Lecture 15 Supplement Biocompatibility

Lecture 15 - Biocompatibility Dr Frame BME 100 Wounds and how we heal Biofilm = bacteria yeast other microbes Bickers et al J Am Acad Dermatol

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Biocompatibility Dr. Frame BME 100 October 26, 2011
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Wounds and how we heal Bickers et al. J Am Acad Dermatol 55:490-500, 2006 Biofilm = bacteria, yeast, other microbes
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Socio-economics • 35 million wounds/yr in USA require major therapeutic intervention • 4.8 million wounds/yr become chronic nonhealing ulcers • Direct costs $9.7 billion/yr (~1/3 of all costs for skin disease)
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Normal wound repair Clark RAF, Ghosh K, Tonnesen M, J Invest Dermatol 127:1018-1029, 2007 “Good” healing of deep wounds Seconds to minutes Cytokines released Clotting cascade initiated Fibrin clot forms Provisional matrix forms Days to weeks Fibroblasts migrate in ?stem cells? Blood vessels form Weeks to months Final parenchyma & tissue regenerated
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Biomaterial-Body interface… • Any biomaterial-body interface is a wound. • Currently, most biomaterial-body interfaces do not completely heal. • Engineering design goal: – to fabricate interface materials that will biodegrade and be replaced with the body’s own living tissue.
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Medical Biocompatibility • Biology of transplantation – Biocompatibility of living tissue from someone else. • Foreign body rejection – Biocompatibility of non-living tissue. • The Immune System
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Biology of Transplantation: Rejection by antibodies • Hyperacute rejection – occurs within minutes to hours – B lymphocytes recruit TH cells – mediated by antibodies; IgM, IgG – inflammatory response ensues – not treatable if initiated by antidonor antibody – ABO-incompatible transplants (liver less susceptible to these)
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http://health.nytimes.com/health/guides/disease/graft-versus-host-disease/overview.html
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Biology of Transplantation: Rejection by T lymphocytes • Acute allograft rejection – occurs within days to weeks – needle biopsy showing lymphocyte infiltrate is the standard diagnostic test – cytotoxic T cells (CD8) initiate, recruit TH – suppressor T cells (?assist, or ?counter)
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http://www.nature.com/ki/journal/v58/n3/images/4495490f2.gif
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Biology of Transplantation: Rejection by cytokines • Chronic rejection – occurs gradually over months to years – parenchymal fibrosis/ischemic changes – mediated by cytokines • Ig supergene family • hematopoietin receptor family • TNF receptor family (tumor necrosis factor)
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How does the immune system work?
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Tissue response to resorbable biomaterial implants Many resorbable biomaterial implants cause inflammation Inflammatory response may occur secondary to indigestible particles, cytotoxicity or innate immune response - Typically self-resolving - tissue restored and abscess drains - Some reactions become chronic with foreign-body granuloma, seromas and/or sterile sinus tract formation Infection - Secondary to contaminated material - Secondary to surgery contamination Some resorbable biomaterial implants
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This note was uploaded on 11/28/2011 for the course BME 100 taught by Professor Dr.frame during the Spring '11 term at SUNY Stony Brook.

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Lecture 15 - Biocompatibility Dr Frame BME 100 Wounds and how we heal Biofilm = bacteria yeast other microbes Bickers et al J Am Acad Dermatol

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