Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford, California, USA.
Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California, USA.
Adv Wound Care (New Rochelle). 2023 Feb;12(2):85-96. doi: 10.1089/wound.2022.0066. Epub 2022 Aug 22.
Foreign body response (FBR), wherein a fibrotic capsule forms around an implanted structure, is a common surgical complication that often leads to pain, discomfort, and eventual revision surgeries. Although believed to have some mechanistic overlap with normal wound healing, much remains to be discovered about the specific mechanism by which this occurs. Current understanding of FBR has focused on the roles of the immune system and the biomaterial, both major contributors to FBR. However, another key player, the fibroblast, is often overlooked. This review summarizes key contributors of FBR, focusing on the roles of fibroblasts. As much remains to be discovered about fibroblasts' specific roles in FBR, we draw on current knowledge of fibroblast subpopulations and functions during wound healing. We also provide an overview on candidate biomaterials and signaling pathways involved in FBR. While the global implantable medical devices market is considerable and continues to appreciate in value, FBR remains one of the most common surgical implant complications. In parallel with the continued development of candidate biomaterials, further exploration of potential fibroblast subpopulations at a transcriptional level would provide key insights into further understanding the underlying mechanisms by which fibrous encapsulation occurs, and unveil novel directions for antifibrotic and regenerative therapies in the future.
异物反应（FBR），即在植入物周围形成纤维囊，是一种常见的手术并发症，常导致疼痛、不适，最终需要进行翻修手术。虽然人们认为它与正常的伤口愈合有一定的机制重叠，但对于导致这种情况的确切机制仍有很多需要发现。目前对 FBR 的理解主要集中在免疫系统和生物材料的作用上，这两者都是 FBR 的主要贡献者。然而，另一个关键角色——成纤维细胞，通常被忽视。这篇综述总结了 FBR 的主要贡献者，重点介绍了成纤维细胞的作用。由于人们对成纤维细胞在 FBR 中的具体作用仍有很多需要发现，我们借鉴了目前关于成纤维细胞亚群及其在伤口愈合过程中的功能的知识。我们还概述了与 FBR 相关的候选生物材料和信号通路。虽然全球可植入医疗器械市场规模相当大且价值不断增长，但 FBR 仍然是最常见的手术植入物并发症之一。随着候选生物材料的不断发展，进一步在转录水平上探索潜在的成纤维细胞亚群，将为进一步了解纤维囊形成的潜在机制提供关键见解，并为未来的抗纤维化和再生治疗开辟新的方向。
