Size- and shape-dependent foreign body immune response to materials implanted in rodents and non-human primates
Open accessAbstract
The efficacy of implanted biomedical devices is often compromised by host recognition and subsequent foreign body responses. Here, we demonstrate the role of the geometry of implanted materials on their biocompatibility in vivo. In rodent and non-human primate animal models, implanted spheres 1.5 mm and above in diameter across a broad spectrum of materials, including hydrogels, ceramics, metals and plastics, significantly abrogated foreign body reactions and fibrosis when compared with smaller spheres. We also show that for encapsulated rat pancreatic islet cells transplanted into streptozotocin-treated diabetic C57BL/6 mice, islets prepared in 1.5-mm alginate capsules were able to restore blood-glucose control for up to 180 days, a period more than five times longer than for transplanted grafts encapsulated within conventionally sized 0.5-mm alginate capsules. Our findings suggest that the in vivo biocompatibility of biomedical devices can be significantly improved simply by tuning their spherical dimensions.
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- Findingown data
At 7 days post-transplantation, a glucose tolerance test showed no significant delays in blood glucose correction kinetics as a function of capsule geometry.
“At 7 days post-transplantation a glucose tolerance test (GTT) was used to evaluate the kinetics of blood glucose correction and no significant delays were measured as a function of capsule geometry”
Quote in the paperNot a substantial claim - Findingown data
Western blot analysis showed that α-SMA expression in the cellular overgrowth on alginate spheres significantly decreased as sphere size increased.
“Western blot analysis of α-SMA expression within the cellular overgrowth on spheres showed a significant decrease as sphere size was increased”
Quote in the paperSubstantial claim - Findingown data
A multiplexed inflammatory mouse cytokine profile further validated the reduction in innate immune cell accumulation with increasing sphere size.
“These findings were further validated through a multiplexed inflammatory mouse cytokine profile (Figure 2e).”
Quote in the paperSubstantial claim - Findingown data
In rodent and non-human primate models, implanted spheres with diameters of 1.5 mm or more, made from a wide range of materials, significantly reduced foreign body reactions and fibrosis relative to smaller spheres.
“In rodent and non-human primate animal models, implanted spheres 1.5 mm and above in diameter across a broad spectrum of materials, including hydrogels, ceramics, metals, and plastics, significantly abrogated foreign body reactions and fibrosis when compared to smaller spheres.”
Quote in the paperSubstantial claim - Findingown data
q-PCR expression of Col1a1, Col1a2, and αSMA in rats verified that increasing glass sphere size resulted in a significant reduction of fibrosis formation directly on spheres.
“q-PCR expression analysis of fibrosis markers, collagen 1a1 (Col1a1), collagen 1a2 (Col1a2), and αSMA, verified that increasing sphere size resulted in a significant reduction of fibrosis formation directly on spheres”
Quote in the paperSubstantial claim
- Findingown data
Across all materials tested, increasing sphere size led to a significant reduction of innate immune cell accumulation in peripheral omental and epididymal fat pad tissue, as measured by flow cytometry and q-PCR.
“These analyses revealed that across all materials tested (SLG20 alginate, LF10/60 alginate, stainless steel, glass, polycaprolactone, and polystyrene) increasing sphere size led to a significant reduction of innate immune cell accumulation in peripheral tissue.”
Quote in the paperSubstantial claim - Findingown data
In the cellular overgrowth on alginate spheres, q-PCR expression of the fibrosis markers Col1a1, Col1a2, and αSMA decreased as sphere size increased.
“q-PCR expression analysis of additional fibrosis markers, namely collagen 1a1 (Col1a1), collagen 1a2 (Col1a2), and αSMA, further indicated reduced cellular deposition as the sphere size was increased”
Quote in the paperSubstantial claim - Findingown data
The difference in blood glucose normalization and fraction cured between the 0.5 mm and 1.5 mm capsule groups was statistically significant (p<0.0001) following the initial failure in regulating BGs by the 0.5 mm group (~day 25) throughout the remainder of the experiment.
“The difference in both BG normalization (Figure 4b) and fraction cured (Figure 4d) was significantly different (p<0.0001) between the 0.5 mm and 1.5 mm capsule groups following the initial failure in regulating BGs by the 0.5 mm group (~day 25) throughout the remainder of the experiment.”
Quote in the paperSubstantial claim - Findingown data
There were no significant differences in diffusion kinetics of glucose or insulin as a function of capsule geometry between 1.5 mm and 0.5 mm alginate capsules loaded with islets.
“We observed no significant differences in diffusion kinetics of glucose (Supplemental Figure S10) or insulin (Supplemental Figure S11) as a function of capsule geometry”
Quote in the paperSubstantial claim - Findingown data
In streptozotocin-treated diabetic C57BL/6 mice receiving encapsulated rat pancreatic islets, islets in 1.5 mm alginate capsules maintained blood-glucose control for up to 180 days, over five times longer than islets in 0.5-mm alginate capsules.
“We also show that for encapsulated rat pancreatic islet cells transplanted into streptozotocin-treated diabetic C57BL/6 mice, islets prepared in 1.5 mm alginate capsules were able to restore blood-glucose control for up to 180 days, a period more than 5-fold longer than for transplanted grafts encapsulated within conventionally sized 0.5-mm alginate capsules.”
Quote in the paperSubstantial claim - Findingown data
On 1.5 mm spheres, expression of macrophage markers associated only with classical and wound-healing phenotypes was enriched.
“In contrast, expression of macrophage markers associated only with classical and wound-healing phenotypes was enriched on 1.5-mm spheres (Figure 5e and Supplemental Table S1).”
