Article

Examination of the foreign body response to biomaterials by nonlinear intravital microscopy

  • Nature Biomedical Engineering 1, Article number: 0007 (2016)
  • doi:10.1038/s41551-016-0007
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Abstract

Implanted biomaterials often fail because they elicit a foreign body response (FBR) and concomitant fibrotic encapsulation. To design clinically relevant interference approaches, it is crucial to first examine the FBR mechanisms. Here, we report the development and validation of infrared-excited nonlinear microscopy to resolve the three-dimensional (3D) organization and fate of 3D-electrospun scaffolds implanted deep into the skin of mice and the following step-wise FBR process. We observed that immigrating myeloid cells (predominantly macrophages of the M1 type) engaged and became immobilized along the scaffold/tissue interface, before forming multinucleated giant cells. Both macrophages and giant cells locally produced vascular endothelial growth factor (VEGF), which initiated and maintained an immature neovessel network, followed by the formation of a dense collagen capsule two- to four-weeks post-implantation. Elimination of the macrophage/giant-cell compartment, by clodronate and/or neutralization of VEGF by VEGF Trap, significantly diminished giant-cell accumulation, neovascularization and fibrosis. Our findings identify macrophages and giant cells as incendiaries of the fibrotic encapsulation of engrafted biomaterials via VEGF release and neovascularization, and therefore as targets for therapy.

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Acknowledgements

We thank M. Starbuck, C. Johnston, Y. Xiaoqing, R. Jimenez and J. Douglas for histological processing of the samples; and E. De Juan Pardo for the manufacturing of the mPCL-CaP scaffolds. E.D. was supported by the Cancer Prevention and Research Institute of Texas (RP140482) and the Prostate Cancer Foundation (16YOUN24). P.F. was supported by the Netherlands Science Organization (NWO-VICI 918.11.626), the European Research Council (ERC-CoG DEEPINSIGHT, Project No. 617430) and the Cancer Genomics Center, The Netherlands. This work was further supported by the National Health and Medical Research Council (NHMRC Project Grant 1082313), the National Breast Cancer Foundation (NBCF IN-15-047) and the Worldwide Cancer Research (WWCR 15-11563) to B.M.H. and D.W.H. and the German Research Foundation (DFG HO 5068/1-1) to B.M.H. The Genitourinary Cancers Program of the CCSG shared resources at the MD Anderson Cancer Center was supported by the National Institute of Health/National Cancer Institute award number P30 CA016672.

Author information

Author notes

    • Stephanie Alexander

    Present address: European Molecular Biology Laboratory, Cell Biology and Biophysics Unit, Heidelberg 39349, Germany.

Affiliations

  1. David H. Koch Center for Applied Research of Genitourinary Cancers, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA

    • Eleonora Dondossola
    • , Stephanie Alexander
    • , Stefano Filippini
    •  & Peter Friedl
  2. Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland 4059, Australia

    • Boris M. Holzapfel
    •  & Dietmar W. Hutmacher
  3. Orthopaedic Center for Musculoskeletal Research, University of Wuerzburg, Wuerzburg 97070, Germany

    • Boris M. Holzapfel
  4. Australian Research Centre in Additive Biomanufacturing, Queensland University of Technology, Brisbane, Queensland 4059, Australia

    • Dietmar W. Hutmacher
  5. Radboud University Nijmegen, Nijmegen HB6500, The Netherlands

    • Peter Friedl
  6. Cancer Genomics Centre, The Netherlands

    • Peter Friedl

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Contributions

E.D., B.M.H., S.A., D.W.H. and P.F. designed the research. E.D., B.M.H., S.A., S.F. and D.W.H. performed the research. E.D., S.F., D.W.H. and P.F. analysed the data. E.D., B.M.H., D.W.H. and P.F. wrote the paper.

Competing interests

The authors declare no competing financial interests.

Corresponding authors

Correspondence to Eleonora Dondossola or Peter Friedl.

Supplementary information

PDF files

  1. 1.

    Supplementary Information

    Supplementary figures and video captions.

Videos

  1. 1.

    Video 1

    Kinetics of infiltrate cells at day 4 post-scaffold implantation.

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    Video 2

    Kinetics of infiltrate cells at day 7 post-scaffold implantation.

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    Video 3

    Kinetics of infiltrate cells at day 10 post-scaffold implantation.

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    Video 4

    Cytoplasmic dynamics of scaffold-associated giant cells.