Skip to main content

Chapter 4 Immune Response

  • Chapter
  • First Online:
Handbook of Biomaterial Properties
  • 3085 Accesses

Abstract

There is increasing concern about the role of specific immune response to implanted materials. This section discusses the general principles governing immune responses and outlines techniques for their measurement and evaluation. This is a necessarily brief presentation of the issues, and the reader is encouraged to pursue the topic through relevant references provided for further study.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Additional Reading

  • General Immunology

    Google Scholar 

  • Golub, E.S. Green, D.R. (1990) Immunology, A Synthesis, 2nd Edition, Sinauer Associates, Inc., Sunderland: Good general text.

    Google Scholar 

  • Roitt, I. (1971) Essential Immunology, Blackwell Scientific Publications, London: Good description of types I–IV reactions.

    Google Scholar 

  • Annual Review of Immunology, Annual Reviews Inc., Palo Alto, CA: Yearly publication with timely reviews.

    Google Scholar 

  • Immunology Today: Elsevier Science Inc. Tarrytown, NY: Monthly: Good review articles.

    Google Scholar 

  • Antigen Presentation

    Google Scholar 

  • Celada, A. and Nathan, C. (1994) Macrophage activation revisited. Immunology Today, 15, 100–102: good review of macrophages.

    Google Scholar 

  • Chicz, R.M. and Urban, R.G. (1994). Analysis of MHC presented peptides: applications in autoimmunity and vaccine development. Immunology Today, 15, 155–160: good review on a complicated subject.

    Google Scholar 

  • CD markers

    Google Scholar 

  • Kemeny, D.M., Noble, A. Holmes, B.J. et al. (1994) Immune regulation: a new role for the CD8+ T cell. Immunology Today, 15, 107–110: Good description of the function of the CD8+ T-cell which is a key cell in Type IV responses.

    Google Scholar 

  • Sclossman, S.F., Boumsell, L., Gilkes, L.W. et al. (1994) CD antigens 1993. Immunology Today, 15, 98–99: good description of recently reported CDs.

    Google Scholar 

  • Cytokines/interleukins

    Google Scholar 

  • Miyajima, A., Kitamura, T., Harada, N. et al. (1992) Cytokine receptors and Signal Transduction. Annual Reviews of Immunology, 10, 295–331: Review of function and methods of stimulation.

    Google Scholar 

  • Mizel, S.B. (1989) The interleukins. FASEB J. 3, 2379–2388: good detailed review.

    Google Scholar 

  • Effects of cytokines/interleukins

    Google Scholar 

  • Goldring, M.B., and Goldring, S.R. (1990) Skeletal tissue response to cytokines. Clin. Orthop. Rel. Res., 258, 245–278: review of cytokines and orthopaedics.

    Google Scholar 

  • Stashenko, P., Obernesser, M.S., and Dewhirst, F.E. (1989) Effect of immune cytokines on bone. Immuno Invest., 18, 239–249: one of the few reviews focussing on bone.

    Google Scholar 

  • Immune response to metals/metallic implants

    Google Scholar 

  • Agrup, G. (1968) Sensitization induced by patch testing, Brit. J. Derm., 80, 631–634: points out problem of routine skin testing in nonallergic individual.

    Google Scholar 

  • Benson, M.K.D., Goodwin, P.G. and Brostoff, J. (1975) Metal sensitivity in patients with joint replacement arthroplasties, Brit. Med. J., 4, 374–375: third of the original 1975 articles pointing to a possible problem. Skin test used.

    Google Scholar 

  • Black J. (1988) Does corrosion matter? J. Bone Jt. Surg., 70B (4), 517–520: discusses issues of importance of understanding corrosion, minimizing it, and recognizing it can be important for the patient.

    Google Scholar 

  • Brown, G.C., Lockshin, M.D., Salvati, E.A. et al., (1977) Sensitivity to metal as a possible cause of sterile loosening after cobalt-chromium total hip-replacement arthroplasty, J. Bone Joint Surg., 59A(2), 164–168: Denies existence of metal allergy in orthopaedics. Complete misinterpretation of data. Uses negative results of an invalid test to draw conclusions. Limited patient population deliberately selected to prove lack of allergy.

    Google Scholar 

  • Burholm, A.; AI-Tawil, N.A.; Marcusson, J.A. et al. (1990): The lymphocyte response to nickel salt in patients with orthopedic implants. Acta Orthop. Scand., 61(2): 248–250: Example of use of LTT test.

