Regulatory strategies for foreign body reactions in biomaterials
叶超 1刘晓红1
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作者信息
1. 海军军医大学附属长海医院心血管外科,上海市 200433
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摘要
背景:生物材料植入体内后引发的异物反应会导致其被纤维组织包裹,阻碍植入物与宿主组织的相互作用,损害植入物的功能,进而缩短其寿命.目的:重点讨论生物材料异物反应的调控策略进展,包括基于生物材料表面改性、药物递送和仿生表面修饰的策略,同时探讨了这些方法的优势和局限性.方法:应用计算机在PubMed、Wiley、EBSCOhost、ScienceDirect和Elsevier数据库检索2000年1月至2024年3月期间的相关文献,以"biological materials,foreign body reaction,fibrosis,macrophage,myofibroblasts,inflammation,regulation,tissue repair"为检索词,最终纳入69篇文献进行分析.结果与结论:通过调整生物材料的表面特性(例如尺寸、形状、粗糙度、表面电荷、亲水性以及机械刚度等)能够减轻其对免疫系统的刺激,进而降低发生异物反应的风险;通过可控量的药物刺激产生持久的化学反应,结合使用可控降解的载体材料,可以减轻异物反应;生物材料仿生表面修饰(如两性离子涂层、蛋白质分子涂层等生物活性分子涂层)在短期能有效减轻异物反应.由于植入物和组织再生的免疫反应具有复杂性,在设计和制造植入物时也应考虑异物反应和组织再生之间的整体平衡.
Abstract
BACKGROUND:The foreign body reaction induced by the implantation of biomaterials can lead to encapsulation in fibrous tissue,impede the interaction between the implant and host tissue,compromise implant functionality,and reduce its lifespan.OBJECTIVE:To focus on the development of regulatory strategies for foreign body reactions in biomaterials,including strategies based on surface modification of biomaterials,drug delivery and biomimetic surface modification and discuss the advantages and limitations of these methods.METHODS:The relevant articles published from January 2000 to March 2024 were searched on PubMed,Wiley,EBSCOhost,ScienceDirect,and Elsevier databases using search terms"biological materials,foreign body reaction,fibrosis,macrophage,myofibroblasts,inflammation,regulation,tissue repair."Finally,69 articles were included for further analysis.RESULTS AND CONCLUSION:By modifying the surface characteristics of biomaterials,such as size,shape,roughness,surface charge,hydrophilicity,and mechanical stiffness,it is possible to mitigate immune system stimulation and reduce the risk of foreign body reaction.Controlled drug stimulation combined with controlled degradation of carrier materials can generate sustained chemical reactions that effectively minimize foreign body reaction.Biomimetic surface modification techniques like zwitterion coating,protein molecular coating,and other bioactive molecular coatings have been shown to significantly decrease short-term foreign body reaction.Due to the complexity of the immune response to implants and tissue regeneration,the overall balance between foreign body reaction and tissue regeneration should also be considered when designing and manufacturing implants.
关键词
生物材料/异物反应/纤维化/巨噬细胞/肌成纤维细胞/炎症/调控/组织修复
Key words
biomaterial/foreign body reaction/fibrosis/macrophage/myofibroblasts/inflammation/regulation/tissue repair
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