Factors Which Affect the Host Response to Biomaterials

The ability of a biomaterial to perform its intended in vivo function is ultimately dependent upon both the structural and biophysical properties of the material and the host response to the given material. Biomaterial-related factors affecting performance include its composition, mechanical and material properties, surface topography and molecular landscape, ability to resist infection, and proper surgical placement, among others. Host-related factors include age, nutritional status, body mass index, comorbidities such as diabetes, previous interventions at the treatment site, and medications being taken by the patient. The host response begins immediately upon implantation and consists of both the response to the inevitable iatrogenic tissue injury during device placement and the response to the material itself. The implantation-induced component resolves quickly as part of the normal wound healing process. However, the response to the material itself will last for the length of time the material is present in the host. The host response is the primary determinant of clinical success in most applications. Hence, the safety and efficacy of these technologies will be well served by placing emphasis upon the understanding of the host response and the dynamic interaction between biomaterial- and host-related factors that affect clinical outcomes.