    Google Scholar 

  • Elves, M.W., Wilson, J.N. and Kemp, H.B.S. (1975) Incidence of metal sensitivity in patients with total joint replacements. Brit. Med. J., 4, 376–378: Second one of the original 1975 articles pointing to a possible problem. Skin test used.

    Google Scholar 

  • Evans, E.M., Freeman, M.A.R., Miller, A.J. et al. (1974) Metal Sensitivity as a Cause of Bone Necrosis and loosening of the Prosthesis in Total Joint Replacement, J. Bone and Joint Surg., 56B (4), 626–642: One of the original articles pointing to a possible problem. Skin test used.

    Google Scholar 

  • Goh, C.L. (1986) Prevalence of contact allergy by sex, race, and age. Contact Dermat., 14, 237–240: discusses normal population

    Google Scholar 

  • Grimsdottir, M.R., Gjerdet, N.R. and Hensten-Pettersen, A. (1992) Composition and in vitro corrosion of orthodontic appliances. Am. J. Orthod. Dentofac. Orthop., 101, 525–532: Discusses sensitivity and stainless steels. Release of nickel related to many metallurgical aspects and not necessarily to nickel content of the metal.

    Google Scholar 

  • Lalor, P.A., Revell, P.A., Gray, A.B. et al. (1991) Sensitivity to titanium. J. Bone and Joint Surg., 73B(1), 25–28: Description of possible titanium sensitivity. Patch test vehicle of unknown composition, larger cobalt-chromium component than titanium component in device. Of interest and important, but not conclusive.

    Google Scholar 

  • Menne, T.; and Maibach, H.I. (1989) Systemic contact allergy reactions. Immunol Allergy Clin. N.A., 9, 507–522: Discusses extension from contact dermatitis to systemic reactions.

    Google Scholar 

  • Merritt, K. (1984) Role of medical materials, both in implant and surface applications, in immune response and in resistance to infection. Biomaterials, 5 (1), 47–53.: Review article. Out of date now but covers literature through 1983.

    Google Scholar 

  • Merritt, K. (1986) Biochemistry/hypersensitivity/clinical reactions. in: Lang B, Morris, J. and Rassoog, J. (eds) Proc. International Workshop on Biocompatibility, Toxicity, and Hypersensitivity to Alloy Systems used in Dentistry. Ann Arbor, U. MI; pp 195–223.: Review article. Covers the literature through 1984. Good discussion of the problem in the discussion section of the symposium

    Google Scholar 

  • Merritt, K. (1986) Chapter 6. Immunological testing of biomaterials, Techniques of Biocompatibility Testing, D.F. Williams (ed.), Vol. II, CRC Press, Boca Raton: Description of possible test methods.

    Google Scholar 

  • Merritt, K.; and Brown, S.A. (1980): Tissue reaction and metal sensitivity: An animal study. Acta Orthop. Scand. 51 (3), 403–411: Example of use of LIF test.

    Google Scholar 

  • Rostoker, G., Robin, J., Binet, O. et al. (1987) Dermatitis due to orthopaedic implants. J. Bone Joint Surg., 69A, 1408–1412: Example of a reaction to implant.

    Google Scholar 

  • Rudner, E.J., Clendenning, W.E., Epstein, E. et al. (1975) The frequency of contact dermatitis in North America 1972–1974. Contact Derm. 1, 277–280: Incidence of contact dermatitis.

    Google Scholar 

  • Shirakawa, T., Kusaka, Y. and Morimoto, K. (1992) Specific IgE antibodies to nickel in workers with known reactivity to cobalt. Clin. Exp. Allergy, 22 (2), 213–218: Measuring IgE and nickel cobalt interactions.

    Google Scholar 

  • Trobelli, L., Virgili, A., Corassa, M. et al. (1992) Systemic contact dermatitis from an orthodontic appliance. Contact Dermatitis, 27, 259–260: Example of reaction to dental application of metals.

    Google Scholar 

  • Yang, J., and Merritt, K. (1994) Detection of antibodies against corrosion products in patients after Co-Cr total joint replacements. J. Biomed. Mater. Res., 28, 1249–1258: Method for measuring antibodies to metals

    Google Scholar 

  • Immune response to latex, collagen, silicones

    Google Scholar 

  • Belsito, D.V. (1990) Contact urticaria caused by rubber. Analysis of seven cases. Dermatol. Clin. 8, 61–66: Questions whether increased demand for latex may have decreased quality with more allergens leachable.

