Foreign-body response with fibroblasts

The foreign body response to carbon fibers is not chronic unless they fragment. One major problem has been the accumulation of wear debris near the acetabular components [129]. However, when used as ligament replacements, carbon fibers appear to induce a type of fibrosis in which collagen fibers align with the fibers. This suggests that carbon fibers can be used as a template for the formation of fibrous tissue [130] and indeed tendon fibroblast cells have been grown on a... 

The mechanism of action of talc in pleurodesis has not been fully elucidated, although it is thought to stimulate a typical local inflammatory response, with reduced fibrinolytic activity, mesothelial cell injury, and fibroblast proliferation. Pneumonitis or respiratory failure can be secondary to downstream inflammatory mediators from more proximal talc injury (7). This acute-phase inflammatory response is dose-related (8,9) and is inhibited by glucocorticoids (10). Talc may also have an adhesion stimulating quality, since empyema alone stimulates a typical inflammatory response but does not lead to pleurodesis (11). In fact, talc stimulates intercellular adhesion molecule-1 in mesothelial cells (12). The mechanism of chronic fibrosis may involve continuous fibroblast activation by foreign body giant cell released mediators or macrophages. 

A minimal response is generally called fibrous encapsulation and the implant is encapsulated within fibrous tissue containing mainly collagen with a few fibroblasts. At the tissue/implant interface, a one to two cell layer of macrophages and foreign body giant cells is present which constitutes the foreign body reaction. 

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