Modulation of immune-inflammatory responses through surface modifications of biomaterials to promote bone healing and regeneration

Abstract

Control of inflammation is indispensable for optimal oral wound healing and tissue regeneration. Several biomaterials have been used to enhance the regenerative outcomes; however, the biomaterial implantation can ensure an immune-inflammatory response. The interface between the cells and the biomaterial surface plays a critical role in determining the success of soft and hard tissue regeneration. The initial inflammatory response upon biomaterial implantation helps in tissue repair and regeneration, however, persistant inflammation impairs the wound healing response. The cells interact with the biomaterials through extracellular matrix proteins leading to protein adsorption followed by recruitment, attachment, migration, and proliferation of several immune-inflammatory cells. Physical nanotopography of biomaterials, such as surface proteins, roughness, and porosity, is crucial for driving cellular attachment and migration. Similarly, modification of scaffold surface chemistry by adapting hydrophilicity, surface charge, surface coatings, can down-regulate the initiation of pro-inflammatory cascades. Besides, functionalization of scaffold surfaces with active biological molecules can down-regulate pro-inflammatory and pro-resorptive mediators’ release as well as actively up-regulate anti-inflammatory markers. This review encompasses various strategies for the optimization of physical, chemical, and biological properties of biomaterial and the underlying mechanisms to modulate the immune-inflammatory response, thereby, promoting the tissue integration and subsequent soft and hard tissue regeneration potential of the administered biomaterial.

The Osteoinductivity of Calcium Phosphate-Based Biomaterials: A Tight Interaction With Bone Healing

“…Cytokines such as M-CSF, RANKL and osteoprotegerin are responsible for stimulating osteoclastogenesis ( Chen Z. et al, 2016 ). Contrary to previous beliefs that all inflammatory responses should be suppressed after biomaterial implantation, healing is promoted by suppression of extended chronic inflammatory responses ( Miron and Bosshardt, 2016 ; Batool et al, 2021 ).…”

Bioactive Materials Promote Wound Healing through Modulation of Cell Behaviors

“…[74] Numerous previously published review articles focused on the impact and application of surface modification techniques, providing preliminary knowledge for this comprehensive review. [71,75] Thus far, little is known about how the immunogenicity of the material itself can help tailor and manipulate the results of tissue engineering. Fortunately, the research fields of immunotherapy and vaccines have delivered worthy information on how material properties influence the immune response.…”

Advances and Prospects in Antibacterial-Osteogenic Multifunctional Dental Implant Surface

“…Pro-inflammatory factors have vasodilatory and chemotactic actions, which might attract more leukocytes to the site and speed up PAMP clearance ( Liu et al, 2014 ). The first inflammatory response after biomaterial implantation aids tissue repair and regeneration; however, the overabundance of M1-type macrophages can lead to chronic inflammation, stymie wound healing, and damaged tissue repair ( Batool et al, 2021 ). M2 macrophages, which have immunosuppressive and anti-inflammatory properties, are essential in this situation.…”

“…Researchers tried to alter the physical properties of the implant surface to a more osteointegration-friendly M2-macrophage type that facilitate angiogenesis and bone regeneration around implants, namely immunomodulating the implant surface and modulating the macrophage phenotype ( Kim, 2020 ). Nanoscale surface treatment of implant surfaces can influence macrophage morphology and phenotypic characteristics, while functionalized bioactive molecular materials can increase anti-inflammatory factors and decrease the release of pro-inflammatory factors by adjusting their surface hydrophilicity, surface charge, and surface coating ( Batool et al, 2021 ).…”