FIG. 1.

Proposed BSI pathway: (A) DAMPs released from injured cells from the implant procedure adhere to the biomaterial surface immediately. Some DAMPs are recognized by immune cells and contribute to the acute inflammation. Others remain “dormant” owing to their orientation. (B) Chronic inflammation is characterized by the dominant presence of macrophages that can recognize DAMPs through PRR. Macrophages may also fuse to form FBGC. (C) The degradation of the biomaterial causes adhered DAMPs to be released into the microenvironment. BSI, biomaterials-driven sterile inflammation; DAMP, damage-associated molecular pattern; FBGCs, foreign body giant cells; PRR, pattern recognition receptor. Color images are available online.