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Concept
Foreign body reaction
Summary
A foreign body reaction (FBR) is a typical tissue response to a foreign body within biological tissue. It usually includes the formation of a foreign body granuloma. Tissue-encapsulation of an implant is an example, as is inflammation around a splinter. Foreign body granuloma formation consists of protein adsorption, macrophages, multinucleated foreign body giant cells (macrophage fusion), fibroblasts, and angiogenesis. It has also been proposed that the mechanical property of the interface between an implant and its surrounding tissues is critical for the host response.
In the long term, the foreign body reaction results in encapsulation of the foreign body within a calcified shell. For example, a lithopedion is a rare phenomenon which occurs most commonly when a fetus dies during an abdominal pregnancy, is too large to be reabsorbed by the body, and calcifies.
Following biomaterial implantation, blood and body fluids contact the implant surface. Host blood proteins adsorb onto the implant surface and a fibrin matrix forms. Acute and chronic inflammation follow the initial blood protein deposition and matrix formation. Macrophages at the implant site fuse to form foreign body giant cells. Following the inflammatory response, granulation tissue form. The end stage of the foreign body reaction is the fibrous capsule formation around the implanted biomaterial. The biocompatibility of the device affects the severity of the foreign body reaction. The foreign body reaction can lead to device failure.
During blood-biomaterial interaction, blood proteins spontaneously adsorb to the biomaterial surface. The biomaterial surface properties affect the types, concentrations, and conformation of proteins that adsorb to the surface. The Vroman effect can describe the time-dependent behavior of this protein adsorption. Surface-adsorbed proteins regulate inflammatory cell interaction and adhesion. The deposited proteins allow inflammatory cells to attach via integrins. The biomaterial surface can also recruit and activate complement proteins.
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Giant cell
A giant cell (also known as a multinucleated giant cell, or multinucleate giant cell) is a mass formed by the union of several distinct cells (usually histiocytes), often forming a granuloma. Although there is typically a focus on the pathological aspects of multinucleate giant cells (MGCs), they also play many important physiological roles. Osteoclasts are a type of MGC that are critical for the maintenance, repair, and remodeling of bone and are present normally in a healthy human body.
Granuloma
A granuloma is an aggregation of macrophages that forms in response to chronic inflammation. This occurs when the immune system attempts to isolate foreign substances that it is otherwise unable to eliminate. Such substances include infectious organisms including bacteria and fungi, as well as other materials such as foreign objects, keratin, and suture fragments. In pathology, a granuloma is an organized collection of macrophages. In medical practice, doctors occasionally use the term granuloma in its more literal meaning: "a small nodule".
Tissue engineering
Tissue engineering is a biomedical engineering discipline that uses a combination of cells, engineering, materials methods, and suitable biochemical and physicochemical factors to restore, maintain, improve, or replace different types of biological tissues. Tissue engineering often involves the use of cells placed on tissue scaffolds in the formation of new viable tissue for a medical purpose but is not limited to applications involving cells and tissue scaffolds.