The recruitment of primitive Lin− Sca-1+, CD34+, c-kit+ and CD271+ cells during the early intraperitoneal foreign body reaction

Implanted materials, such as medical devices, provoke the body to initiate an inflammatory reaction, known as the foreign body reaction (FBR), which causes several complications for example in hip prostheses, silicone implants, peritoneal dialysis catheters and left ventricular assist devices. FBR is initiated by macrophage adherence and results in granulation tissue formation. The early immunobiology and development of this tissue is not completely understood, but there are indications from related myofibroblast-forming diseases such as vascular repair and fibrosis that primitive stem cells also play a role in the formation of FBR-tissue. To investigate this, acellular photo-oxidized bovine pericardium patches were implanted intraperitoneally in rats and retrieved at time-points ranging from 6 h to 7 days. A significant fraction of Sca-1+ (6 h–2 days), c-kit+, CD34+ and CD271+ (2–3 days) stem/progenitor cells were detected. Colony-forming and differentiation capacity of the primitive stem cells into adipo-, osteo-, and myofibroblasts were shown. The presence of these primitive cells and their myofibroblastic differentiation potential were also confirmed at RNA level. The identification of specific primitive cells during FBR may have important implications for the inflammatory responses to inert materials and their use in tissue prostheses.