TABLE 2.

Summary of biomimetic strategies for FBR modulation

Biomimetic Strategy	Material	Implant type	Methods	Surface modification effects	References
Zwitterionic	PCMA hydrogel	Hydrogel for multiple applications	In vivo testing in mice for >3 months	Avoids macrophage recognition and FC formation	124
	Phosphoserine hydrogel discs	Hydrogel for drug delivery	In vitro testing in culture with fibrinogen	Antiadhesive properties towards proteins	225
	Triazole‐modified alginate	Microspheres for islets encapsulation	In vivo testing in mice and NHP for 4 weeks	Low immune cell recruitment and prevented macrophage activation	200
	Sulfobetaine modified alginate	Microspheres for islets encapsulation	In vivo testing in mice for 200 days, pigs and dogs for 90 days	Mitigate cellular overgrowth and fibrous tissue around transplanted islets	204
	Triazole hydrogel	Hydrogel for islets encapsulation	In vivo testing in mice for 4 weeks	Anti‐biofouling properties and improved mechanical stability	226
	Polysulfobetaine and poly(carboxybetaine) hydrogels	Tissue scaffolds	In vitro incubation with serum proteins and in vivo testing in mice for 1 year	Antifouling properties and resistance against fibrosis	227
	2‐Methacryloyloxyethyl phosphorylcholine (MPC)	Coating on CGM devices	In vivo testing in mice and NHP for up to 8 days	Reduction of proinflammatory markers on implantable glucose sensor and mitigated signal‐to‐noise ratio	123
		Silicone breast implant coating	In vitro incubation in BSA and in vivo implantation in pigs for 6 months	Reduction of BSA adsorption, reduction of proinflammatory factors and inhibition of fibrous tissue formation	228
ECM molecule coating	Gelatin–hyaluronic acid	PDMS surface coating	In vivo testing in rats for 2 months	Attenuated fibrotic tissue formation	229
	HA and heparin	Surface modification for silicon wafers	In vitro culture with THP‐1‐derived macrophages	Supression of the NF‐κB signaling pathway	230
Protein coating	Gelatin	Electrospun membrane coating for implantable glucose sensors	In vivo testing in rats for 3 weeks	Reduced fibrosis and improved sensor sensitivity	231
	Fibronectin and IL‐4	Functionalization and coating of hollow PES fibers for cell encapsulation	In vivo testing in mice for 14 days	Reduced fibrotic capsule thickness in the early stage of inflammation and improved angiogenesis and encapsulated cells survival	232
	Pectin	3D‐printed alginate‐pectin construct for cell encapsulation	In vivo testing in mice for 4 weeks	Decreased fibrotic capsule thickness and reduced cellular infiltration at the implantation site Slight improvement in islet xenograft survival	233
	Silk fibroin and mechano growth factor	Decoration of an electrospun PCL scaffold	In vivo testing in rats for 4 weeks	Thinner fibrotic tissue formation and improved islet encapsulation in a microcapsule device by reducing immune cell infiltration and triggering an anti‐inflammatory pathway	234
	Colony‐stimulating factor‐1 (CSF‐1)	Surface functionalization of PLLA scaffolds	In vivo testing in mice for 4 weeks	Reduced proinflammatory cytokine and increased wound‐healing macrophages	235
Surface patterning	Patterned PDMS mimicking breast tissue	Breast implant surface modification	In vitro culture with THP‐1 macrophages	Enhance M2 polarization and reduced TNF‐α levels	236
Implant wrapping	Biocellulose	CIED wrap	In vivo testing in minipigs for 12 months	Reduced fibrotic tissue formation	237
Scaffold modification	Melatonin, thiolated HA and collagen I	PCL/melatonin fibers + thiolated HA/collagen I scaffold for muscle regeneration	In vivo testing in rats for 8 weeks	Promoted cell proliferation on the scaffold and enhanced M2 polarization leading to muscle regeneration	238
	Endometrial MSCs	Poly‐l‐lactic acid‐co‐poly ε‐caprolactone nanofibrous transvaginal mesh loaded with endometrial MSCs	In vivo testing in mice for 6 weeks	Enhanced angiogenesis, collagen production, and M2 polarization	239
Surface modification	Human cardiomyocytes	3D nonporous carbon fiber electrodes embedded in human cardiomyocytes	In vitro testing with tissue engineered spontaneously beating human cardiac patches	Reduced FBR and have the regenerative capacity in vitro	240

Abbreviations: 3D, three‐dimensional; BSA, bovine serum albumin; CGM, continuous glucose monitoring; CIED, cardiovascular implantable electronic device; FBR, foreign body response; IL‐4, interleukin‐4; MSC, mesenchymal stem cell; NF‐κB, nuclear factor kappa B; NHP, nonhuman primate; PCL, polycaprolactone; PCMA, poly(carboxybetaine methacrylate); PDMS, polydimethylsiloxane; PES, polyethersulfone; PLLA, poly‐l‐lactic acid; TNF‐α, tumor necrosis factor‐α.