{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T06:34:09Z","timestamp":1772778849383,"version":"3.50.1"},"reference-count":167,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1758373","type":"journal-article","created":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T05:29:51Z","timestamp":1772774991000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Platelets: the first cellular responders in the foreign body response to blood-contacting biomaterials"],"prefix":"10.3389","volume":"17","author":[{"given":"Mackenzie E.","family":"Turner","sequence":"first","affiliation":[{"name":"The Center for Regenerative Medicine, Abigail Wexner Research Institute Nationwide Children\u2019s Hospital","place":["Columbus, OH, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Delaney J.","family":"Villarreal","sequence":"additional","affiliation":[{"name":"The Center for Regenerative Medicine, Abigail Wexner Research Institute Nationwide Children\u2019s Hospital","place":["Columbus, OH, United States"]},{"name":"The Ohio State University College of Medicine","place":["Columbus, OH, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James W.","family":"Reinhardt","sequence":"additional","affiliation":[{"name":"The Center for Regenerative Medicine, Abigail Wexner Research Institute Nationwide Children\u2019s Hospital","place":["Columbus, OH, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher K.","family":"Breuer","sequence":"additional","affiliation":[{"name":"The Center for Regenerative Medicine, Abigail Wexner Research Institute Nationwide Children\u2019s Hospital","place":["Columbus, OH, United States"]},{"name":"Department of Surgery, The Ohio State University College of Medicine","place":["Columbus,\u00a0OH, United States"]},{"name":"Department of Surgery, Nationwide Children\u2019s Hospital","place":["Columbus, OH, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1016\/j.smim.2007.11.004","article-title":"FOREIGN BODY REACTION TO BIOMATERIALS","volume":"20","author":"Anderson","year":"2008","journal-title":"Semin Immunol"},{"key":"B2","doi-asserted-by":"crossref","first-page":"389","DOI":"10.2217\/rme-2018-0133","article-title":"Early natural history of neotissue formation in tissue-engineered vascular grafts in a murine model","volume":"14","author":"Reinhardt","year":"","journal-title":"Regener Med"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1007\/s40883-022-00279-6","article-title":"Harnessing biomaterials for immunomodulatory-driven tissue engineering","volume":"9","author":"Zhong","year":"2023","journal-title":"Regener Eng Transl Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1038\/s41536-025-00419-w","article-title":"Modulating the platelet-mediated innate foreign body response to affect in situ vascular tissue engineering outcomes","volume":"10","author":"Turner","year":"2025","journal-title":"NPJ Regener Med"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-197811000-00005","article-title":"The preclotting of porous arterial prostheses","volume":"188","author":"Yates","year":"1978","journal-title":"Ann Surg"},{"key":"B6","doi-asserted-by":"crossref","first-page":"1074878","DOI":"10.3389\/fmed.2023.1074878","article-title":"Platelet, a key regulator of innate and adaptive immunity","volume":"10","author":"Yan","year":"2023","journal-title":"Front Med Lausanne."},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2019.01320","article-title":"Regulation of innate immune responses by platelets","volume":"10","author":"Ribeiro","year":"2019","journal-title":"Front Immunol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1021\/acsbiomaterials.7b00013","article-title":"Platelets and platelet-inspired biomaterials technologies in wound healing applications","volume":"4","author":"Sekhon","year":"2018","journal-title":"ACS Biomater. 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