Mesenchymal stem cell-based bioengineered constructs: Foreign body response, cross-talk with macrophages and impact of biomaterial design strategies for pelvic floor disorders

Shayanti Mukherjee, Saeedeh Darzi, Kallyanashis Paul, Jerome A. Werkmeister, Caroline E. Gargett

Research output: Contribution to journalReview ArticleResearchpeer-review

48 Citations (Scopus)


An excessive foreign body response (FBR) has contributed to the adverse events associated with polypropylene mesh usage for augmenting pelvic organ prolapse surgery. Consequently, current biomaterial research considers the critical role of the FBR and now focuses on developing better biocompatible biomaterials rather than using inert implants to improve the clinical outcomes of their use. Tissue engineering approaches using mesenchymal stem cells (MSCs) have improved outcomes over traditional implants in other biological systems through their interaction with macrophages, the main cellular player in the FBR. The unique angiogenic, immunomodulatory and regenerative properties of MSCs have a direct impact on the FBR following biomaterial implantation. In this review, we focus on key aspects of the FBR to tissue-engineered MSC-based implants for supporting pelvic organs and beyond. We also discuss the immunomodulatory effects of the recently discovered endometrial MSCs on the macrophage response to new biomaterials designed for use in pelvic floor reconstructive surgery. We conclude with a focus on considerations in biomaterial design that take into account the FBR and will likely influence the development of the next generation of biomaterials for gynaecological applications.

Original languageEnglish
Article number20180089
Number of pages15
JournalInterface Focus
Issue number4
Publication statusPublished - 6 Aug 2019


  • Biomaterials
  • Foreign body reaction
  • Immunomodulation
  • M1
  • M2
  • Macrophages
  • Mesenchymal stem cells
  • Pelvic organ prolapse
  • Tissue engineering

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