Dissecting the Immune Response to Biomaterials for Pelvic Floor Disorders: A Multi-Model Approach

Pelvic Organ Prolapse (POP) is a prevalent pelvic floor disorder, affecting up to 50% of post-menopausal women. Although surgical repair with synthetic polypropylene (PP) mesh has been widely used, it is frequently associated with long-term complications such as chronic inflammation, pain, mesh erosion, and exposure. These issues are strongly linked to an unresolved and excessive foreign body response (FBR). As a result, regulatory bodies worldwide have imposed restrictions on the clinical use of PP meshes. This has underscored the urgent need for safer, more effective treatment options and a deeper understanding of how implanted materials interact with the host immune system. This research project aims to investigate the innate and adaptive immune response, and the underlying cellular and molecular mechanisms involved in host reactions to tissue-engineered constructs used for POP repair. By focusing on the interactions between various immune cells and resident fibroblasts at the mesh–tissue interface, the project seeks to provide critical insights into the pathways that govern either successful tissue integration or pathological outcomes such as fibrosis. By uncovering the immunological basis of the FBR to various biomaterials, this study will contribute to the rational evaluation and selection of existing mesh types and support the development of immune-informed preclinical testing models. Ultimately, the findings will enhance our understanding of biomaterial–immune system interactions, guiding safer and more effective surgical solutions for POP and related conditions.