This essay analyzes the scientific evidence that forms the basis of bioactive materials, covering the fundamental understanding of bioactivity phenomena and correlation with the mechanisms of biocompatibility of biomaterials. This is a detailed assessment of performance in areas such as bone-induction, cell adhesion, immunomodulation, thrombogenicity and antimicrobial behavior. Bioactivity is the modulation of biological activity by characteristics of the interfacial region that incorporates the material surface and the immediate local host tissue. Although the term ‘bioactive material’ is widely used and has a well understood general meaning, it would be useful now to concentrate on this interfacial region, considered as ‘the bioactivity zone’. Bioactivity phenomena are either due to topographical/micromechanical characteristics, or to biologically active species that are presented in the bioactivity zone. Examples of topographical/micromechanical effects are the modulation of the osteoblast – osteoclast balance, nanotopographical regulation of cell adhesion, and bactericidal nanostructures. Regulation of bioactivity by biologically active species include their influence, especially of metal ions, on signaling pathways in bone formation, the role of cell adhesion molecules and bioactive peptides in cell attachment, macrophage polarization by immunoregulatory molecules and antimicrobial peptides. While much experimental data exists to demonstrate the potential of such phenomena, there are considerable barriers to their effective clinical translation. This essay shows that there is solid scientific evidence of the existence of bioactivity mechanisms that are associated with some types of biomaterials, especially when the material is modified in a manner designed to specifically induce that activity.

本文分析了构成生物活性材料基础的科学证据，涵盖了对生物活性现象的基本理解以及与生物材料生物相容性机制的相关性。这是对骨诱导、细胞粘附、免疫调节、血栓形成和抗菌行为等领域性能的详细评估。生物活性是通过结合材料表面和直接局部宿主组织的界面区域的特征来调节生物活性。尽管术语“生物活性材料”被广泛使用并且具有很好理解的一般含义，但现在将注意力集中在这个被认为是“生物活性区”的界面区域将是有用的. 生物活性现象要么是由于地形/微机械特性，要么是由于生物活性区域中存在的生物活性物质。形貌/微机械效应的例子是成骨细胞-破骨细胞平衡的调节、细胞粘附的纳米形貌调节和杀菌纳米结构。生物活性物质对生物活性的调节包括它们对骨形成信号通路的影响，尤其是金属离子，细胞粘附分子和生物活性肽在细胞粘附中的作用，免疫调节分子和抗菌肽对巨噬细胞的极化。尽管存在大量实验数据来证明此类现象的潜力，但对其有效的临床转化存在相当大的障碍。