Role of TRPV4 mechanosensing in foreign body response and giant cell formation

Abstract

Implantable biomaterials and medical devices are used in millions of procedures each year worldwide. However, the implantation of these devices leads to the development of a foreign body response (FBR), a chronic inflammatory condition that can ultimately lead to implant failure, which may cause harm to or death of the patient. Despite decades of research, the mechanisms underlying the FBR remain poorly understood, as neither the materials from which these implants are made nor their chemical properties can explain triggering of the FBR. Hallmarks of the FBR include activation of macrophages at the tissue‐implant interface, formation of destructive foreign body giant cells (FBGCs), and development of fibrous tissue that encapsulates the implant. Here, we report that genetic ablation of TRPV4, an ion channel in the transient receptor potential vanilloid family, and which is a mechanosensor, is possibly the mediator of FBR. Specifically, we found that: 1) Trpv4 deletion in mice prevented macrophage accumulation, FBGC formation, and collagen accumulation in a subcutaneous implantation model; 2) the severity of the in vivo macrophage accumulation at the tissue‐implant interface was dependent on the stiffness of the implant; 3) genetic ablation of TRPV4 blocked macrophage adhesion and spreading on stiff matrix in bone marrow derived macrophages; and 4) genetic deficiency of TRPV4 blocked cytokine‐induced FBGC formation, which was restored by lentivirus‐mediated TRPV4 reintroduction. Furthermore, we found that: 5) TRPV4 activity (calcium influx) was augmented in response to a biomechanical stimulus; and 6) loss of TRPV4 activity reduced internal stiffness in macrophages as determined by Atomic Force Microscopy analysis. Taken together, these results suggest an important, previously unknown role for TRPV4 in FBR and giant cell formation.Support or Funding InformationFunding: This work was supported by NIH (1R01EB024556‐01) and NSF (CMMI‐1662776) grants to Shaik O. Rahaman.