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REVIEW article

Front. Immunol.

Sec. Inflammation

This article is part of the Research TopicCoagulation, Inflammation, and Healing: Defining the Intricate Network for Clinical InnovationView all 10 articles

Platelets: The First Cellular Responders in the Foreign Body Response to Blood-Contacting Biomaterials

Provisionally accepted
  • 1Nationwide Children's Hospital, Columbus, United States
  • 2The Ohio State University College of Medicine, Columbus, United States

The final, formatted version of the article will be published soon.

Implanting biomaterials gives rise to the foreign body response (FBR), a complex cascade consisting of blood-material interactions, provisional matrix formation, inflammation, wound healing, and remodeling. While tissue engineering seeks to harness this host response to transform implanted materials into living tissue, the FBR can drive various complications that undermine construct function and longevity with significant clinical impact for patients. The past several decades yielded important insights regarding protein adsorption dynamics and the subsequent cellular responders that exert significant influence over the inflammatory and healing processes governing the FBR. However, the contributions of platelets have often been overlooked and continue to remain underappreciated, especially compared to other major players like macrophages and fibroblasts. Beyond their classical role in hemostasis, platelet-derived products have long been explored for regenerative applications, and platelets are now recognized as immunomodulators. In this review, we highlight platelets as the first cellular responders to biomaterial implantation, emphasizing their active and multifaceted roles in the FBR. We further propose platelet modulation as a strategy to optimize host-material interactions and improve patient outcomes. A complete understanding of the FBR for blood-contacting biomaterials must begin with the arrival of the platelet.

Keywords: Foreign body response, Inflammation, innate immunity, Platelet, Tissue Engineering

Received: 01 Dec 2025; Accepted: 16 Feb 2026.

Copyright: © 2026 Turner, Villarreal, Reinhardt and Breuer. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Mackenzie Elizabeth Turner
Christopher Breuer

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.