Dual-inflammatory cytokines on TiO2 nanotube-coated surfaces used for regulating macrophage polarization in bone implants.

Excessive immune responses following the use of implantable, biomaterial-based medical devices represent a substantial challenge for treatment efficacy and patient well-being. Specifically, after implantation, pro-inflammatory M1 macrophages are activated by cytokines such as interferon-γ (IFN-γ) followed by anti-inflammatory M2 macrophages polarized by cytokines including interleukin-4 (IL-4), leading to healing and long-term stability of implants. Here, we report the loading of an immunomodulatory cytokine,IL-4, into TiO2 nanotubes (TNTs) followed by hydrogel coating on the TNTs for subsequent release of IL-4. Finally, IFN-γ was added onto the gel layer to effect rapid release. The release rates of both cytokines from the samples were monitored using an immersion test in phosphate-buffered solution. The cytocompatibility of the sample was evaluated using cultures of osteoblasts and macrophages. Macrophage phenotype switching in vitro was examined via cytokine secretion and gene expression analyses. In vitro testing showed that the sample could stimulate macrophage polarization from the M1 to M2 phenotype at the desired period owing to temporal release of IFN-γ and IL-4. Another biomaterial containing only IL-4 in TNTs was also able to modulate the transformation of M1 to M2 although with weaker effect than that containing IFN-γ and IL-4. The biomaterial may be useful as an osteoimplant in vivo owing to the inflammation caused by a wound or implantation. This study provided biomaterials capable of facilitating smooth M1 to M2 macrophages switching, which might be helpful to research immune responses of tissues to implants and will likely contribute to the development of bone substitute materials.