CSIRO Manufacturing, Research Way, Clayton 3168, Victoria, Australia; La Trobe Institute for Molecular Science, La Trobe University, Kingsbury Drive, Bundoora 3086, Victoria, Australia.
CSIRO Manufacturing, Research Way, Clayton 3168, Victoria, Australia; La Trobe Institute for Molecular Science, La Trobe University, Kingsbury Drive, Bundoora 3086, Victoria, Australia; Monash Institute of Pharmaceutical Sciences, Monash University, Royal Parade, Parkville 3052, Victoria, Australia; School of Pharmacy, The University of Nottingham, Nottingham NG7 2RD, United Kingdom.
Adv Drug Deliv Rev. 2020 Dec;167:109-120. doi: 10.1016/j.addr.2020.06.008. Epub 2020 Jun 15.
A broad range of medical devices initiate an immune reaction known as the foreign body response (FBR) upon implantation. Here, collagen deposition at the surface of the implant occurs as a result of the FBR, ultimately leading to fibrous encapsulation and, in many cases, reduced function or failure of the device. Despite significant efforts, the prevention of fibrotic encapsulation has not been realized at this point in time. However, many next-generation medical technologies including cellular therapies, sensors and devices depend on the ability to modulate and control the FBR. For these technologies to become viable, significant advances must be made in understanding the underlying mechanism of this response as well as in the methods modulating this response. In this review, we highlight recent advances in the development of materials and coatings providing a reduced FBR and emphasize key characteristics of high-performing approaches. We also provide a detailed overview of the state-of-the-art in strategies relying on controlled drug release, the surface display of bioactive signals, materials-based approaches, and combinations of these approaches. Finally, we offer perspectives on future directions in this field.
在植入后，广泛的医疗器械会引发一种被称为异物反应（FBR）的免疫反应。在这里，由于 FBR，在植入物表面会发生胶原蛋白沉积，最终导致纤维囊形成，并且在许多情况下，器械的功能降低或失效。尽管付出了巨大的努力，但在现阶段还没有实现对纤维囊形成的预防。然而，许多下一代医疗技术，包括细胞疗法、传感器和器械，都依赖于调节和控制 FBR 的能力。为了使这些技术成为可行的，必须在理解这种反应的潜在机制以及调节这种反应的方法方面取得重大进展。在这篇综述中，我们重点介绍了在开发提供降低 FBR 的材料和涂层方面的最新进展，并强调了高性能方法的关键特性。我们还详细概述了依赖于控制药物释放、生物活性信号的表面展示、基于材料的方法以及这些方法的组合的最新策略。最后，我们对该领域的未来方向提出了展望。
