Stress-related changes to immune cells in the skin prior to wounding may impair subsequent healing

Repeated stress-induced crosstalk between the sympathetic nervous system and mast cells contributes to delayed cutaneous wound healing in mice

The study identifies a link between the neuroimmune interaction and the impairment of wound healing induced by repeated stress. Stress increased mast cell mobilization and degranulation, levels of IL-10, and sympathetic reinnervation in mouse wounds. In contrast to mast cells, macrophage infiltration into wounds was significantly delayed in stressed mice. Chemical sympathectomy and the blockade of mast cell degranulation reversed the effect of stress on skin wound healing in vivo. In vitro, high epinephrine levels stimulated mast cell degranulation and IL-10 release. In conclusion, catecholamines released by the sympathetic nervous system stimulate mast cells to secrete anti-inflammatory cytokines that impair inflammatory cell mobilization, leading to a delay in the resolution of wound healing under stress conditions.

The effect of expressive writing on wound healing: Immunohistochemistry analysis of skin tissue two weeks after punch biopsy wounding

OBJECTIVE

To investigate the effects of expressive writing and its timing (pre or post wounding) on re-epithelialisation and leucocyte subsets within healing tissue. We previously showed expressive writing pre-wounding improved re-epithelialisation. Here we investigate cellular processes in the wound.

METHODS

In a 2(writing content) x 2(writing timing) randomized trial, 122 participants were randomized to perform either expressive or control writing, before or after a 4 mm punch biopsy wound. On day 14 post-wounding, participants had a 5 mm punch biopsy of the initial wound. Seven of 16 primary registered outcomes were analysed, including re-epithelialisation from two photographs of the 4 mm biopsy (previously reported). This paper reports immunohistochemistry analysis of five primary outcomes - Langerhans cells, immune cell activation (HLA and CD3+), and macrophages (CD68 and MPO) - in the 5 mm biopsies in a random sample of 96 participants.

RESULTS

Participants who performed either writing task pre-wounding had greater Langerhans cell infiltration, than those who wrote post-wounding (F_(1,85) = 7.86, p = .006, η_p² = 0.08). Those who performed expressive writing also had greater Langerhans cell infiltration than those who performed control writing (F_(1,85) = 4.00, p = .049, η_p² = 0.04). There were no significant group or interaction effects on immune cell activation or macrophages. Healed wounds on day 10 had lower levels of macrophages (z = -1.96, p = .050), and CD3+ cells (z = -1.99, p = .046) than non-healed wounds.

CONCLUSION

Langerhans cells in the healing skin are affected by the timing and topic of writing. More research is needed to further explore timing and corroborate these results.

CLINICAL TRIALS REGISTRATION

Registered at https://www.anzctr.org.au/ (Trial ID: ACTRN12614000971639).

Advances in the study of OSA and diabetic foot

Diabetic foot is one of the most serious and painful chronic complications of diabetic patients, especially elderly diabetic patients. It has a high rate of death, disability and amputation. Obstructive sleep apnea (OSA) is a treatable chronic sleep disorder. Existing evidence suggests that OSA may promote the development and delay the healing of diabetic foot, and continuous positive airway pressure therapy may promote the healing of ulcers. Therefore, in the multidisciplinary diagnosis and treatment of diabetes, cooperation with sleep medicine should be strengthened, and the basic and clinical research on diabetic foot combined with OSA should be strengthened, so as to reduce the amputation rate, improve the cure rate and reduce the incidence of cardiovascular events.

Modeling of the immune response in the pathogenesis of solid tumors and its prognostic significance

BACKGROUND

Tumor initiation and subsequent progression are usually long-term processes, spread over time and conditioned by diverse aspects. Many cancers develop on the basis of chronic inflammation; however, despite dozens of years of research, little is known about the factors triggering neoplastic transformation under these conditions. Molecular characterization of both pathogenetic states, i.e., similarities and differences between chronic inflammation and cancer, is also poorly defined. The secretory activity of tumor cells may change the immunophenotype of immune cells and modify the extracellular microenvironment, which allows the bypass of host defense mechanisms and seems to have diagnostic and prognostic value. The phenomenon of immunosuppression is also present during chronic inflammation, and the development of cancer, due to its duration, predisposes patients to the promotion of chronic inflammation. The aim of our work was to discuss the above issues based on the latest scientific insights. A theoretical mechanism of cancer immunosuppression is also proposed.

CONCLUSIONS

Development of solid tumors may occur both during acute and chronic phases of inflammation. Differences in the regulation of immune responses between precancerous states and the cancers resulting from them emphasize the importance of immunosuppressive factors in oncogenesis. Cancer cells may, through their secretory activity and extracellular transport mechanisms, enhance deterioration of the immune system which, in turn, may have prognostic implications.

Nightingale's Legacy: Old Holistic Insight Supported by New Science

Nursing today could benefit from building on Florence Nightingale's legacy. The aim of this article is to describe and discuss how her holistic approach to nursing is supported by scientific discoveries within human ecology, psychoneuroimmunology, and communicology. This combination may bridge the gap between current nursing practices and Nightingale's ethos.

The Dynamics of the Skin's Immune System

The skin is a complex organ that has devised numerous strategies, such as physical, chemical, and microbiological barriers, to protect the host from external insults. In addition, the skin contains an intricate network of immune cells resident to the tissue, crucial for host defense as well as tissue homeostasis. In the event of an insult, the skin-resident immune cells are crucial not only for prevention of infection but also for tissue reconstruction. Deregulation of immune responses often leads to impaired healing and poor tissue restoration and function. In this review, we will discuss the defensive components of the skin and focus on the function of skin-resident immune cells in homeostasis and their role in wound healing.