Quote in the paperSubstantial claim - Findingown data
Alginate microspheres 1.5 mm in diameter warded off cellular deposition for at least 6 months.
“Significantly, alginate microspheres of 1.5 mm in diameter demonstrated an ability to ward off cellular deposition for at least 6 months.”
Quote in the paperSubstantial claim - Findingown data
Fibrotic tissue from 0.5 mm spheres showed increasing expression of markers associated with all three macrophage phenotypes.
“Fibrotic tissue obtained directly from the 0.5 mm-sized s showed increasing expression of markers associated with all three macrophage phenotypes.”
Quote in the paperSubstantial claim - Findingown data
At all evaluated time points, myeloid cell accumulation was significantly greater on 0.5 mm spheres than on 1.5 mm spheres.
“At all time points evaluated, we observed a significant increase in the accumulation of myeloid cells onto 0.5 mm-sized spheres compared to the 1.5 mm-sized spheres (Figure 5a).”
Quote in the paperSubstantial claim - Findingown data
Increased expression of regulatory macrophage markers was observed on days 4 and 7 in cells associated with 0.5 mm spheres.
“However, increased expression of markers associated with this macrophage phenotype was observed on days 4 and 7 in cells associated with the 0.5 mm spheres (Figure 5e).”
Quote in the paperSubstantial claim - Findingown data
Confocal imaging of retrieved capsules showed positive Newport Green (islet viability marker) staining only in the 1.5 mm group.
“Confocal images acquired from retrieved 0.5 mm and 1.5 mm capsules showed positive Newport Green (islet viability marker) staining only in the 1.5 mm group”
Quote in the paperSubstantial claim - Findingown data
Regulatory macrophage markers were not significantly up-regulated at any time point or in any compartment tested after implantation of 1.5 mm spheres.
“Regulatory macrophage markers were not significantly up-regulated at any time point or in any compartment tested following implantation of 1.5 mm-sized spheres.”
Quote in the paperSubstantial claim - Findingown data
Implantation of both 0.5 mm and 1.5 mm spheres increased expression of wound-healing phenotype markers in the intraperitoneal and peripheral omentum fat compartments.
“Implantation of both 0.5 mm- and 1.5 mm-sized spheres resulted in an increased expression of markers associated with a wound healing phenotype in the intraperitoneal and peripheral omentum fat compartments (Supplemental Figures S15 and S16, and Supplemental Table S1).”
Quote in the paperSubstantial claim - Findingown data
No significant fibrosis buildup was observed on 1.5 mm capsules retrieved after 180 days.
“while we did not observe significant buildup of fibrosis on the capsules upon retrieval after 180 days”
Quote in the paperSubstantial claim - Findingown data
qPCR analysis showed ~8-fold higher levels of rat Pdx1 in 1.5 mm capsules compared to 0.5 mm capsules.
“PDX1 expression results were further verified using qPCR analysis of RNA isolated from retrieved capsules, and an ~8-fold higher levels of rat Pdx1 was detectable in the 1.5 mm capsules compared to 0.5 mm capsules group”
Quote in the paperSubstantial claim - Findingown data
Mice in the 1.5 mm capsule treatment group lost blood glucose control after about 140 days.
“the mice in this treatment group lost blood glucose control after approximately 140 days.”
Quote in the paperSubstantial claim - Findingreasoning
Grafts in 1.5 mm capsules survived about six times longer than grafts in 0.5 mm capsules.
“Combined our results suggest that grafts in 1.5 mm-sized capsules survived ~ 6 fold prolonged duration compared to those prepared in conventionally sized 0.5 mm capsules because the tuned geometry hydrogels were able to resists fibrosis for a longer duration.”
Quote in the paperSubstantial claim - Findingown data
Gene expression patterns of cells from intraperitoneal space, omental fat pad tissue, and directly on spheres were significantly different after implantation of 0.5 mm spheres compared with 1.5 mm spheres.
“Overall, we observed significantly different gene expression patterns for cells associated with these tissues following implantation of 0.5 mm-sized spheres when compared to 1.5 mm-sized spheres (Supplemental Table S1).”
Quote in the paperSubstantial claim - Findingown data
Modulating spherical dimensions of a broad spectrum of materials (hydrogels, ceramics, metals, plastics) showed that spheres 1.5 mm or greater significantly mitigated foreign reactions and fibrosis.
“Modulating the spherical dimensions of a broad spectrum of materials encompassing hydrogels, ceramics, metals, and plastics also showed that spheres of 1.5 mm in diameter or greater significantly mitigated foreign reactions and fibrosis.”
Quote in the paperSubstantial claim - Findingown data
Intravital imaging showed macrophages extravasating from peripheral fat pad tissue and accumulating on 0.5 mm spheres over one week, with very few macrophages near 1.5 mm spheres.
“In vivo Z-stacked intravital images obtained from implanted medium- and large-sized spheres at 1, 4, and 7 days post-implant indicate that macrophage cells extravasate from peripheral fat pad tissue and accumulate onto 0.5 mm spheres over that one week period, while very few macrophages can be observed near the 1.5 mm spheres (Figure 5d).”
- Also stated in: § Abstract · boosted
“Z-stacked and time lapse intravital images of macrophage accumulation onto 0.5 mm and 1.5 mm sized spheres at 1, 4, and 7 days post-implantation confirm both a lack of macrophage activity and numbers surrounding 1.5 mm size spheres, and significant macrophage activity and numbers around 0.5 mm sized spheres (Supplemental Videos V3–V8).”
