scholarly journals Fibrin Polymer on the Surface of Biomaterial Implants Drives the Foreign Body Reaction

2021 ◽  
Author(s):  
Arnat Balabiyev ◽  
Nataly P. Podolnikova ◽  
Jacquelyn A. Kilbourne ◽  
D. Page Baluch ◽  
David Lowry ◽  
...  

ABSTRACTImplantation of biomaterials and medical devices in the body triggers the foreign body reaction (FBR) which is characterized by macrophage fusion at the implant surface leading to the formation of foreign body giant cells and the development of the fibrous capsule enveloping the implant. While adhesion of macrophages to the surface is an essential step in macrophage fusion and implanted biomaterials are known to rapidly acquire a layer of host proteins, a biological substrate that is responsible for this process in vivo is unknown. Here we show that mice with genetically-imposed fibrinogen deficiency display a dramatic reduction of macrophage fusion on implanted biomaterials and are protected from the formation of fibrin-containing granulation tissue, a precursor of the fibrous capsule. Furthermore, macrophage fusion on biomaterials implanted in FibAEK mice that express a mutated form of fibrinogen incapable of thrombin-mediated polymerization was strongly reduced. Surprisingly, despite the lack of fibrin, the capsule was formed in FibAEK mice, although it had a different composition and distinct mechanical properties than that in wild-type mice. Specifically, while mononuclear α-SMA-expressing macrophages embedded in the capsule of both strains of mice secreted collagen, the amount of collagen and its density in the tissue of FibAEK mice was reduced. These data identify fibrin polymer as a key biological substrate driving the development of the FBR.

2007 ◽  
Vol 330-332 ◽  
pp. 193-196
Author(s):  
Duck Hyun Kim ◽  
Kang Sik Lee ◽  
Jung Hwa Kim ◽  
Jae Suk Chang ◽  
Yung Tae Kim

We observed the cytotoxicity of human bone marrow stromal cells(hBMSCs) by microparticles of bioactive glass with four particle groups(same chemical composition-45S5 but produced by two different manufacturer and two different size groups). In vivo test using rat calvaria were also carried out. The apoptosis rates of all small particle groups(10-20 ㎛) were increased than large(500-700 ㎛ or 200-900 ㎛) particle groups in any culture time and any amount of particles with statistical significance. In vivo study we observed pathologic signs such as macrophages and foreign-body giant cells in rat calvaria by micro-particles of bioglass. Small(10- 20 ㎛) sized particles induced foreign body reaction and bone resorption. There was proliferation of macrophages and cells in large number. But in large particle groups, only fibroblasts were surrounding the particles. The micro-particles of bioglass induced apoptosis of hBMSC and foreign body reaction in calvaria of rat, therefore micro-particles of bioglass may cause osteolysis if used in replacement arthroplasty.


2019 ◽  
Author(s):  
Alejandro Carnicer-Lombarte ◽  
Damiano G. Barone ◽  
Ivan B. Dimov ◽  
Russell S. Hamilton ◽  
Malwina Prater ◽  
...  

AbstractMedical implants offer a unique and powerful therapeutic approach in many areas of medicine. However, their lifetime is often limited as they may cause a foreign body reaction (FBR) leading to their encapsulation by scar tissue1–4. Despite the importance of this process, how cells recognise implanted materials is still poorly understood5, 6. Here, we show how the mechanical mismatch between implants and host tissue leads to FBR. Fibroblasts and macrophages, which are both crucially involved in mediating FBR, became activated when cultured on materials just above the stiffness found in healthy tissue. Coating implants with a thin layer of hydrogel or silicone with a tissue-like elastic modulus of ∼1 kPa or below led to significantly reduced levels of inflammation and fibrosis after chronic implantation both in peripheral nerves and subcutaneously. This effect was linked to the nuclear localisation of the mechanosensitive transcriptional regulator YAP in vivo. Hence, we identify the mechanical mismatch between implant and tissue as a driver of FBR. Soft implant coatings matching the mechanical properties of host tissue minimized FBR and may be used as a novel therapeutic strategy to improve long-term biomedical implant stability without extensive modification of current implant manufacturing techniques, thus facilitating clinical translation.One sentence summaryForeign body reaction to medical implants can be avoided by matching the stiffness of the implant surface to that of the host tissue.


