Major Melanie R, Wong Victor W, Nelson Emily R, Longaker Michael T, Gurtner Geoffrey C
Baltimore, Md.; and Stanford, Calif. From the Departments of Plastic and Reconstructive Surgery and Pathology, Johns Hopkins Medical Institutions; and the Division of Plastic Surgery, Department of Surgery, Stanford University.
Plast Reconstr Surg. 2015 May;135(5):1489-1498. doi: 10.1097/PRS.0000000000001193.
The surgical implantation of materials and devices has dramatically increased over the past decade. This trend is expected to continue with the broadening application of biomaterials and rapid expansion of aging populations. One major factor that limits the potential of implantable materials and devices is the foreign body response, an immunologic reaction characterized by chronic inflammation, foreign body giant cell formation, and fibrotic capsule formation.
The English literature on the foreign body response to implanted materials and devices is reviewed.
Fibrotic encapsulation can cause device malfunction and dramatically limit the function of an implanted medical device or material. Basic science studies suggest a role for immune and inflammatory pathways at the implant-host interface that drive the foreign body response. Current strategies that aim to modulate the host response and improve construct biocompatibility appear promising.
This review article summarizes recent basic science, preclinical, and clinicopathologic studies examining the mechanisms driving the foreign body response, with particular focus on breast implants and synthetic meshes. Understanding these molecular and cellular mechanisms will be critical for achieving the full potential of implanted biomaterials to restore human tissues and organs.
在过去十年中，材料和器械的外科植入显著增加。随着生物材料应用的不断拓展以及老龄人口的迅速增长，这一趋势预计将持续下去。限制可植入材料和器械潜力的一个主要因素是异物反应，这是一种以慢性炎症、异物巨细胞形成和纤维化包膜形成为特征的免疫反应。
对关于植入材料和器械异物反应的英文文献进行综述。
纤维化包封可导致器械故障，并极大地限制植入式医疗器械或材料的功能。基础科学研究表明，在植入物与宿主界面处，免疫和炎症途径在驱动异物反应中发挥作用。目前旨在调节宿主反应并提高构建体生物相容性的策略似乎很有前景。
这篇综述文章总结了最近关于驱动异物反应机制的基础科学、临床前和临床病理学研究，特别关注乳房植入物和合成网片。了解这些分子和细胞机制对于充分发挥植入生物材料修复人体组织和器官的潜力至关重要。
