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Design of biodegradable, implantable devices towards clinical translation
Nature Reviews Materials ( IF 79.8 ) Pub Date : 2019-12-02 , DOI: 10.1038/s41578-019-0150-z
Chunmei Li , Chengchen Guo , Vincent Fitzpatrick , Ahmed Ibrahim , Myrthe Jasmijn Zwierstra , Philip Hanna , Aron Lechtig , Ara Nazarian , Samuel J. Lin , David L. Kaplan

Biodegradable materials, including natural and synthetic polymers and hydrolyzable metals, constitute the main components of temporary, implantable medical devices. Besides the intrinsic properties of the materials, the most critical factor determining the successful clinical outcome of implantable and degradable devices is the host response, particularly the immune response, which largely depends on the material features and degradation mechanisms. In this Review, we first survey the state of the art in terms of materials options for use in biodegradable medical devices, focusing on degradation mechanisms and their control. In particular, we highlight silk, which is emerging as an important polymer, owing to its mechanical robustness, bioactive component sequestration, degradability without problematic metabolic products and biocompatibility. We then discuss the host response to these biodegradable materials in terms of dynamic tissue–implant interfaces. Next, we examine the clinical translation of three leading biodegradable material systems — natural and synthetic biodegradable polymers and biodegradable metals — and the related challenges in the context of orthopaedic fixation devices, cardiovascular stents and biodegradable electronic devices. Looking to the future, we propose updated material design strategies to improve the clinical outcomes for these biodegradable medical devices.



中文翻译:

可生物降解,可植入设备的临床设计

包括天然和合成聚合物以及可水解金属在内的可生物降解材料构成了临时性可植入医疗设备的主要组成部分。除了材料的固有特性外,决定可植入和可降解设备成功临床结果的最关键因素是宿主反应,尤其是免疫反应,这在很大程度上取决于材料的特性和降解机理。在本综述中,我们首先就可生物降解医疗设备中使用的材料选择调查了最新技术,重点是降解机理及其控制。特别是,我们将重点介绍丝绸,由于其机械强度,生物活性成分螯合,可降解性而没有问题的代谢产物和生物相容性,丝绸已成为一种重要的聚合物。然后,我们根据动态组织-植入物界面讨论宿主对这些可生物降解材料的反应。接下来,我们研究了三种主要的可生物降解材料系统的临床翻译-天然和合成的可生物降解聚合物和可生物降解金属-以及骨科固定设备,心血管支架和可生物降解电子设备的相关挑战。展望未来,我们提出了更新的材料设计策略,以改善这些可生物降解医疗设备的临床效果。我们研究了三种主要的可生物降解材料系统的临床翻译-天然和合成的可生物降解聚合物和可生物降解金属-以及骨科固定设备,心血管支架和可生物降解电子设备的相关挑战。展望未来,我们提出了更新的材料设计策略,以改善这些可生物降解医疗设备的临床效果。我们研究了三种主要的可生物降解材料系统的临床翻译-天然和合成的可生物降解聚合物和可生物降解金属-以及骨科固定设备,心血管支架和可生物降解电子设备的相关挑战。展望未来,我们提出了更新的材料设计策略,以改善这些可生物降解医疗设备的临床效果。

更新日期:2019-12-02
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