2001 ◽  
Vol 125 (6) ◽  
pp. 822-823 ◽  
Author(s):  
Telma C. Pereira ◽  
Jeffrey W. Prichard ◽  
Mushtaq Khalid ◽  
David S. Medich ◽  
Jan F. Silverman

Abstract Pulse granuloma is a rare benign entity, most likely representing a foreign body reaction to vegetable particles. We report a case of a pulse granuloma involving the rectum. The patient presented with a submucosal and intramuscular mass lesion found at routine rectal examination and subsequent colonoscopy. The mass was excised and the microscopic examination revealed acute and chronic inflammatory cells, foreign-body giant cells, vegetable matter, and convoluted hyaline rings and scattered circular structures containing basophilic granules, consistent with pulse granuloma. There are a few reports in the literature of pulse granulomas, with most occurring in the oral cavity or lungs. To the best of our knowledge, this is the first reported example of pulse granuloma in the rectum. Although rare, familiarity with this entity's distinctive histopathologic features may avoid a delay in diagnosis and prevent the expense of distinguishing it from its histologic lookalikes.


2014 ◽  
Vol 7 (1) ◽  
pp. 27-33 ◽  
Author(s):  
Amy S. Xue ◽  
John C. Koshy ◽  
William M. Weathers ◽  
Erik M. Wolfswinkel ◽  
Yoav Kaufman ◽  
...  

Biodegradable plates have been used extensively in fracture fixation since the 1960s. They rarely cause stress-protection atrophy or problems requiring secondary plate removal, common complications seen with metallic plates. However, aseptic foreign-body reactions have been reported, sometimes years after the original implantation. Both inadequate polymer degradation and debris accumulation have been implicated as causes. The current generation of commercial biodegradable plates is formulated to minimize this complication by altering the ratio of polylactic and polyglycolic acids. This in vivo study compares the degree of local foreign-body reaction of two commercially available resorbable plates in rabbits. Two types of biodegradable plates were examined: poly(D/L)lactide acid (PDLLA) and polylactide-co-glycolide acid (PLGA). Each plate was placed into a periosteal pericalvarial pocket created beneath the anterior or posterior scalp of a rabbit. Humane killing occurred at 3, 6, and 12 months postoperatively. Foreign-body reaction was evaluated histologically. The PDLLA plates demonstrated marked local foreign-body reactions within the implant capsule as early as 3 months after implantation, with presence of inflammatory cells and granulomatous giant cells in close association with the implant material. All local foreign-body reactions were subclinical with no corresponding tissue swelling requiring drainage. PLGA plates did not demonstrate any signs of inflammatory reactions. In addition, the PLGA plates did not appear to resorb or integrate at 12 months. Neither PDLLA nor PLGA plates demonstrated inflammation of the soft tissue or adjacent bone outside the implant capsule. In our study, the PDLLA plates demonstrated histological evidence of foreign-body reaction that is confined within the implant capsule, which was not seen with the PLGA plates. This finding may be attributable to the lack of significant resorption seen in the PLGA plates. Both PDLLA and PLGA plates were biocompatible with the rabbit tissue environment and should be considered for continued use in craniofacial, maxillofacial, and orthopedic reconstruction.


2004 ◽  
Vol 94 (6) ◽  
pp. 550-557 ◽  
Author(s):  
William Dean Wallace ◽  
S. W. Balkin ◽  
Leo Kaplan ◽  
Scott Nelson

This study analyzed the histologic effects of and host response to subdermally injected liquid silicone to augment soft-tissue cushioning of the bony prominences of the foot. A total of 148 postmortem and surgical specimens of pedal skin with attached soft tissue were obtained from 49 patients between July 1, 1974, and November 30, 2002. The longest period that silicone was in vivo was 38 years. The specimens were then processed into paraffin blocks and examined for specific findings. The variables considered included distribution of silicone within the tissue, host response, migration to regional lymph nodes, and viability of the host tissue after treatment. The host response to silicone therapy consisted primarily of delicate-to-robust fibrous deposition and histiocytic phagocytosis, with eventual formation of well-formed elliptic fibrous pads. The response in the foot appears different from that in the breast and other areas of the body previously studied. No examples of granulomas, chronic lymphoplasmacytic inflammation, or granulation tissue formation were seen, with only rare foreign-body giant cells present. Silicone injections in fat pads for the treatment of atrophy and loss of viable tissue show a histologically stable and biologically tolerated host response that is effective, with no evidence of any systemic changes. (J Am Podiatr Med Assoc 94(6): 550–557, 2004)


2021 ◽  
Vol 11 (2) ◽  
pp. 212-215
Author(s):  
Mariya Zatolokina ◽  
Ekaterina Mishina ◽  
Alexander Sozykin ◽  
Marina Gorbunova ◽  
Alexander Alekseev

