Using Biomaterials to Modulate the Immune System to Heal Chronic Wounds

Non-healing wounds are a feature of aging and inflammatory metabolic diseases such as type 2 diabetes. To some meaningful degree these injuries are the result of dysfunction in the immune system, and thus strategies targeting the behavior of immune cells might prove to be useful, particularly if resolving excessive inflammatory signaling. The paper noted here focuses on the use of biomaterials, such as the scaffolding currently used in the development of cell therapies and tissue engineering approaches, to achieve this goal of immunomodulation.

Understanding the immune response in the context of chronic wound healing can inspire innovative strategies to enhance the efficacy of therapies by modulating immune cell behaviors. Thus, advances in this field require the convergence of multiple disciplines, including immunology, skin cell biology, biomaterial science, chemistry, and nanotechnology. Delving into the nuances of chronic wound healing from an immunology viewpoint reveals the complex interplay of the different immune cell types and their interactions between them and the extracellular matrix (ECM). By deciphering the dynamics of immune cell wound recruitment and leave and also the leucocyte polarization, we can devise strategies to optimize the healing process, minimizing inflammation and scarring, and also reducing the risk of infection.

Biomaterials, with their versatility, provide a platform for finely controlling immune cell behaviors. Thus, by carefully modulating their surface moieties, tuning their physical properties and combining them with bioactive agents or living entities, such as mesenchymal stem cells (MSCs), we can design therapies that can actively modulate the immune system. These modifications have been demonstrated to successfully facilitate different immune cells recruitment - polymorphonuclear neutrophils (PMNs), monocytes, macrophages, and lymphocytes - and activate and polarize macrophage and lymphocyte phenotypes.

Nonetheless, current research endeavors have primarily focused on understanding the behavior of macrophages, leaving a notable gap in the comprehension of the responses and interactions exhibited by mastocytes, lymphocytes, PMNs, and innate lymphoid cells (ILCs) in the context of varying biomaterial properties. In this regard, further investigation is needed to comprehensively understand the diverse immune responses elicited by biomaterial-based strategies, aiming to devise multifunctional therapeutic strategies for a precise modulation of distinct immune cell types.


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