samenvatting

• Titanium implants enhance blood cell adhesion.
• Blood clot helps ECM formation and remodeling, material-dependent.
• Cells remodel blood clot, make pockets where they make new tissue.
• Fibroblasts are active in the chronic inflammation phase.
• Material-specific macrophage secretome, which are cytokines secreted by macrophages, result in fibroblast chemotaxis and ECM formation.
• Dynamic models, such as bioreactors, control hemodynamic conditions which affect the inflammatory state by shear stresses and cyclic strains.
• The inflammatory state regulates the tissue formation.
• Host response of a man ≠ woman ≠ newborn ≠ infant ≠ elderly indicates that personalized treatment is needed.
• Ageing is associated with immunosenescence and disturbed redox balance.
• Dysfunctional immune system is a characteristic of ageing.
• Ageing increases the risk of thrombosis.
• Ageing increases the risk of infection.
• Ageing impairs wound healing.
• Patient-specific characteristics are poorly studied, both in vivo and in vitro.
• Inter species differences, for example between mice, rats, sheep, and humans, need to be considered.
• Hypothesis driven animal research is common in the field of biomaterials.
• Human in vitro models are often oversimplified and strongly reductionist, focusing on cytokine/GF secretion and ECM formation.
• Human in vitro models are accessible but lack the complexity and throughput of native-like models.
• Biomaterials are materials that have an interaction with your body.
• The response to biomaterials has to be studied for device safety.
• There are many problems that can occur during the interaction of biomaterials with the body: local interactions, systemic interactions and device- patient complications.
• Immunomodulatory biomaterials cannot be considered as inert, as they cannot be hidden from the immune system.
• The host response is not always bad, it needs to be controlled.
• The inflammation in the beginning is necessary to kick start the healing process.
• Biomaterials can interact with/instruct the immune system.
• There are materials that induce tissue regeneration, which work on the innate immune system.
• There are also materials to silence/activate immune cells, which work on the adaptive immune system.
• Biomaterial applications include replacement (permanent) implants and regenerative (degradable) implants, which have different effects on the immune system.
• Biocompatibility is the ability of a material to perform with an appropriate host response in a specific application.
• Biotolerability is the ability of materials to reside in the body for long periods of time with only low degrees of inflammatory reaction.
• Factors that influence the host-response include biomaterial-related factors such as composition, material, degradability, mechanical properties, sterility, antigenicity and active ingredients (drugs).
• Host-related factors that influence the host-response include age, gender, anatomic location, previous interventions, comorbidities, immune response and medications.
• The first line of defense in the immune system is mechanical barriers such as a mosquito breaking through.
• The second line of defense in the immune system is the innate immune system.
• The third line of defense in the immune system is the adaptive immune system.
• Immune cells move from the vasculature to the parasites in the innate immune system.
• Innate immune system is nonspecific and responds quickly.
• Biomaterials mainly trigger the innate immune response, they are typically not antigenic (adaptive).
• Adaptive immune system is specific and involves antigen presentation, it responds slowly the first time but has a memory.
• The adaptive immune system plays a role in FBR.