Background: The purpose of our work was determined by the accumulation of a significant amount of experimental material under the conditions of implantation of a foreign body, a mesh implant, into the region of the anterior abdominal wall in order to obtain experimental inflammation, in which foreign body giant cells (FBGCs) were constantly visualized as reactive formations. This research aimed to study the dynamics of morphological changes in FBGCs under conditions of experimental implantation of a foreign body, a mesh implant, and the possible mechanism of their formation Methods and Results: This study was carried out on male Wistar rats, in which a foreign body was implanted—a mesh endoprosthesis made of polypropylene—in the region of the anterior abdominal wall under the aponeurosis of the rectus abdominis muscles. A section of the anterior abdominal wall with the implanted endoprosthesis was excised on Days 10, 21, 30, and 60 after surgery, fixed in 10% buffered formalin solution. The obtained samples were embedded in paraffin according to standard prescriptions; histological sections with a thickness of 5-7µm were made and stained with H&E, according to the methods of Van Gieson and Mallory, and an immunohistochemical study was performed using the marker of cell proliferation (Ki-67). The revealed structural features of multinucleated cells were recorded by microphotography using a photo attachment and a Levenhuk video camera (USA). During the study, it was revealed that the amount, functional activity and morphological diversity of FBGCs gradually increased, reaching a maximum by Day 30 of the experiment. At a later date, some of them died, while the remaining part was differentiated, splitting into small multinucleated cells and mononuclear elements, morphologically identical to macrophages and fibroblasts. The formation of FBGCs continued as long as the mesh implant was in the body. Conclusion: FBGCs are reactive formations that arise in response to various endo- and exogenous irritation.


2020 ◽  
Vol 142 ◽  
pp. 55-61
Author(s):  
WT Li ◽  
YL Chiang ◽  
TY Chen ◽  
CL Lai

Eurasian otters Lutra lutra are listed as Near Threatened on the IUCN Red List and are imperiled by habitat loss, water pollution, and poaching. Harassment and attacks by stray animals are also recognized threats to the health of wild Eurasian otters. Pulmonary hair embolism is a possible complication in animals with deep traumatic injury, but to date no cases have been reported in wildlife. A free-ranging, adult male Eurasian otter was rescued due to severe emaciation and multiple bite wounds. The otter died 3 d after rescue and was necropsied. Grossly, a 1.5 × 1.5 × 1.5 cm firm nodule was observed in the left cranial lung lobe. Histologically, a fragment of hair shaft surrounded by multinucleated foreign body giant cells was observed in a medium-sized vein, and extensive eosinophilic infiltration was noted in the adjacent vascular wall and lung parenchyma. Based on the gross and histological findings, the pulmonary lesion was consistent with eosinophilic pneumonia and vasculitis induced by hair embolism. The presence of well-formed multinucleated foreign body giant cells and eosinophils may imply a late stage of foreign body reaction, and thus the presumptive source of hair embolism is an animal bite. This is the first report of pulmonary hair embolism associated with animal bite in a rescued free-ranging Eurasian otter.


2020 ◽  
pp. 021849232098409
Author(s):  
Ihsanul Amal ◽  
Heroe Soebroto ◽  
Puruhito

Background Sternotomy is a standard approach performed in almost every surgical procedure on the heart and mediastinum. Effective hemostasis of the sternum is required to keep the operative field dry, avoid excessive blood transfusions during surgery, and prevent reoperation due to massive postoperative bleeding, which can further increase morbidity and mortality in patients. Bone wax is a mechanical hemostat commonly used after sternotomy and has been known to affect bone healing, trigger chronic inflammatory reactions, and increase the rate of infection. The application of chitosan, which has intrinsic hemostat ability, as hemostatic material is believed to improve bone healing following sternotomy. This study aimed to compare the effectiveness of bone wax and chitosan on bone healing after sternotomy. Methods Median sternotomies were performed on 2 groups of New Zealand White rabbits. Each group of 16 animals received either bone wax or chitosan powder as hemostatic material. The degree of bone healing, the number of foreign-body giant cells, and the number of osteoblasts were evaluated after 6 weeks. Results Radiographs showed that significantly more animals in the chitosan group had total sternal healing ( p = 0.033). Histopathology revealed that the number of foreign-body giant cells was significantly less ( p = 0.036) and the number of osteoblasts was significantly greater ( p < 0.0001) in the group of animals that received chitosan. Conclusion The use of chitosan as hemostatic material can promote better bone healing compared to bone wax.


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