Quote in the paperSubstantial claim - Also stated in: § Abstract · boosted
- Interpretationown data
Size and shape, rather than stiffness, play a critical role in biocompatibility, based on evaluation of materials with stiffness ranging from soft alginate hydrogels (<100 kPa) to hard stainless steel (100s of GPa).
“Notably, our evaluation of a spectrum of materials with a range of mechanical stiffness properties varying from soft (Alginate hydrogels, < 100 kPa)34 to hard (Stainless steel, 100s of GPa)35 demonstrates that size and shape rather than stiffness plays a critical role in biocompatibility.”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [34] Papajova, E., Bujdos, M., Chorvat, D., Stach, M. & Lacik, I. Method for preparation of planar alginate hydrogels by external gelling using an aerosol of gelling solution. Carbohydr. Polym. 90, 472–482 (2012). source
Not checked in the free run.
- cites [35] Fujie, T. et al. Evaluation of substrata effect on cell adhesion properties using freestanding poly(L-lactic acid) nanosheets. Langmuir 27, 13173–13182 (2011). source
Not checked in the free run.
- Rests on an assumption: Findings in rodents and non-human primates about foreign body response to implanted spheres translate to humans.
- Interpretationown data
The size-dependent fibrotic response observations in C57BL/6 mice also translate to other larger rodent species.
“These results suggest our size-dependent fibrotic response observations in C57BL/6 mice also translate to other larger rodent species.”
Quote in the paperSubstantial claim - Interpretationown data
Tuning the spherical dimensions of biomedical devices can markedly improve their in vivo biocompatibility.
“Our findings suggest that the in vivo biocompatibility of biomedical devices can be significantly improved by simply tuning their spherical dimensions.”
Quote in the paperSubstantial claim- Rests on an assumption: Findings in rodents and non-human primates about foreign body response to implanted spheres translate to humans.
- Interpretationreasoning
The tuned geometry hydrogels resisted fibrosis for a longer duration than conventional 0.5 mm capsules.
“because the tuned geometry hydrogels were able to resists fibrosis for a longer duration.”
Quote in the paperSubstantial claim - Premisecitation
The MAFIA model enables induction of macrophage depletion via a Fas-induced apoptosis transgene under the Csf1r promoter.
“In this model, a macrophage Fas-induced apoptosis transgene enable inducible/reversible apoptosis of macrophages using the mouse colony stimulating factor 1 receptor promoter (Csf1r) to drive expression of a mutant human FK506 binding protein 1A, 12kDa42.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [42] Burnett, S. H. et al. Conditional macrophage ablation in transgenic mice expressing a Fas-based suicide gene. J. Leukocyte Biol. 75, 612–623 (2004). source
Not checked in the free run.
- Premisecitation
No consensus exists on the ideal geometry for biocompatibility.
“however there is still no consensus on an ideal geometry21.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [21] Helton, K. L., Ratner, B. D. & Wisniewski, N. A. Biomechanics of the sensor-tissue interface-effects of motion, pressure, and design on sensor performance and the foreign body response-part I: Theoretical framework. J. Diabetes Sci. Technol. 5, 632–646 (2011). source
Not checked in the free run.
- Interpretationown data
Spherical materials 1.5 mm in diameter or greater were significantly more biocompatible than smaller-sized counterparts.
“Spherical materials that are of 1.5 mm in diameter or greater proved to be significantly more biocompatible compared to their smaller-sized or counterparts.”
Quote in the paperSubstantial claim - Interpretationown data
These data are consistent with macrophage activation in those compartments being reduced when the implanted material is 1.5 mm spheres.
“We believe that these data are consistent with macrophage activation in these compartments, that is reduced when the implanted material are 1.5 mm spheres.”
Quote in the paperSubstantial claim - Premisecitation
Salthouse et al. observed that implants with smooth, well-contoured surfaces and no acute angles are more biocompatible.
“Salthouse et al. described that implant shape can profoundly affect macrophage behavior at the interface of percutaneous implants and observed that smooth, well contoured implants with no acute angles are more biocompatible20.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [20] Salthouse, T. N. Some aspects of macrophage behavior at the implant interface. J. Biomed. Mater. Res. 18, 395–401 (1984). source
Not checked in the free run.
- Premisecitation
The C57BL/6 mouse strain mounts a strong fibrotic and foreign body response that resembles what is seen in human patients.
“this strain is known to produce a strong fibrotic and foreign body response similar to observations made in human patients31.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [31] Kolb, M. et al. Differences in the fibrogenic response after transfer of active transforming growth factor-β1 gene to lungs of “fibrosis-prone” and “fibrosis-resistant” mouse strains. Am. J. Respir. Cell Mol. Biol. 27, 141–150 (2002). source
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- Premisecitation
Alginate microspheres placed in the intraperitoneal space of non-human primates or immunocompetent rodents cause foreign body reactions and fibrosis.
“When implanted into the intraperitoneal space of non-human primates or immunocompetent rodents, alginate microspheres elicit foreign body reactions and fibrosis29, 30.”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [29] Dang, T. T. et al. Spatiotemporal effects of a controlled-release anti-inflammatory drug on the cellular dynamics of host response. Biomaterials 32, 4464–4470 (2011). source
Not checked in the free run.
- cites [30] King, A., Sandler, S. & Andersson, A. The effect of host factors and capsule composition on the cellular overgrowth on implanted alginate capsules. J. Biomed. Mater. Res. 57, 374–383 (2001). source
Not checked in the free run.
- Interpretationown data
Lack of regulatory macrophage accumulation on large spheres correlates with truncated fibrosis responses.
“Combined our observations suggest that a lack of regulatory macrophage cell accumulation on large size spheres correlates with the truncated fibrosis responses.”
