The biocompatibility of coatings applied to implants is a critical factor in ensuring optimal implant performance and patient safety. Recent studies have highlighted the significant impact of protein interactions on the biocompatibility of these coatings. This review aims to provide a comprehensive overview of the current understanding of how proteins influence the biocompatibility of coatings applied to implants. The biocompatibility of these coatings is affected by various factors, including the type and concentration of proteins present in the surrounding environment. Proteins can interact with the coating material, altering its surface properties—such as hydrophilicity, roughness, and charge—and subsequently affecting the host response,including inflammation, fibrosis, and osseointegration.Protein adsorption onto the surface forms a layer that mediates blood cell adhesion and cellular responses, significantly influencing the surface's biocompatibility. This review emphasizes the dual nature of proteins: while some enhance biocompatibility by promoting cell adhesion and proliferation, others may induce adverse effects. The article explores the mechanisms through which proteins interact with coatings and discusses how these interactions can be optimized to improve biocompatibility. Finally, the review highlights the potential of protein-modified coatings to enhance both biocompatibility and functionality in various implant applications, including orthopedic and cardiovascular implants. Such coatings demonstrate the ability to improve cell adhesion, promote tissue integration, and reduce inflammatory responses.
