Tehran University of Medical Sciences Iranian Journal of Allergy, Asthma and Immunology 1735-1502 17 5 2018 10 07 398 408 EN Zahra Jamalpoor Trauma Research Center, AJA University of Medical Sciences, Tehran, Iran Alireza Asgari Aerospace Medicine Research Center, AJA University of Medical Sciences, Tehran, Iran Mohammad Hossein Lashkari Department of Surgery, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran Abbas Mirshafiey Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Monireh Mohsenzadegan Department of Medical Laboratory Science, Faculty of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran 2017 08 21 2017 12 13 Innate immune cells play a crucial role in bone development and repair. Macrophages are the main effector cells in immune responses to implants and are indispensable for bone healing success. The heterogeneity and plasticity of macrophages make them a prime target for immune system modulation to enhance bone repair and regeneration. It is believed that the polarization of macrophage phenotype towards the anti-inflammatory M2, rather than the inflammatory M1 phenotype, promotes osteogenesis. Tissue-engineered bioimplants are potentially capable of producing signals to modulate macrophage polarization. Therefore, development of smart immunomodulatory bioimplants via manipulation of their properties seem a promising strategy for tuning immune responses to optimize bone repair without any unwanted inflammatory reactions. The purpose of the present review is to summarize the currently available studies performed on the effects of macrophage polarization, especially towards M2 phenotype, both in bone repair and in bioimplant-stimulated osteogenesis. Moreover, this literature highlights the need to focus future studies on the development of smart immunomodulatory implants capable of switching macrophage polarization-enhancing bone implant-host tissue integration. https://ijaai.tums.ac.ir/index.php/ijaai/article/view/1636 https://ijaai.tums.ac.ir/index.php/ijaai/article/download/1636/1352