Quote in the paperSubstantial claim - Study design and conductcitation
For initial screening, the study used an immunocompetent C57BL/6 mouse model to ensure proper biocompatibility assessment.
“To ensure proper biocompatibility assessment in our studies we used an immunocompetent C57BL/6 mouse model for our initial screening”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [31] Kolb, M. et al. Differences in the fibrogenic response after transfer of active transforming growth factor-β1 gene to lungs of “fibrosis-prone” and “fibrosis-resistant” mouse strains. Am. J. Respir. Cell Mol. Biol. 27, 141–150 (2002). source
Not checked in the free run.
- Premisecitation
Prior work by the authors and others showed that cellular and collagen deposition on the surface of transplanted 0.5 mm alginate microcapsules causes encapsulated islet graft death and failure to correct diabetes in STZ-treated C57BL/6 mice.
“Previously, we and others have shown that host recognition and fibrosis via cellular and collagen deposition on the surface of transplanted 0.5 mm sized alginate microcapsules results in encapsulated islet graft cell death and the failure of diabetic correction in STZ-treated C57BL/6 mice28, 37, 38.”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [28] Dolgin, E. Encapsulate this. Nature Med. 20, 9–11 (2014). source
Not checked in the free run.
- cites [37] Dang, T. T. et al. Enhanced function of immuno-isolated islets in diabetes therapy by co-encapsulation with an anti-inflammatory drug. Biomaterials 34, 5792–5801 (2013). source
Not checked in the free run.
- cites [38] de Groot, M., Schuurs, T. A. & van Schilfgaarde, R. Causes of limited survival of microencapsulated pancreatic islet grafts. J. Surg. Res. 121, 141–150 (2004). source
Not checked in the free run.
- Interpretationown data
Macrophages are a key driver of the fibrotic responses to the implanted materials.
“These results confirm that macrophages are indeed a key driver of the fibrotic responses we have observed in response to our transplanted materials.”
- Also stated in: § Abstract · hedged
“Macrophages have been implicated as key drivers of the foreign-body reaction to implanted materials41.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [41] Shi, C. & Pamer, E. G. Monocyte recruitment during infection and inflammation. Nature Rev. Immunol. 11, 762–774 (2011). source
Not checked in the free run.
- Also stated in: § Abstract · hedged
- Premisecitation
In humans, host recognition and fibrosis of alginate capsules, regardless of donor tissue, is the main obstacle to using encapsulated donor islets to treat type-1 diabetes.
“Host recognition and fibrosis of alginate capsules in humans, independent of donor tissue, is the key barrier to the clinical translation of encapsulated donor islets for treatment of type-1 diabetes26, 27, 28.”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [26] Lim, F. & Sun, A. M. Microencapsulated islets as bioartificial endocrine pancreas. Science 210, 908–910 (1980). source
Not checked in the free run.
- cites [27] Scharp, D. W. & Marchetti, P. Encapsulated islets for diabetes therapy: History, current progress, and critical issues requiring solution. Adv. Drug Deliv. Rev. 67–68, 35–73 (2014). source
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- cites [28] Dolgin, E. Encapsulate this. Nature Med. 20, 9–11 (2014). source
Not checked in the free run.
- Interpretationreasoning
The loss of blood glucose control in the 1.5 mm capsule group likely indicates some islet viability loss after transplantation.
“This likely suggests some islet viability loss after transplantation, which could be related to the long-term durability of the rat islets used in this treatment model.”
Quote in the paperSubstantial claim - Interpretationown data
Tuning the geometry of implanted materials can influence host recognition and propagation of foreign body reactions.
“In summary, we have demonstrated that tuning the geometry of implanted materials we can influence their host recognition and propagation of foreign body reactions.”
Quote in the paperSubstantial claim
- May combine two claims. 19
- The quote only partly states this claim. 2
- Classified as probably not a substantial claim. 8
May combine two claims.
Findingown dataRetrieved 1.5 mm spheres from the NHP intraperitoneal study had minimal cellular deposition, lack of immune macrophages, and fibrosis-associated activated myofibroblast coverage.
“Z-stacked confocal imaging of the retrieved 1.5 mm spheres confirms minimal cellular deposition, a lack of immune macrophages, and fibrosis-associated activated myofibroblast coverage”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataImmunofluorescence showed a significant decrease in macrophage (CD68) and myofibroblast (αSMA) deposition across all materials tested with increased sphere size; large SLG20 alginate, LF10/60, glass, and stainless steel spheres had negligible cellular deposition.
“Immunofluorescence stained z-stacked confocal images of retrieved materials showed a significant decrease in macrophage (CD68) and myofibroblast (αSMA) deposition across all materials tested, and significantly, large SLG20 alginate, LF10/60 (endotoxin containing alginate), glass, and stainless steel spheres had negligible cellular deposition”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataThe size-modulated fibrotic deposition effect is not due to delayed kinetics: after 6 months, 1.5 mm SLG20 alginate spheres were largely free of cellular deposition, whereas 0.3 mm spheres were covered with deposited cells and clumped in fibrotic tissue.
“Dark field phase contrast images from retrieved capsules show that the 1.5 mm spheres are largely devoid of cellular deposition while the 0.3 mm sized spheres are covered with deposited cells and are clumped together in fibrotic tissue”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataThe size-modulated fibrotic deposition phenomenon extends to other materials: for SLG20 alginate, LF10/60 alginate, stainless steel, glass, polycaprolactone, and polystyrene spheres implanted in C57BL/6 mice, larger spheres (1.5-2.5 mm) had markedly reduced cellular overgrowth thickness compared to medium-sized spheres (0.4-0.6 mm) after 14 days.
