Fixing the future of medical implants

When most people think about medical implants, they picture life‑changing tools like surgical meshes, artificial joints, breast reconstruction devices, shunts, stents, and other appliances that restore mobility, comfort, and independence. 

They’re right, but for a surprising number of patients, implants can also trigger chronic inflammation and scarring, leading to pain, complications, and the need for additional surgeries. 

Now, a new study has been published in Science Advances titled “Persistent glycolysis defines pathological foreign body–associated inflammation to polymeric implants,” led by Dalhousie trainees, Christian Rempe and Dr. Neal Callaghan. Under the supervision of Dr. Locke Davenport Huyer, assistant professor in the Department of Biomaterials & Applied Oral Sciences at Dalhousie’s Faculty of Dentistry, the study unveils a breakthrough insight into why this happens and how researchers can finally begin to prevent it.

When the immune system gets “stuck”

Our immune system is built to keep us safe. But when foreign material, like a medical implant, is inserted into the body, the same protective response can misfire. Instead of helping, the immune system can lock into a persistent inflammatory state known as glycolysis, forming a tight, fibrotic bubble around the device that interferes with how it works. 

“Implantable devices are everywhere,” says Dr. Callaghan, research assistant in the Davenport Huyer Lab and internal medicine resident physician. “But in some patients, these devices cause chronic inflammation—not because of the surgery or the device itself—but because of how the immune system reacts.”

The team discovered that certain immune cells near implants switch into a metabolic mode that doesn’t match what the body actually needs, and then they stay that way. 

Rempe, a PhD student who studies microbiology and immunology, is co-supervised by Drs. Michael Bezuhly and Locke Davenport Huyer. He primarily works in the Davenport Huyer Lab and explains the research with an analogy: “Different activities need different kinds of energy,” he says. “A sprinter and a marathoner don’t fuel the same way. Immune cells are similar, but in chronic inflammation, they get stuck using the wrong energy system.” 

Simply put, when doctors put a medical implant into the body, the immune system rushes in to check things out. Normally, those immune cells calm down once they realize there’s no infection, but this study discovered that around implants, the immune cells switch into a high-energy “sprint mode” (glycolysis) and then get stuck there. Instead of settling back down into “marathon mode” and helping the body heal, those immune cells stay revved up, acting like they’re fighting a threat that isn’t there.  

This constant, unnecessary activation drives long-lasting inflammation and scarring, which can cause pain, deformity, and even implant failure. Understanding this “stuck metabolism” gives researchers a new way to design safer implants and develop treatments that gently nudge immune cells back into a healthy, healing state.

Why this discovery matters  

Complication rates for common implantable devices are higher than most people realize.

“Meshes and breast reconstruction devices can have complication rates of 5 to 30 per cent or more,” Dr. Callaghan explains. “If we can pinpoint the exact immune pathways involved, we can prevent tens of thousands of patients every year from needing painful revision surgeries.” 

Understanding how and why immune cells get stuck in glycolysis opens the door to targeted therapies and approaches that gently steer the immune system in the right direction without the risks of full immunosuppression.

A foundation for next generation biomaterials 

Rather than identifying a single culprit, this research maps out a broader pattern—a foundation on which future breakthroughs can be built.

“What we’ve done is establish the broad strokes,” says Rempe. “By understanding these metabolic signatures, we can now start zeroing in on specific targets—the ones that will lead to new biomaterials or therapies that prevent harmful inflammation from happening in the first place.”  

The team is already digging deeper. Patient volunteers who experienced complications during breast reconstruction revisions have generously donated tissue samples. By studying these real-world responses, researchers hope to pinpoint exactly how and when inflammation becomes counterproductive.

“Our patient partners have shown incredible trust,” Callaghan says. “We’re hopeful we can identify meaningful targets for tailormade, next generation biomaterials.” 

