Combating Implant Infections: Shifting Focus from Bacteria to Host

Area of Science:

• Biomaterials Science
• Immunology
• Infectious Diseases

Background:

• Implant-associated infections pose a significant threat to the widespread use of biomaterials.
• Current anti-infective biomaterial strategies often focus solely on direct antibacterial properties, leading to issues like antibiotic resistance and compromised host responses.

Purpose of the Study:

• To review the potential of host immunomodulation as a strategy for developing advanced anti-infective biomaterials.
• To highlight how biomaterial surface modifications can enhance immune cell function against infections.

Main Methods:

• Discussion of how biomaterial surface features can interfere with immune cell functions (neutrophils, macrophages).
• Review of strategies involving modification of surface biophysical cues and incorporation of immunomodulatory drug delivery systems.
• Examination of the roles of host defense peptides, metallic particles, quorum sensing inhibitors, and therapeutic adjuvants.

Main Results:

• Biomaterial features can dysregulate critical immune cell subsets, undermining antibacterial treatments.
• Modifying biomaterial surface cues and incorporating immunomodulatory systems can create immune-compatible and protective properties.
• Specific agents like host defense peptides and quorum sensing inhibitors show promise.

Conclusions:

• Host immunomodulation offers a promising alternative to direct antibacterial approaches for anti-infective biomaterials.
• This strategy can potentiate host defense mechanisms and mitigate the growing threat of antibacterial drug resistance.
• Future development of anti-infective biomaterials should prioritize immune compatibility and host defense.