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Tam J. The case for considering volar skin in a "separate status" for wound healing. Front Med (Lausanne) 2023; 10:1156828. [PMID: 37035315 PMCID: PMC10076700 DOI: 10.3389/fmed.2023.1156828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/07/2023] [Indexed: 04/11/2023] Open
Abstract
Foot ulcers, particularly in the diabetic setting, are a major medical and socioeconomic challenge. While the effects of diabetes and its various sequelae have been extensively studied, in the wound field it is commonly assumed that the wound healing process is essentially identical between different skin types, despite the many well-known specializations in palmoplantar skin, most of which are presumed to be evolutionary adaptations for weightbearing. This article will examine how these specializations could alter the wound healing trajectory and contribute to the pathology of foot ulcers.
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Affiliation(s)
- Joshua Tam
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, United States
- Department of Dermatology, Harvard Medical School, Boston, MA, United States
- *Correspondence: Joshua Tam,
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2
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Fibronectin in development and wound healing. Adv Drug Deliv Rev 2021; 170:353-368. [PMID: 32961203 DOI: 10.1016/j.addr.2020.09.005] [Citation(s) in RCA: 112] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/26/2020] [Accepted: 09/15/2020] [Indexed: 01/15/2023]
Abstract
Fibronectin structure and composition regulate contextual cell signaling. Recent advances have been made in understanding fibronectin and its role in tissue organization and repair. This review outlines fibronectin splice variants and their functions, evaluates potential therapeutic strategies targeting or utilizing fibronectin, and concludes by discussing potential future directions to modulate fibronectin function in development and wound healing.
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3
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Persa OD, Koester J, Niessen CM. Regulation of Cell Polarity and Tissue Architecture in Epidermal Aging and Cancer. J Invest Dermatol 2021; 141:1017-1023. [PMID: 33531135 DOI: 10.1016/j.jid.2020.12.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 12/15/2022]
Abstract
The mammalian skin is essential to protect the organism from external damage while at the same time enabling communication with the environment. Aging compromises skin function and regeneration, which is further exacerbated by external influences, such as UVR from the sun. Aging and UVR are also major risk factors contributing to the development of skin cancer. Whereas aging research traditionally has focused on the role of DNA damage and metabolic and stress pathways, less is known about how aging affects tissue architecture and cell dynamics in skin homeostasis and regeneration and whether changes in these processes promote skin cancer. This review highlights how key regulators of cell polarity and adhesion affect epidermal mechanics, tissue architecture, and stem cell dynamics in skin aging and cancer.
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Affiliation(s)
- Oana D Persa
- Department Cell Biology of the Skin, University of Cologne, Cologne, Germany; Cologne Excellence Cluster on Stress Responses in Aging-associated Diseases (CECAD), University of Cologne, Cologne, Germany; Department of Dermatology and Venerology, University Hospital of Cologne, Cologne, Germany; Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
| | - Janis Koester
- Cologne Excellence Cluster on Stress Responses in Aging-associated Diseases (CECAD), University of Cologne, Cologne, Germany; Max Planck Institute for Biology of Ageing, Cologne, Germany
| | - Carien M Niessen
- Department Cell Biology of the Skin, University of Cologne, Cologne, Germany; Cologne Excellence Cluster on Stress Responses in Aging-associated Diseases (CECAD), University of Cologne, Cologne, Germany; Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany.
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4
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Worthen CA, Cui Y, Orringer JS, Johnson TM, Voorhees JJ, Fisher GJ. CD26 Identifies a Subpopulation of Fibroblasts that Produce the Majority of Collagen during Wound Healing in Human Skin. J Invest Dermatol 2020; 140:2515-2524.e3. [PMID: 32407715 PMCID: PMC7655599 DOI: 10.1016/j.jid.2020.04.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/13/2020] [Accepted: 04/17/2020] [Indexed: 12/23/2022]
Abstract
Fibroblasts produce collagens and other proteins that form the bulk of the extracellular matrix (ECM) in connective tissues. Emerging data point to functional heterogeneity of fibroblasts. However, the lack of subtype-specific markers hinders our understanding of the different roles of fibroblasts in ECM biology, wound healing, diseases, and aging. We have investigated the utility of the cell surface protein CD26 to identify functionally distinct fibroblast subpopulations in human skin. Using flow cytometry and immunohistology, we found that CD26, in combination with the cell surface glycoprotein CD90, identifies a distinct subpopulation of cells, which express relatively high levels of COL1A1, a hallmark of fibroblasts. Importantly, the population of CD26+ fibroblasts is selectively increased after wounding of human skin. These cells account for the majority of COL1A1 expression during the ECM remodeling phase of healing. The proportion of CD26+ fibroblasts in the skin of young and aged individuals is similar, indicating that the loss of collagen production during aging does not involve selective reduction of CD26+ fibroblasts. In culture, the majority of freshly isolated CD26- fibroblasts gain expression of CD26+. Taken together, these data provide a foundation for targeting CD26+ fibroblasts to modulate wound healing in human skin.