“Bright-field images from retrieved materials 14 days post-implant revealed significant cellular deposition on the medium-sized versions of all materials tested. Interestingly, all materials tested at an increased size led to a marked reduction of the thickness of cellular overgrowth deposition”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataIn Sprague-Dawley rats, 2.0 mm glass spheres implanted intraperitoneally had no cellular deposition while 0.5 mm spheres were clumped and embedded in a thick fibrotic capsule after 14 days.
“Bright field and Z-stacked confocal images obtained from retrieved glass microspheres show that the large spheres are devoid of any cellular deposition while the smaller spheres are significantly clumped together and embedded within a thick fibrotic capsule”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataIn a pilot non-human primate intraperitoneal study, 1.5 mm SLG20 alginate spheres remained translucent and not embedded in omentum/fat tissue after 14 days, while 0.5 mm spheres were embedded in omentum/fat tissue.
“The obtained in situ images reveal that the 1.5 mm-sized spheres remain translucent and are not embedded into host omentum/fat tissue after 14 days; conversely, the 0.5 mm sized spheres are impeded in to the omentum/fat tissue”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataIn STZ-induced diabetic C57BL/6 mice transplanted with rat islets, all mice in the 0.5 mm capsule group failed (BG above 200 mg/dl for 3 consecutive measurements) on average by 30 days, while the 1.5 mm capsule group stayed cured on average until 175 days (greater than 5-fold increase) post-transplantation.
“All mice (n = 5) in the 0.5 mm capsule group failed (i.e. BG above 200 mg/dl for 3 consecutive measurements), on average, by 30 days following transplantation, while in the 1.5 mm capsule group (n = 5), stayed cured, on average, even until 175 days (greater than a 5-fold increase) post-transplantation”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataAt 6 months post-transplantation, retrieved 0.5 mm capsules were covered in cellular deposition and clumped, while 1.5 mm capsules were largely clean and void of cellular deposition.
“Dark field imaging revealed that the 0.5 mm capsules were covered in cellular deposition and clumped but the 1.5 mm capsules were largely clean and void of cellular deposition”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataThe size-modulated fibrotic response is not merely a function of total surface area: when 0.5 mm and 1.5 mm spheres were implanted with equalized total surface area, the 1.5 mm spheres had limited cellular deposition while the 0.5 mm spheres had significant deposition.
“To ensure that the size-modulated fibrotic response effect is not simply a function of surface area, we implanted spheres of two sizes, 0.5 mm and 1.5 mm, normalized in total surface area.”
- Also stated in: § Abstract · plain
“Dark field phase contrast images of the retrieved spheres revealed only limited cellular deposition on the 1.5 mm-sized spheres and significant cellular deposition on the 0.5 mm sized spheres”
Quote in the paperSubstantial claim- Also stated in: § Abstract · plain
The quote only partly states this claim.
Findingown dataIn C57BL/6 mice, increasing the diameter of implanted Ba+-cross-linked SLG20 alginate hydrogel spheres from 0.3 to 1.9 mm reduced cellular and fibrotic deposition on the spheres after 14 days.
“Dark field phase contrast images from retrieved spheres show a marked reduction in cellular deposition onto spheres as their size is increased”
- Also stated in: § Abstract · plain
“Interestingly, the larger spheres had significantly reduced fibrotic deposition”
Quote in the paperSubstantial claim- Also stated in: § Abstract · plain
May combine two claims. The quote only partly states this claim.
Findingown dataIn non-human primates, subcutaneously implanted 1.5 mm SLG20 alginate spheres were not embedded in host tissue and had negligible cellular deposition and lack of fibrosis at 14 and 28 days, whereas 0.5 mm spheres and cylinders were profusely embedded in host tissues with fibrosis up to 100 μm thick.
“At both 14 and 28 days post implantation retrieval time points the 1.5 mm-sized SLG20 alginate spheres were not embedded in host tissue and freely dissociated from the implant site upon incision with a biopsy punch”
- Also stated in: § Abstract · plain
“extensive embedding and fibrosis buildup (up to 100 μm thick) is visible enveloping the implanted cylinders and medium sized spheres.”
Quote in the paperSubstantial claim- Also stated in: § Abstract · plain
May combine two claims.
Findingown dataWestern blot analysis of retrieved capsules showed that 4 out of 5 mice in the 0.5 mm group had diminished PDX-1 expression and all 5 had high αSMA; all 5 mice in the 1.5 mm group had high PDX-1 and minimal αSMA.
“4 out of 5 mice in the 0.5 mm capsule group had comparatively diminished PDX-1 expression and all 5 mice showed high levels of alpha smooth muscle expression; conversely, high levels of PDX-1 and minimal alpha smooth muscle actin were detected in capsules retrieved from all 5 mice in the 1.5 mm capsule group”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataThe wound-healing phenotype marker expression was elevated at day 4 for both sphere sizes and decreased by day 7 for 1.5 mm spheres.
“This phenotype was elevated at day 4 for both sizes of spheres implanted in mice, and decreased by day 7 for the 1.5 mm-sized spheres.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataOn 1.5 mm spheres, neutrophil numbers were negligible and myeloid and macrophage cell numbers were limited at all time points.
“Notably, on 1.5 mm-sized spheres we observed negligible numbers of neutrophil cells and a limited number of myeloid and macrophage cells at all time points.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataIn MAFIA mice with induced macrophage depletion, 0.5 mm spheres retrieved after 14 days had limited cellular deposition, whereas non-depleted MAFIA mice had significant cellular deposition.