    Google Scholar 

  • Hanke, C.W., Higley, H.R., Jolivette, D.M. et al. (1991) Abscess formation and local necrosis after treatment with Zyderm or Zyplast collagen implant. J. Amer. Acad. Dermatol. 25, 319–326: Deals with some adverse responses to collagen materials which may be related to the immune response. Points to possible problems.

    Google Scholar 

  • Meade, K.R., Silver, F.H. (1990) Immunogenicity of collagenous implants. Biomaterials, 11, 176–180: Discusses immunogenicity problem and cross linking. Good place to begin reading.

    Google Scholar 

  • Naim, J.O., Lanzafame, R.J. and van Oss, C.J. (1993). The adjuvant effect of silicone gel on antibody formation in rats. Immunol Inv., 22, 151–161: Shows that the gel is better than Freund’s adjuvant in stimulating the response to BSA in rats. Caution on use of gel.

    Google Scholar 

  • Slater, J.E. (1989) Rubber anaphylaxis. New Eng. J. Med. 320, 1126–1130: Good methods. Good literature review, real cases reacting to anaesthesia mask.

    Google Scholar 

  • Sussman, G.L., Tarlo, S. and Dolovich, J. (1991). The spectrum of IgE responses to latex. J. Am. Med. Assoc. 265, 2844–2847: Latex gloves on health workers causing allergic responses in patients. Can do skin test with latex to check patients or use non-latex gloves.

    Google Scholar 

  • Warpinski, J.R., Folgert, J., Cohen, M. et al. (1991) R.K. Bush. Allergic reaction to latex: a risk factor for unsuspected anaphylaxis. Allergy Proc. 12, 95–102: Clinical symptoms of Type I allergy. Identifies IgE antibodies against latex (gloves, balloons, condoms). IgE against proteins from latex.

    Google Scholar 

  • Wolk, L.E., Lappe, M., Peterson, R.D. et al. (1993) Immune response to polydimethylsiloxane (silicone): screening studies in a breast implant population. FASEB J., 7, 1265–1268: Very important study with a good technique. Hopefully more studies will be done with this technique. Valid test of antibody to silicone.

    Google Scholar 

  • Oxidative damage of implants

    Google Scholar 

  • Carter, W.O., Narayanan, P.K. and Robinson, J.P. (1994). Intracellular hydrogen peroxide and superoxide anion detection in endothelial cells. J. Leukocyte Biol. 55, 253–258: Good method for detecting H2O2 release and superoxide production. Example of biologically produced oxidizing species.

    Google Scholar 

  • Kao, W.J., Zhao, Q.H., Hiltner, A. et al. (1994) Theoretical analysis of in vivo macrophage adhesion and foreign body giant cell formation on polymethylsiloxane, low density polyethylene, and polyetherurethanes. J. Biomed. Mater. Res., 28 (1), 73–80: Recent article on macrophages on polymers and references some articles on oxidative events.

    Google Scholar 

  • Kaplan, S.S., Basford, R.E., Jeong, M.H. et al. (1994) Mechanisms of biomaterial induced superoxide release by neutrophils. J. Biomed. Mater. Res., 28, 377–86: Discusses the release of reactive oxygen species stimulated by biomaterials. Not all materials are activating.

    Google Scholar 

  • Consequences of immune responses to materials

    Google Scholar 

  • Angell, M. (1994) Do Breast implants cause systemic disease? Science in the court-room New Eng. J. Med., 330 (24), 1748–1749: Editorial in response to article by Gabriel et al. (1994) Reiterates the necessity of doing detailed studies. Indictment of patients, manufacturers and government jumping to conclusions using inadequate data. Doesn’t say how we get the adequate data though.

    Google Scholar 

  • Gabriel, S.E., O’Fallon, W.M., Kurland, L.T. et al. (1994) Risk of connective tissue diseases and other disorders after breast implantation. New Eng. J. Med., 330 (24), (1697–1702): Excellent study. Shows problems of doing studies on long term consequences. Example of how it ought to be done.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer Science+Business Media New York

About this chapter

Cite this chapter

Merritt, K. (2016). Chapter 4 Immune Response. In: Murphy, W., Black, J., Hastings, G. (eds) Handbook of Biomaterial Properties. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-3305-1_31

Download citation

Publish with us

Policies and ethics