使用生物材料和植入物进行关节置换,骨折固定术,脊柱稳定和其他骨科适应症通过可靠地减少疼痛和改善功能,彻底改变了患者护理。这些外科手术最初总是引起急性炎症反应,在大多数情况下,很容易平息。偶尔,植入物周围的慢性炎症发展并持续;这导致持续的疼痛和损害功能。慢性炎症的病因可能是特异性的,比如感染,或者是未知的。慢性炎症的组织学标志包括活化的巨噬细胞,成纤维细胞,T细胞亚群,和先天免疫系统的其他细胞。适应性免疫系统细胞的存在通常表明对金属半抗原的过敏反应。异物反应由活化的巨噬细胞组成,巨细胞,成纤维细胞,和其他细胞通常以特征性的组织学排列分布;这种反应通常是由于植入物中使用的生物材料的颗粒碎片和其他副产物。慢性炎症和异物反应都对植入物与周围组织的整合具有不利的生物学作用。减轻慢性炎症和异物反应的策略将增强植入物的初始掺入和寿命,因此,改善患者的长期疼痛缓解和整体功能。詹姆斯·安德森博士和同事在实验室进行的开创性研究为我们实验室关于间充质细胞之间的相互作用和串扰的工作提供了鼓舞人心的动力。免疫,和血管谱系,和骨科生物材料。安德森博士描述了急性和慢性炎症的基本生物学过程和机制,异物反应,决议,植入物在不同器官系统中的最终功能整合为研究人员提供了一种在许多临床场景中使用生物材料改善健康的战略方法。
The use of biomaterials and implants for joint replacement, fracture fixation, spinal stabilization and other orthopedic indications has revolutionized patient care by reliably decreasing pain and improving function. These surgical procedures always invoke an acute inflammatory reaction initially, that in most cases, readily subsides. Occasionally, chronic inflammation around the implant develops and persists; this results in unremitting pain and compromises function. The etiology of chronic inflammation may be specific, such as with infection, or be unknown. The histological hallmarks of chronic inflammation include activated macrophages, fibroblasts, T cell subsets, and other cells of the innate immune system. The presence of cells of the adaptive immune system usually indicates allergic reactions to metallic haptens. A foreign body reaction is composed of activated macrophages, giant cells, fibroblasts, and other cells often distributed in a characteristic histological arrangement; this reaction is usually due to particulate debris and other byproducts from the biomaterials used in the implant. Both chronic inflammation and the foreign body response have adverse biological effects on the integration of the implant with the surrounding tissues. Strategies to mitigate chronic inflammation and the foreign body response will enhance the initial incorporation and longevity of the implant, and thereby, improve long-term pain relief and overall function for the patient. The seminal research performed in the laboratory of Dr. James Anderson and co-workers has provided an inspirational and driving force for our laboratory\'s work on the interactions and crosstalk among cells of the mesenchymal, immune, and vascular lineages, and orthopedic biomaterials. Dr. Anderson\'s delineation of the fundamental biologic processes and mechanisms underlying acute and chronic inflammation, the foreign body response, resolution, and eventual functional integration of implants in different organ systems has provided researchers with a strategic approach to the use of biomaterials to improve health in numerous clinical scenarios.