“Dark field microscope images of the retrieved spheres revealed only limited cellular deposition onto spheres implanted in mice with depleted macrophages and conversely significant cellular deposition onto spheres received from mice with macrophages (Supplemental Figure S13).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataBy four days after implantation, macrophage and neutrophil accumulation was significantly increased on 0.5 mm spheres and appeared to plateau by day 7.
“In probing macrophage and neutrophil cells, by four days post-implantation we observed significantly increased accumulation on 0.5 mm-sized spheres, which appears to plateau by day 7 (Figure 5b and c).”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationMacrophages have remarkable plasticity allowing them to respond to environmental signals and change phenotype.
“Macrophage cells have remarkable plasticity that allows them to efficiently respond to environmental signals and change their phenotype to address the implicated stimuli43.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [43] Gordon, S. Alternative activation of macrophages. Nature Rev. Immunol. 3, 23–35 (2003). source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationThe material spheres evaluated had relatively smooth surfaces, with roughness below 1 μm.
“The surface roughness of material spheres we evaluated here only included relatively smooth surfaced materials (<1 μm roughness)32, 33.”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [32] Lekka, M., Sainz-Serp, D., Kulik, A. J. & Wandrey, C. Hydrogel microspheres: Influence of chemical composition on surface morphology, local elastic properties, and bulk mechanical characteristics. Langmuir 20, 9968–9977 (2004). source
Not checked in the free run.
- cites [33] Shellenberger, K. & Logan, B. E. Effect of molecular scale roughness of glass beads on colloidal and bacterial deposition. Environ. Sci. Technol. 36, 184–189 (2002). source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationFor materials larger than 100 μm, greater thickness is generally thought to produce proportionally stronger foreign body responses and fibrosis.
“At the macro level (>100 μm in size), it is generally held that thicker materials produce a proportionally higher magnitude of foreign body responses and fibrosis3, 21.”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [3] Nichols, S. P., Koh, A., Storm, W. L., Shin, J. H. & Schoenfisch, M. H. Biocompatible materials for continuous glucose monitoring devices. Chem. Rev. 113, 2528–2549 (2013). source
Not checked in the free run.
- cites [21] Helton, K. L., Ratner, B. D. & Wisniewski, N. A. Biomechanics of the sensor-tissue interface-effects of motion, pressure, and design on sensor performance and the foreign body response-part I: Theoretical framework. J. Diabetes Sci. Technol. 5, 632–646 (2011). source
Not checked in the free run.
May combine two claims.
PremisecitationMalaga et al. reported that in rat gluteal muscle implants, circular rod cross-sections caused the least foreign body response, then pentagonal, and triangular caused the most.
“Among the shapes tested, circular rods produced the least amount of foreign body responses followed by pentagonal, and then triangular.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [19] Matlaga, B. F., Yasenchak, L. P. & Salthouse, T. N. Tissue response to implanted polymers: The significance of sample shape. J. Biomed. Mater. Res. 10, 391–397 (1976). source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationA regulatory macrophage phenotype correlates with elevated expression of IL10, Light, and Sphk1.
“Meanwhile, a regulatory macrophage phenotype has been characterized to correlate with elevated expression of Interleukin 10 (IL10), TNF superfamily member 14 (Light), and Sphingosine Kinase 1 (Sphk1)44, 45, 46.”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [44] Mosser, D. M. & Edwards, J. P. Exploring the full spectrum of macrophage activation. Nature Rev. Immunol. 8, 958–969 (2008). source
Not checked in the free run.
- cites [45] Murray, P. J. et al. Macrophage activation and polarization: Nomenclature and experimental guidelines. Immunity 41, 14–20 (2014). source
Not checked in the free run.
- cites [46] Gordon, S. & Martinez, F. O. Alternative activation of macrophages: Mechanism and functions. Immunity 32, 593–604 (2010). source
Not checked in the free run.
May combine two claims.
PremisecitationWard et al. reported that larger implanted polyurethane cylinders caused greater foreign body reactions and a thicker fibrotic layer around the implant.
“They found that increasing the size of implanted materials resulted in larger foreign body reactions, and the formation of a thicker layer of fibrosis around the implant23.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [23] Ward, W. K., Slobodzian, E. P., Tiekotter, K. L. & Wood, M. D. The effect of microgeometry, implant thickness and polyurethane chemistry on the foreign body response to subcutaneous implants. Biomaterials 23, 4185–4192 (2002). source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe MAFIA model's EGFP transgene enables in situ fluorescent monitoring of macrophages.
“Furthermore, an EGFP transgene included in this model enables the in situ fluorescent monitoring of macrophage cells42.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [42] Burnett, S. H. et al. Conditional macrophage ablation in transgenic mice expressing a Fas-based suicide gene. J. Leukocyte Biol. 75, 612–623 (2004). source
Not checked in the free run.
Classified as probably not a substantial claim.
PremisecitationMacrophages can be categorized into three activation states: classical/pro-inflammatory, alternative/pro-healing, and regulatory.
“There is a broad spectrum of macrophage activations which can be categorized into three states namely, classical activation (pro-inflammatory, MClassic), alternative activation (pro-healing, MWound), and regulatory activation (MReg)44.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [44] Mosser, D. M. & Edwards, J. P. Exploring the full spectrum of macrophage activation. Nature Rev. Immunol. 8, 958–969 (2008). source
Not checked in the free run.
Classified as probably not a substantial claim.
PremisecitationA pro-wound healing macrophage phenotype correlates with upregulation of Dcir, Stab1, CCL22, YM1, and Arg1.
