), whereas only mononuclear cells (MNCs) were found within the membrane central region. Peri-implant vascularization was significantly enhanced after the formation of MNGCs. No vessels were found within the central region of the membrane. Physiological wound healing revealed no MNGCs at any time point. These dynamic changes in the cellular reaction and vascularization within the test-group are related typical indications of a foreign body reaction. Due to the membrane-specific porosity, mononuclear cells migrated into the central region, and the membrane maintained its integrity over 30 days by showing no breakdown or disintegration. The ex vivo investigation analyzed the interaction between the membrane and a blood concentrate system, liquid platelet-rich fibrin (liquid PRF), derived from human peripheral blood and consisting of platelets, leukocytes and fibrin. PRF penetrated the membrane after just 15 min. The data question the role of biomaterial-induced MNGCs as a pathological reaction and whether this is acceptable to trigger vascularization or should be considered as an adverse reaction. Therefore, further pre-clinical and clinical studies are needed to identify the types of MNGCs that are induced by clinically approved biomaterials.
Highlights
The biomaterial physicochemical properties play a major role in induced cellular reactions (Ghanaati et al, 2012)
The mid-term cellular reaction on day 10 was characterized by a high number of macrophages (CD-68-positive) on the membrane surface, reflecting a significant increase in their number compared the number of macrophages observed on day 3
The present results showed that the occurrence of multinucleated giant cells (MNGCs) is induced by the implanted biomaterial, no MNGCs were observed within the control group, which simulated physiological wound healing
Summary
The biomaterial physicochemical properties play a major role in induced cellular reactions (Ghanaati et al, 2012). Natural biomaterials e.g., allogeneic and xenogeneic biomaterials are mostly derived from a particular region of the donor body without de novo synthesis (Ghanaati et al, 2011) Thereby, these materials undergo strict processing using different chemical and physical methods to reach an adequate state of purification and deactivation of potential pathogens and donor-cells, which may affect the native structure (Ghanaati et al, 2014). In this sense, the resultant structure and surface characteristics of natural biomaterials depend on the donor tissues and the processing techniques used for their purification (Al-Maawi et al, 2017). Different in vitro and in vivo models are utilized to understand the patterns of inflammatory responses to biomaterials and assess their biocompatibility and potential adverse reactions
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