Phagocytosis: Reemerging roles for a primitive function

BACKGROUND:: Described by Metchnikoff, it has been 100 years since the discovery of phagocytosis was awarded the Nobel Prize. Since then, advances in phagocytosis research have vastly expanded its potential clinical application to health and disease. In this article, the authors revisit this process of evolution and chart out its relevance to plastic surgery. METHODS:: The discovery and evolution of the concept of phagocytosis are described. Its role in innate and adaptive immune responses is reviewed in the light of converging new discoveries in allied fields. Lastly, how the Rubicon of phagocytosis research could specifically address brittle plastic surgical problems is examined and currently available research tools that would specifically facilitate this work are described. RESULTS:: Phagocytosis is centrally important in an expanded repertoire of plastic surgical problems. These include aging, wherein a rapid rate of elimination of apoptotic elements could slow chronologic damage. Other examples include problematic wound repair; skin cancers including melanoma; in radiation and metabolic tissue insult; keloid and hypertrophic scarring; burns and antibiotic-resistant infections; transplantation immunology; regenerative medicine; and lastly "cosmeceuticals," wherein nanoparticle-based drug delivery systems could be explored using novel phagocytic carriers. CONCLUSIONS:: For plastic surgeons, phagocytosis research is an attractive opportunity to solve some tough clinical problems. For biologists, the collaboration with plastic surgeons opens a vista of novel translational research. It holds the robust promise of developing a new class of drugs with which to address vast unmet clinical needs. For phagocytosis, its reemergence is a well-deserved encore. Lastly, for Metchnikoff, it is a befitting 100-year anniversary.