“A pro-wound healing phenotype of macrophage correlates with up regulation in expression of Dendritic Cell Immune Receptor (Dcir), Stabilin 1 (Stab1), chemokine (C-C motif) ligand 22 (CCL22), Chitinase-like 3 (YM1), and Arginase 1 (Arg1)44, 45, 46.”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [44] Mosser, D. M. & Edwards, J. P. Exploring the full spectrum of macrophage activation. Nature Rev. Immunol. 8, 958–969 (2008). source
Not checked in the free run.
- cites [45] Murray, P. J. et al. Macrophage activation and polarization: Nomenclature and experimental guidelines. Immunity 41, 14–20 (2014). source
Not checked in the free run.
- cites [46] Gordon, S. & Martinez, F. O. Alternative activation of macrophages: Mechanism and functions. Immunity 32, 593–604 (2010). source
Not checked in the free run.
May combine two claims.
Interpretationown dataThe effect of sphere size on biocompatibility was independent of total implanted surface area and was visible with all materials tested.
“This effect was demonstrated to be independent of total implanted surface area and visible with all materials tested.”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationown dataIncreasing implant size alone is insufficient to resist foreign body responses; a spherical shape is also integral for resisting host fibrosis/rejection.
“Further, our finding suggests that simply increasing implant size is insufficient to resist foreign body responses and that a spherical shape is also integral for resisting host fibrosis/rejection.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
PremisecitationA pro-inflammatory macrophage phenotype correlates with elevated expression of TNFα, IL1, and IRF5.
“A pro-inflammatory macrophage phenotype correlates with elevated expression of Tumor Necrosis Factor α (TNF α), Interleukin 1 (IL1), and Interferon Regulatory Factor 5 (IRF5)44, 45, 46.”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [44] Mosser, D. M. & Edwards, J. P. Exploring the full spectrum of macrophage activation. Nature Rev. Immunol. 8, 958–969 (2008). source
Not checked in the free run.
- cites [45] Murray, P. J. et al. Macrophage activation and polarization: Nomenclature and experimental guidelines. Immunity 41, 14–20 (2014). source
Not checked in the free run.
- cites [46] Gordon, S. & Martinez, F. O. Alternative activation of macrophages: Mechanism and functions. Immunity 32, 593–604 (2010). source
Not checked in the free run.
The paper relies on this without support.
No prior study has examined the effect of sphere diameter on biocompatibility.
“Interestingly, to our knowledge no one has studied the effect of sphere diameter on biocompatibility.”
The paper relies on this without support.
Larger 1.5 mm sized spherical capsules have not previously been evaluated for islet cell encapsulation.
“Thus, to our knowledge larger 1.5 mm sized spherical capsules have previously not been evaluated for islet cell encapsulation.”
The paper relies on this without support.
Findings in rodents and non-human primates about foreign body response to implanted spheres translate to humans.
“Our findings suggest that the in vivo biocompatibility of biomedical devices can be significantly improved by simply tuning their spherical dimensions.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Smoother implant designs avoiding sharp corners can decrease tissue damage and chronic FBR.
“Smoother implant designs, avoiding sharp corners which can be particularly damaging to tissue when motion between the two occurs, can also be implemented to decrease tissue damage and chronic FBR (Veiseh et al., 2015).”
From Foreign Body Reaction to Implanted Biomaterials and Its Impact in Nerve Neuroprosthetics (2021) · cites this paper as Veiseh et al., 2015
The passage indexed under Abstract says that smooth, well-contoured implants without acute angles are more biocompatible, and the paper reports that implant geometry affects foreign body reactions and fibrosis (page unavailable). It does not establish that sharp corners cause damage specifically when the implant moves against tissue, or that smoothing corners reduces that damage. (LLM, conf=0.85)
Experimental — accuracy not yet measuredDecreasing the size of encapsulation devices down to the scale of individual islet microcapsules increases nutrient diffusion shortly after transplantation compared to macroencapsulation devices, but smaller capsule sizes have also been shown to induce a robust foreign body response and subsequent fibrosis.
“Interestingly, while decreasing the size of encapsulation devices down to the scale of individual islet microcapsules increases nutrient diffusion shortly after transplantation when compared to macroencapsulation devices, smaller capsule sizes have been shown to also induce a robust foreign body response and subsequent fibrosis.”
From Developments in stem cell-derived islet replacement therapy for treating type 1 diabetes (2023) · cites this paper as [103]
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredThe size effect was persistent in in vivo mouse, rat, and monkey models, implanting in both subcutaneous and intraperitoneal space, irrespective to the range of materials used, including alginate, stainless steel, glass, PCL, and polystyrene (PS).
“This extensive study showed observation in size effect to be persistent in in vivo mouse, rat, and monkey models, implanting in both subcutaneous and intraperitoneal space, irrespective to the range of materials used, including alginate, stainless steel, glass, PCL, and polystyrene (PS).”
From Unraveling and Harnessing the Immune Response at the Cell–Biomaterial Interface for Tissue Engineering Purposes (2024) · cites this paper as [122]
These size observations are restricted to spherical shapes, as changing the geometry and increasing the biomaterial size provoked in contrast fibrosis or implant rejection.
“However, these size observations are restricted to spherical shapes, as changing the geometry and increasing the biomaterial size provoked in contrast fibrosis or implant rejection.”
From Unraveling and Harnessing the Immune Response at the Cell–Biomaterial Interface for Tissue Engineering Purposes (2024) · cites this paper as [122]
Spheres with a small diameter (≤0.5 mm) induced severe FBR, while large spheres (1.5 mm) scarcely provoked FBR.
