Macrophage responses to implants: prospects for personalized medicine

[摘要] Implants,transplants,andimplantablebiomedicaldevicesaremainstreamsolutionsforawidevarietyofhumanpathologies.Oneofthepersistentproblemsaroundnondegradablemetallicandpolymericimplantsisfailureofmacrophagestoresolvetheinflammationandtheirtendencytostayinastate,named“frustratedphagocytosis.”Duringtheinitialphase,proinflammatorymacrophagesinduceacutereactionstotraumaandforeignmaterials,whereastolerogenicanti‐inflammatorymacrophagescontrolresolutionofinflammationandinducethesubsequenthealingstage.However,implantedmaterialscaninduceamixedpro/anti‐inflammatoryphenotype,supportingchronicinflammatoryreactionsaccompaniedbymicrobialcontaminationandresultinginimplantfailure.Severalmaterialsbasedonnaturalpolymersforimprovedinteractionwithhosttissueorsurfacesthatreleaseanti‐inflammatorydrugs/bioactiveagentshavebeendevelopedforimplantcoatingtoreduceimplantrejection.However,nodefinitive,long‐termsolutiontoavoidadverseimmuneresponsestotheimplantedmaterialsisavailabletodate.Thepreventionofimplant‐associatedinfectionsorchronicinflammationbymanipulatingthemacrophagephenotypeisapromisingstrategytoimproveimplantacceptance.Theimmunomodulatorypropertiesofcurrentlyavailableimplantcoatingsneedtobeimprovedtodeveloppersonalizedtherapeuticsolutions.Humanprimarymacrophagesexposedtotheimplantablematerialsexvivocanbeusedtopredicttheindividual'sreactionsandallowselectionofanoptimalcoatingcomposition.Ourreviewdescribescurrentunderstandingofthemechanismsofmacrophageinteractionswithimplantablematerialsandoutlinestheprospectsforuseofhumanprimarymacrophagesfordiagnosticandtherapeuticapproachestopersonalizedimplanttherapy...

[学科分类] 生理学

[关键词] cytokine;biomarker;biomaterial;titanium;coating