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Affiliation(s)
- Christal A Worthen
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Yilei Cui
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Jeffrey S Orringer
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Timothy M Johnson
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - John J Voorhees
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Gary J Fisher
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA.
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5
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Bajpai A, Li R, Chen W. The cellular mechanobiology of aging: from biology to mechanics. Ann N Y Acad Sci 2020; 1491:3-24. [PMID: 33231326 DOI: 10.1111/nyas.14529] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 10/10/2020] [Accepted: 10/21/2020] [Indexed: 12/14/2022]
Abstract
Aging is a chronic, complicated process that leads to degenerative physical and biological changes in living organisms. Aging is associated with permanent, gradual physiological cellular decay that affects all aspects of cellular mechanobiological features, including cellular cytoskeleton structures, mechanosensitive signaling pathways, and forces in the cell, as well as the cell's ability to sense and adapt to extracellular biomechanical signals in the tissue environment through mechanotransduction. These mechanobiological changes in cells are directly or indirectly responsible for dysfunctions and diseases in various organ systems, including the cardiovascular, musculoskeletal, skin, and immune systems. This review critically examines the role of aging in the progressive decline of the mechanobiology occurring in cells, and establishes mechanistic frameworks to understand the mechanobiological effects of aging on disease progression and to develop new strategies for halting and reversing the aging process. Our review also highlights the recent development of novel bioengineering approaches for studying the key mechanobiological mechanisms in aging.
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Affiliation(s)
- Apratim Bajpai
- Department of Mechanical and Aerospace Engineering, Tandon School of Engineering, New York University, Brooklyn, New York
| | - Rui Li
- Department of Mechanical and Aerospace Engineering, Tandon School of Engineering, New York University, Brooklyn, New York.,Department of Biomedical Engineering, Tandon School of Engineering, New York University, Brooklyn, New York
| | - Weiqiang Chen
- Department of Mechanical and Aerospace Engineering, Tandon School of Engineering, New York University, Brooklyn, New York.,Department of Biomedical Engineering, Tandon School of Engineering, New York University, Brooklyn, New York.,Laura and Isaac Perlmutter Cancer Center, NYU Langone Health, New York, New York
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6
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Coates M, Mariottoni P, Corcoran DL, Kirshner HF, Jaleel T, Brown DA, Brooks SR, Murray J, Morasso MI, MacLeod AS. The skin transcriptome in hidradenitis suppurativa uncovers an antimicrobial and sweat gland gene signature which has distinct overlap with wounded skin. PLoS One 2019; 14:e0216249. [PMID: 31059533 PMCID: PMC6502346 DOI: 10.1371/journal.pone.0216249] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 04/16/2019] [Indexed: 12/15/2022] Open
Abstract
Hidradenitis suppurativa (HS) is a debilitating chronic inflammatory skin disease resulting in non-healing wounds affecting body areas of high hair follicle and sweat gland density. The pathogenesis of HS is not well understood but appears to involve dysbiosis-driven aberrant activation of the innate immune system leading to excessive inflammation. Marked dysregulation of antimicrobial peptides and proteins (AMPs) in HS is observed, which may contribute to this sustained inflammation. Here, we analyzed HS skin transcriptomes from previously published studies and integrated these findings through a comparative analysis with a published wound healing data set and with immunofluorescence and qPCR analysis from new HS patient samples. Among the top differently expressed genes between lesional and non-lesional HS skin were members of the S100 family as well as dermcidin, the latter known as a sweat gland-associated AMP and one of the most downregulated genes in HS lesions. Interestingly, many genes associated with sweat gland function, such as secretoglobins and aquaporin 5, were decreased in HS lesional skin and we discovered that these genes demonstrated opposite expression profiles in healing skin. Conversely, HS lesional and wounded skin shared a common gene signature including genes encoding for S100 proteins, defensins, and genes encoding antiviral proteins. Overall, our results suggest that the pathogenesis of HS may be driven by changes in AMP expression and altered sweat gland function, and may share a similar pathology with chronic wounds.