Under Dr. Davenport Huyer and Dr. Bezuhly's leadership, the collection of tissue samples is continually expanding with partners at Nova Scotia Health, giving them the ability to identify exactly where and when inflammation shifts from helpful to harmful.

“By providing us with tissue samples, our patient partners are helping us truly understand the unique inflammation caused by implants. These insights are helping accelerate the development of new biomaterials innovations aimed at preventing implant complications,” says Dr. Davenport Huyer. 

The Pulse BioMed Hub Impact

Both Rempe and Dr. Callaghan emphasized that discoveries like this don’t happen in isolation. They require clinicians, engineers, and scientists working side by side—the kind of collaboration Atlantic Canada urgently needs more of. 

The Pulse BioMed Hub is a proposed facility at Dalhousie that would provide shared lab space, equipment, and multi-disciplinary collaboration opportunities to researchers across faculties like medicine, dentistry, and engineering.

Right now, Dalhousie’s most innovative biomedical work is happening across multiple buildings, departments, and health partners. The proposed Pulse BioMed Hub would connect these people, tools, and specializations more intentionally by creating shared infrastructure and coordinated spaces on campus. Importantly, the Hub’s biomaterials lab will be a highly specialized, access‑controlled environment that adds to Dalhousie’s research capacity. Together, these spaces are designed to strengthen collaboration, accelerate discovery, and give researchers access to the advanced facilities they need to drive medical innovation forward.  

And that’s where donors can make all the difference. 

“Innovation happens at the intersections,” Dr. Callaghan says. “When people with different expertise share a space, you get what’s known as ‘forced serendipity’. Moments that spark ideas none of us could create alone.”

Rempe agrees. “More collaboration is always better in science,” he says. “A shared hub would amplify everything we’re already doing and open the door to discoveries we haven’t even imagined yet.”  

With donor support, the Pulse BioMed Hub would offer state-of-the-art wet labs and specialized equipment, tools that individual labs could never afford alone that dramatically accelerate testing, prototyping, and refinement, and a place where engineers can hear clinical problems in real time and clinicians can learn about emerging technologies that could transform patient care. 

The Pulse BioMed Hub would also serve as a talent magnet for Atlantic Canada, attracting world‑class scientists, clinicians, entrepreneurs, and trainees who want to build their careers here. "In other places in the country, expertise in biomaterials development and translation is dispersed across a number of basic science disciplines. Dalhousie's focused expertise, investment, and emerging talent in biomaterials is what makes discoveries like this possible,” says Dr. Davenport Huyer. “I am excited to see how the Pulse BioMed Hub will expand this impact and drive future discoveries in patient-informed biomaterial design.” 

This space would be home to a pipeline that connects research to real-world solutions, ensuring discoveries like Rempe and Dr. Callaghan’s don’t sit on a shelf, but move toward safer, smarter medical devices. The Pulse BioMed Hub is not just an idea and it’s not just infrastructure. It’s a long-term engine for better patient outcomes and economic growth.

A defining moment for two emerging clinician scientists 

For Rempe, this study marks his first research publication as primary author—something he describes as both exhilarating and humbling.  

For Dr. Callaghan, the project has shaped his understanding of how clinical insight and scientific discovery fuel each other. 

“My biggest goal in medicine is to help more patients,” he says. “That means understanding disease at its roots, questioning what we assume we already know, and finding the gaps where innovation can happen.”

Both see Atlantic Canada as a place where this kind of innovation can thrive, especially if the Pulse BioMed Hub becomes a reality. 

What comes next

The team’s next steps include studying unusual fused immune cells called foreign body giant cells, still poorly understood in implant inflammation, expanding clinical research using donated patient samples, and identifying molecular targets that could enable “smart” implant materials engineered to avoid harmful immune responses.  

With the support of donors willing to invest in spaces like the Pulse BioMed Hub, that future may arrive much sooner than we think.

To learn more about the Pulse BioMed Hub at Dalhousie, contact: 

Melanie Bremner
Melanie.bremner@dal.ca 
(902) 266-2021