In vivo induction of macrophage Ia antigen (MHC class II) expression by biomedical polymers in the cage implant system

Examination of the cellular components in the inflammatory exudate, which infiltrates subcutaneous cages, can be used to monitor the progress of an inflammatory response to an implanted material. Of particular interest is the study of monocyte/macrophage infiltration into the implanted cages containing biomaterials, as macrophages may initiate a wide spectrum of responses upon interaction with a foreign material. In this study, the authors propose a technique using subcutaneous tissue cages in conjunction with cytofluorimetric analysis of exudate leukocytes to evaluate the monocyte/macrophage cell activation in response to different materials. The studies reported here used several materials (thermoplastic and elastomeric polymers) as the challenging agent, to demonstrate whether polymers, chemically different from each other, could differentially activate macrophages to carry out their proinflammatory role more effectively. The materials tested included: poly(etherurethane ureas) (PEUU A'), poly(etherurethane ureas) with a surface active additive, Methacrol, (PEUU C'), polymethylsiloxane (PDMS), polyetherimide, (PEI), and polyetheretherketone, (PEEK). For all tested materials, the maximum numbers of exudate cells and of Ia-positive macrophages were found on day 7, although the entity of the cell increase was associated with the material used for the implant. Similarly, the percentage of Ia-positive macrophages varied according to the specific polymer present in the cages after 7 days. By day 14, the percentage of Ia-positive macrophages decreased with individual exudates showing 19-32% Ia-positive cells depending on the different type of material. Only in the case of PDMS did the percentage of Ia-positive macrophages remain the same as compared with control empty cage macrophages.