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Affiliation(s)
- Margaret Coates
- Department of Dermatology, Duke University, Durham, NC, United States of America
| | - Paula Mariottoni
- Department of Dermatology, Duke University, Durham, NC, United States of America
| | - David L. Corcoran
- Duke Center for Genomic and Computational Biology, Duke University, Durham, NC, United States of America
| | - Hélène Fradin Kirshner
- Duke Center for Genomic and Computational Biology, Duke University, Durham, NC, United States of America
| | - Tarannum Jaleel
- Department of Dermatology, Duke University, Durham, NC, United States of America
| | - David A. Brown
- Department of Surgery, Duke University, Durham, NC, United States of America
| | - Stephen R. Brooks
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD, United States of America
| | - John Murray
- Department of Dermatology, Duke University, Durham, NC, United States of America
| | - Maria I. Morasso
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD, United States of America
| | - Amanda S. MacLeod
- Department of Dermatology, Duke University, Durham, NC, United States of America
- Department of Immunology, Duke University, Durham, NC, United States of America
- Pinnell Center for Investigative Dermatology, Duke University, Durham, NC, United States of America
- * E-mail:
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7
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Abstract
The skin provides the primary protection for the body against external injuries and is essential in the maintenance of general homeostasis. During ageing, resident cells become senescent and the extracellular matrix, mainly in the dermis, is progressively damaged affecting the normal organization of the skin and its capacity for repair. In parallel, extrinsic factors such as ultraviolet irradiation, pollution, and intrinsic factors such as diabetes or vascular disease can further accelerate this phenomenon. Indeed, numerous mechanisms are involved in age-induced degradation of the skin and these also relate to non-healing or chronic wounds in the elderly. In particular, the generation of reactive oxygen species seems to play a major role in age-related skin modifications. Certainly, targeting both the hormonal status of the skin or its surface nutrition can slow down age-induced degradation of the skin and improve healing of skin damage in the elderly. Skin care regimens that prevent radiation and pollution damage, and reinforce the skin surface and its microbiota are among the different approaches able to minimize the effects of ageing on the skin.
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8
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Saad I, Fournier CT, Wilson RL, Lakshmanan R, Selvaraju V, Thirunavukkarasu M, Alexander Palesty J, McFadden DW, Maulik N. Thioredoxin-1 augments wound healing and promote angiogenesis in a murine ischemic full-thickness wound model. Surgery 2018; 164:1077-1086. [PMID: 30131176 DOI: 10.1016/j.surg.2018.05.045] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 05/06/2018] [Accepted: 05/29/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Nonhealing wounds are a continuing health problem in the United States. Overproduction of reactive oxygen species is a major causative factor behind delayed wound healing. Previously we reported that thioredoxin-1 treatment could alleviate oxidative stress under ischemic conditions, such as myocardial infarction and hindlimb ischemia. In this study, we explored the potential for thioredoxin-1 gene therapy to effectively aid wound healing through improved angiogenesis in a murine ischemic wound model. METHODS Full-thickness, cutaneous, ischemic wounds were created in the dorsum skin flap of 8- to 12-week-old CD1 mice. Nonischemic wounds created lateral to the ischemic skin flap served as internal controls. Mice with both ischemic wounds and nonischemic wounds were treated with Adeno-LacZ (1 × 109 pfu) or Adeno-thioredoxin-1 (1 × 109 pfu), injected intradermally around the wound. Digital imaging was performed on days 0, 3, 6, and 9 to assess the rate of wound closure. Tissue samples collected at predetermined time intervals were processed for immunohistochemical analysis. RESULTS No significant differences in wound closure were identified among the nonischemic wounds control, nonischemic wounds-LacZ, and nonischemic wounds-thioredoxin-1 groups. Hence, only mice with ischemic wounds were further analyzed. The ischemic wounds-thioredoxin-1 group had significant improvement in wound closure on days 6 and 9 after surgery compared with the ischemic wounds control and ischemic wounds-LacZ groups. Immunohistochemical analysis indicated increased thioredoxin-1, vascular endothelial cell growth factor, and β-catenin levels in the ischemic wounds-thioredoxin-1 group compared with the ischemic wounds control and ischemic wounds-LacZ groups, as well as increased capillary density and cell proliferation, as represented by Ki-67 staining. CONCLUSION Taken together, thioredoxin-1 gene therapy promotes vascular endothelial cell growth factor signaling and re-epithelialization and activates wound closure in mice with ischemic wounds.
