Abstract
Biology ubiquitously uses molecular recognition and specificity to do its work. In contrast, the biomaterials widely used in medicine today non-specifically adsorb complex protein mixtures to their surfaces. These ill-defined protein layers are “read” by the cells (neutrophils, macrophages) that interrogate the implanted materials - the protein coat may be the trigger of subsequent biological reactions. Given the heterogeneity in composition (there are 200+ proteins in blood) and organization (proteins are adsorbed with no control of orientation or conformation) of adsorbed protein layers, it is no surprise that biological reactions, particularly in vivo, are poorly controlled. If fact, implanted synthetic materials are almost universally seen by the body as foreign objects and walled off into a tough, avascular, collagenous bag1.
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