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Bones are remarkable tissues that can repair themselves, but in cases of major injury, disease, or surgery, this natural healing ability is often not enough. Surgeons typically use bone grafts to support healing, with the patient’s own bone (autograft) considered the best option. However, autografts are limited and require additional surgery, creating the need for better alternatives. Traditionally, new bone materials have been designed to mimic bone structure, but recent research shows that the immune system is just as important in determining whether healing succeeds.

This thesis investigates how the immune system can be guided to support bone regeneration by using microbial components. Our immune system recognizes microbes through specific patterns called PAMPs (pathogen-associated molecular patterns). By safely using non-viable microbes or synthetic versions of these patterns, it may be possible to trigger a controlled immune response that encourages bone repair. To test this, different microbial components were combined with calcium phosphate, a common bone substitute, and their effects studied in cells and animal models.

The results show that certain components, such as BCG and CpG ODN C, promoted bone cell growth, while others, like Poly(I:C) and LPS, hindered it. Importantly, the studies also found that immune “memory” influences bone repair, meaning past exposures can affect how a patient responds to implants. These findings highlight the potential of using the immune system not as an obstacle, but as an ally, in developing new bone grafts that are more effective and personalized.