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Affiliation(s)
- Ibnalwalid Saad
- Molecular Cardiology and Angiogenesis Laboratory, UConn Health, Farmington, CT; Department of Surgery, UConn Health, Farmington, CT; Stanley J. Dudrick Department of Surgery, Saint Mary's Hospital, Waterbury, CT
| | - Craig T Fournier
- Molecular Cardiology and Angiogenesis Laboratory, UConn Health, Farmington, CT; Department of Surgery, UConn Health, Farmington, CT; Department of Plastic and Reconstructive Surgery, Albany Medical Center, Albany, NY
| | - Rickesha L Wilson
- Molecular Cardiology and Angiogenesis Laboratory, UConn Health, Farmington, CT; Department of Surgery, UConn Health, Farmington, CT
| | - Rajesh Lakshmanan
- Molecular Cardiology and Angiogenesis Laboratory, UConn Health, Farmington, CT; Department of Surgery, UConn Health, Farmington, CT
| | - Vaithinathan Selvaraju
- Molecular Cardiology and Angiogenesis Laboratory, UConn Health, Farmington, CT; Department of Surgery, UConn Health, Farmington, CT
| | - Mahesh Thirunavukkarasu
- Molecular Cardiology and Angiogenesis Laboratory, UConn Health, Farmington, CT; Department of Surgery, UConn Health, Farmington, CT
| | - J Alexander Palesty
- Stanley J. Dudrick Department of Surgery, Saint Mary's Hospital, Waterbury, CT
| | | | - Nilanjana Maulik
- Molecular Cardiology and Angiogenesis Laboratory, UConn Health, Farmington, CT; Department of Surgery, UConn Health, Farmington, CT.
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9
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Agrawal K, Sivamani RK, Newman JW. Noninvasive profiling of sweat-derived lipid mediators for cutaneous research. Skin Res Technol 2018; 25:3-11. [PMID: 30030941 DOI: 10.1111/srt.12617] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND OBJECTIVE Recent increases in the use of noninvasive matrices for biomedical analysis has led to interest in the evaluation of sweat for both clinical and research applications. However, despite being one of the two main cutaneous secretions, until very recently, only one study actually analyzed sweat in the context of cutaneous disease. This review attempts to make the case for increased use of sweat in cutaneous research, and discusses lipid mediators as potential analytical targets in sweat. METHODS Sweat composition and its relationship with the skin and systemic circulation are discussed, as are practical considerations for sweat sampling and analysis. Previous analyses of lipid mediators in skin biopsies are provided to show that lipid mediators can regulate cutaneous processes and disease pathways. Summaries of recent studies involving the analysis of sweat lipid mediators are provided to demonstrate the utility of sweat lipid mediator testing to support future cutaneous research studies. RESULTS Sweat has the potential to reflect both local and systemic biochemical changes in response to disease or intervention, and two recent studies of sweat lipid mediators confirm this ability. Additionally, sweat lipid mediators appear to be temporally stable with individual variability comparable to other matrices, suggesting that these analytes could be useful biomarkers. CONCLUSIONS Sweat metabolites may be capable of reporting changes in cutaneous biochemical pathways, thereby providing insight into the immunomodulatory biochemistry of the skin. Lipid mediator analysis of sweat appears to be a non invasive approach that could enhance existing cutaneous research and diagnostic methodologies.