“Veiseh et al. supported this dimension effect, as spheres with a small diameter (≤0.5 mm) induced severe FBR, while large spheres (1.5 mm) scarcely provoked FBR.[ 122 ]”
From Unraveling and Harnessing the Immune Response at the Cell–Biomaterial Interface for Tissue Engineering Purposes (2024) · cites this paper as [122]
Spherical implants of 0.5 mm diameter generate higher degrees of FBR than larger 1.5 mm ones, an effect consistent for a wide range of materials.
“Spherical implants of 0.5 mm diameter generate higher degrees of FBR than larger 1.5 mm ones, an effect which is consistent for a wide range of materials (Veiseh et al., 2015).”
From Foreign Body Reaction to Implanted Biomaterials and Its Impact in Nerve Neuroprosthetics (2021) · cites this paper as Veiseh et al., 2015
Shape appears to directly influence FBR, with sharper edges generating more fibrosis than spherical implants.
“Similarly, shape appears to directly influence FBR, with sharper edges generating more fibrosis than spherical implants (Veiseh et al., 2015).”
From Foreign Body Reaction to Implanted Biomaterials and Its Impact in Nerve Neuroprosthetics (2021) · cites this paper as Veiseh et al., 2015
Newer evidence indicates that material geometry might be the main driver of the immune response.
“recent evidence suggests that material geometry, or size and shape, may in fact dominate the overall response.5-7”
From Micro- and Nanopatterned Topographical Cues for Regulating Macrophage Cell Shape and Phenotype (2015) · cites this paper as [6]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Conflicting duration of blood-glucose control
MajorThe 1.5-mm capsule group is described as remaining cured on average until day 175, when the experiment stopped. Later, the paper says mice in that treatment group lost blood-glucose control after approximately 140 days.
“while in the 1.5 mm capsule group (n = 5), stayed cured, on average, even until 175 days (greater than a 5-fold increase) post-transplantation, when the experiment was stopped”
“Interestingly, while we did not observe significant buildup of fibrosis on the capsules upon retrieval after 180 days, however the mice in this treatment group lost blood glucose control after approximately 140 days.”
Figure 4c is assigned to two different results
MinorThe text cites Figure 4c for both histology of retrieved primate implants and a glucose-tolerance test of transplanted islets, leaving the panel's identity inconsistent.
“H&E stained sections of retrieved large spheres confirmed negligible cellular deposition and a lack of fibrosis (Figure 4c).”
“At 7 days post-transplantation a glucose tolerance test (GTT) was used to evaluate the kinetics of blood glucose correction and no significant delays were measured as a function of capsule geometry (Figure 4c).”
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Hydrogel microparticles for biomedical applications
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“Smoother implant designs, avoiding sharp corners which can be particularly damaging to tissue when motion between the two occurs, can also be implemented to decrease tissue damage and chronic FBR (Veiseh et al., 2015).”
BackgroundInfluentialEngineering the next generation of cell-based therapeutics
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- Authors
- Veiseh, O., Doloff, J. C., Ma, M., Vegas, A. J., Tam, H. H., Bader, A. R., Li, J., Langan, E., Wyckoff, J., Loo, W. S., Jhunjhunwala, S., Chiu, A., Siebert, S., Tang, K., Hollister-Lock, J., Aresta-Dasilva, S., Bochenek, M., Mendoza-Elias, J., Wang, Y., Qi, M., Lavin, D. M., Chen, M., Dholakia, N., Thakrar, R., Lacík, I., Weir, G. C., Oberholzer, J., Greiner, D. L., Langer, R., & Anderson, D. G.
- Affiliations
- Boston Children's Hospital (US)
- Koch Institute for Integrative Cancer Research At MIT (US)
- Massachusetts Institute of Technology (US)
- University of Illinois Chicago (US)
- Joslin Diabetes Center (US)
- University of Massachusetts Chan Medical School (US)
- Corresponding author
- Anderson, Daniel G.
- ORCID
- Venue
- Nature Materials
- Published
- 2015-05-18
- Volume
- 14
- Issue
- 6
- Pages
- 643-651
- ISSN
- 1476-1122 (ISSN-L)
- 1476-4660
- PMC
- PMC4477281
- OpenAlex
- W1482515349
- Cited by
- 897
- References
- 51
- Citations by year
- 2026: 63 · 2025: 71 · 2024: 77 · 2023: 79 · 2022: 72 · 2021: 118 · 2020: 107 · 2019: 98 · 2018: 67 · 2017: 69 · 2016: 65 · 2015: 11
- FWCI
- 71.23
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Nature Materials (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship@UMassChan (acceptedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- DSpace@MIT (Massachusetts Institute of Technology) (submittedVersion, cc-by-nc-sa)
- PMC
- Funders
- National Institutes of Health (4r37eb000244-34, 5u54ca119349-05)
- National Cancer Institute (U54CA151884, CA151884, P30CA014051, P30-CA-14051, U54 CA-119349)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK091526)
- National Institute of Biomedical Imaging and Bioengineering (EB-000244, R01EB000244, R37-EB000244, EB 000351, R01EB000351)
- National Institute of Dental and Craniofacial Research (DE013023, R01DE013023)
- Topics
- Health Sciences › Medicine › Surgery › Tissue Engineering and Regenerative Medicine
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Physical Sciences › Engineering › Biomedical Engineering › Bone Tissue Engineering Materials
- Keywords
- foreign body reaction, biocompatibility, implant geometry, islet transplantation, alginate capsules, streptozotocin-induced diabetes, fibrosis, hydrogels, ceramics, metals, plastics, non-human primates, rodent models
- MeSH terms
- Animals, Foreign-Body Reaction, Mice, Inbred C57BL, Primates, Mice
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