The function of immunomodulation and biomaterials for scaffold in the process of bone defect repair: A review

Abstract

The process of bone regeneration involves the interaction of the skeletal, blood, and immune systems. Bone provides a solid barrier for the origin and development of immune cells in the bone marrow. At the same time, immune cells secrete related factors to feedback on the remodeling of the skeletal system. Pathological or traumatic injury of bone tissue involves changes in blood supply, cell behavior, and cytokine expression. Immune cells and their factors play an essential role in repairing foreign bodies in bone injury or implantation of biomaterials, the clearance of dead cells, and the regeneration of bone tissue. This article reviews the bone regeneration application of the bone tissue repair microenvironment in bone cells and immune cells in the bone marrow and the interaction of materials and immune cells.

Keywords: BMSCs; biomaterials; bone regeneration; immune cells; interaction.

FIGURE 1

Bone cells and immune cells in bones.

FIGURE 2

Bone remodeling and its involved cells. (A):Four types of cells are found within bone tissue. (B): Interaction between Osteoblasts-Osteoclasts-Osteocytes during bone remodeling. The graph was reprinted with permission from (Behzadi et al., 2017) and (Dar et al., 2018).

FIGURE 3

The interaction of the skeletal system and the immune system. (A) Interaction between skeletal and immune cells by secreting related factors, the graph was reprinted with permission from (Xie et al., 2020). (B) M1 and M2 interact with osteoblasts through cytokines such as IL-6, IL-23, IL-10, and TGF-β. The graph was reprinted with permission from (Lee et al., 2019). (C) T cells, macrophages, and neutrophils’ role in rheumatoid arthritis-induced bone erosion, the graph was reprinted with permission from (Tsukasaki and Takayanagi, 2019). (D) The role of T cells, macrophages, and DCs, in bacterial periodontitis-induced bone erosion, the graph was reprinted with permission from (Tsukasaki and Takayanagi, 2019).

FIGURE 4

Immune cascade after bone implant material, the graph was reprinted with permission from (Xie et al., 2020).

FIGURE 5

Immune cascade after bone implant material. (A) The interaction of biomaterials, skeletal cells, and immune cells, the graph was reprinted with permission from (Xie et al., 2020). (B–D) Zn²⁺ and BMP-2 peptide-modified titanium screws promote macrophage M2 polarization and synergize with BMP-2 to promote bone formation. The graph was reprinted with permission from (Wang et al., 2022).

FIGURE 6

Immunomodulatory material for bone regeneration. (A,B) DOPA4@BMP2pPEEK material regulates the differentiation of CD4 T cells and synergizes with BMP-2 to promote bone regeneration. The graph was reprinted with permission from (Zhao et al., 2021c).