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Affiliation(s)
- Karan Agrawal
- Department of Nutrition, University of California-Davis, Davis, California.,West Coast Metabolomics Center, Genome Center, Davis, California
| | - Raja K Sivamani
- Department of Dermatology, University of California-Davis Medical Center, Sacramento, California.,Department of Biological Sciences, California State University-Sacramento, Sacramento, California
| | - John W Newman
- Department of Nutrition, University of California-Davis, Davis, California.,West Coast Metabolomics Center, Genome Center, Davis, California.,United States Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, California
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10
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Watt SM, Pleat JM. Stem cells, niches and scaffolds: Applications to burns and wound care. Adv Drug Deliv Rev 2018; 123:82-106. [PMID: 29106911 DOI: 10.1016/j.addr.2017.10.012] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 10/19/2017] [Accepted: 10/22/2017] [Indexed: 12/11/2022]
Abstract
The importance of skin to survival, and the devastating physical and psychological consequences of scarring following reparative healing of extensive or difficult to heal human wounds, cannot be disputed. We discuss the significant challenges faced by patients and healthcare providers alike in treating these wounds. New state of the art technologies have provided remarkable insights into the role of skin stem and progenitor cells and their niches in maintaining skin homeostasis and in reparative wound healing. Based on this knowledge, we examine different approaches to repair extensive burn injury and chronic wounds, including full and split thickness skin grafts, temporising matrices and scaffolds, and composite cultured skin products. Notable developments include next generation skin substitutes to replace split thickness skin autografts and next generation gene editing coupled with cell therapies to treat genodermatoses. Further refinements are predicted with the advent of bioprinting technologies, and newly defined biomaterials and autologous cell sources that can be engineered to more accurately replicate human skin architecture, function and cosmesis. These advances will undoubtedly improve quality of life for patients with extensive burns and difficult to heal wounds.
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Affiliation(s)
- Suzanne M Watt
- Stem Cell Research, Nuffield Division of Clinical Laboratory Medicine, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9BQ, UK.
| | - Jonathan M Pleat
- Department of Plastic and Reconstructive Surgery, North Bristol NHS Trust and University of Bristol, Westbury on Trym, Bristol BS9 3TZ, UK.
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11
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Fisher G, Rittié L. Restoration of the basement membrane after wounding: a hallmark of young human skin altered with aging. J Cell Commun Signal 2017; 12:401-411. [PMID: 29086203 DOI: 10.1007/s12079-017-0417-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 10/11/2017] [Indexed: 11/30/2022] Open
Abstract
In skin, the basement membrane at the dermal-epidermal junction (DEJ-BM) is an important structure that tightly binds the epidermis to the dermis, and acts as a permeability barrier that controls exchange of macromolecules. Repair of the DEJ-BM during wound healing is important for restoration of skin functional properties after wounding. Here, we used a CO2 laser to perform partial thickness wounds in human volunteers, and directly compared wound repair in healthy young and aged individuals, focusing on the DEJ-BM. Our results show that the DEJ-BM is restored within four weeks after partial thickness wounds in young adults. We identified laminin-γ2 as preferred substrate for keratinocytes during reepithelialization of partial thickness human wounds. Laminin-γ2 is expressed continuously by migrating keratinocytes during reepithelialization, whereas collagen IV and collagen VII are deposited after wound closure. In contrast, our study shows that the DEJ-BM restoration following wounding is deficient in elderly individuals. Specifically, COL7A2 was barely increased during wound repair in aged skin and, as a result, the DEJ-BM in elderly skin was not restored and showed abnormal structure. Our data suggest that ameliorating the quality of the DEJ-BM restoration is a promising therapeutic approach to improve the quality of repaired skin in the elderly.
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Affiliation(s)
- Gary Fisher
- Department of Dermatology, Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Laure Rittié
- Department of Dermatology, Medical School, University of Michigan, Ann Arbor, MI, USA. .,Dermatology Unit, R&D Immuno-Inflammation Therapeutic Area, GlaxoSmithKline, 1250 Collegeville Rd, UP1410, Collegeville, PA, 19426, USA.
