Biological response against foreign implants often leads to encapsulation, possibly resulting in malfunction of implants devices. The aim of this study was to reduce the foreign body reaction by surface modification of biomaterials through layer-by-layer deposition of type I collagen (COL)/hyaluronic acid (HA) multilayer films. Polydimethylsiloxane (PDMS) samples were coated with alternative COL and HA layers with different layers. We found that the in vitro adhesion, proliferation, and activation of macrophage-like cells were greatly decreased by COL/HA multilayered deposition. The PDMS samples modified with 20 bilayers of COL/HA were implanted in rats for 3 weeks, and the thickness of encapsulation surrounding the samples was decreased by 29–57% compared to the control unmodified PDMS. This study demonstrates the potential of COL/HA multilayer films to reduce foreign body reaction. 1. Introduction Biological response against artificial implants leads to encapsulation of implants, which often causes malfunction of implants or patients’ agonies due to capsular contracture [1–3]. For example, capsule contracture of fibrous tissues overlying silicone breast implants may cause the implant rupture and become painful [3]. When a foreign material is implanted into a host, the interaction between the material and the surrounding injured tissues causes acute inflammation, similar to the natural healing process that usually lasts for a week [1, 2]. Chronic inflammation with the participation of monocytes, macrophages, and foreign body giant cells (FBGCs) may occur with a duration of less than 3 weeks if the wound is not healed [1]. Macrophages try to eliminate the foreign object from the host. However, the implant is too large to be phagocytosized, so activated macrophages fuse together to form multinucleated FBGCs [1]. The inability of FGBCs in eliminating the foreign object will lead to a route to encapsulation of the implant with dense collagen matrix that is secreted by fibroblasts in order to wall the foreign object off the host [1, 2]. Macrophages can be considered as a hallmark due to their critical roles in guiding through the entire wound healing process [2, 4]. Activated macrophages release biosignals such as interleukins to induce the formation of FBGCs as well as collagen synthesis from fibroblasts. To prevent these undesirable events from occurring, scientists have sought suitable surface modifications on biomaterials to prevent capsule formation by altering the hydrophilicity, topology, roughness, and surface chemistry of surfaces [5, 6].
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