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12
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Borowczyk-Michalowska J, Zimolag E, Waligorska A, Dobrucki J, Madeja Z, Drukala J. Stage-specific embryonic antigen-4 as a novel marker of ductal cells of human eccrine sweat glands. Br J Dermatol 2017; 176:1541-1548. [DOI: 10.1111/bjd.15154] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2016] [Indexed: 11/27/2022]
Affiliation(s)
- J. Borowczyk-Michalowska
- Cell Bank; Department of Cell Biology; Faculty of Biochemistry, Biophysics and Biotechnology and Malopolska Centre of Biotechnology; Jagiellonian University; Krakow Poland
| | - E. Zimolag
- Cell Bank; Department of Cell Biology; Faculty of Biochemistry, Biophysics and Biotechnology and Malopolska Centre of Biotechnology; Jagiellonian University; Krakow Poland
| | - A. Waligorska
- Department of Cell Biophysics; Faculty of Biochemistry, Biophysics and Biotechnology; Jagiellonian University; Krakow Poland
| | - J. Dobrucki
- Department of Cell Biophysics; Faculty of Biochemistry, Biophysics and Biotechnology; Jagiellonian University; Krakow Poland
| | - Z. Madeja
- Cell Bank; Department of Cell Biology; Faculty of Biochemistry, Biophysics and Biotechnology and Malopolska Centre of Biotechnology; Jagiellonian University; Krakow Poland
| | - J. Drukala
- Cell Bank; Department of Cell Biology; Faculty of Biochemistry, Biophysics and Biotechnology and Malopolska Centre of Biotechnology; Jagiellonian University; Krakow Poland
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13
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Sorg H, Tilkorn DJ, Hager S, Hauser J, Mirastschijski U. Skin Wound Healing: An Update on the Current Knowledge and Concepts. Eur Surg Res 2016; 58:81-94. [PMID: 27974711 DOI: 10.1159/000454919] [Citation(s) in RCA: 596] [Impact Index Per Article: 74.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Accepted: 12/05/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND The integrity of healthy skin plays a crucial role in maintaining physiological homeostasis of the human body. The skin is the largest organ system of the body. As such, it plays pivotal roles in the protection against mechanical forces and infections, fluid imbalance, and thermal dysregulation. At the same time, it allows for flexibility to enable joint function in some areas of the body and more rigid fixation to hinder shifting of the palm or foot sole. Many instances lead to inadequate wound healing which necessitates medical intervention. Chronic conditions such as diabetes mellitus or peripheral vascular disease can lead to impaired wound healing. Acute trauma such as degloving or large-scale thermal injuries are followed by a loss of skin organ function rendering the organism vulnerable to infections, thermal dysregulation, and fluid loss. METHODS For this update article, we have reviewed the actual literature on skin wound healing purposes focusing on the main phases of wound healing, i.e., inflammation, proliferation, epithelialization, angiogenesis, remodeling, and scarring. RESULTS The reader will get briefed on new insights and up-to-date concepts in skin wound healing. The macrophage as a key player in the inflammatory phase will be highlighted. During the epithelialization process, we will present the different concepts of how the wound will get closed, e.g., leapfrogging, lamellipodial crawling, shuffling, and the stem cell niche. The neovascularization represents an essential component in wound healing due to its fundamental impact from the very beginning after skin injury until the end of the wound remodeling. Here, the distinct pattern of the neovascularization process and the special new functions of the pericyte will be underscored. At the end, this update will present 3 topics of high interest in skin wound healing issues, dealing with scarring, tissue engineering, and plasma application. CONCLUSION Although wound healing mechanisms and specific cell functions in wound repair have been delineated in part, many underlying pathophysiological processes are still unknown. The purpose of the following update on skin wound healing is to focus on the different phases and to brief the reader on the current knowledge and new insights. Skin wound healing is a complex process, which is dependent on many cell types and mediators interacting in a highly sophisticated temporal sequence. Although some interactions during the healing process are crucial, redundancy is high and other cells or mediators can adopt functions or signaling without major complications.
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Affiliation(s)
- Heiko Sorg
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hand Surgery, Alfried Krupp Krankenhaus Essen, Essen, Germany
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14
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Rittié L. Cellular mechanisms of skin repair in humans and other mammals. J Cell Commun Signal 2016; 10:103-20. [PMID: 27170326 PMCID: PMC4882309 DOI: 10.1007/s12079-016-0330-1] [Citation(s) in RCA: 166] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Accepted: 05/05/2016] [Indexed: 12/16/2022] Open
Abstract
The increased incidence of non-healing skin wounds in developed societies has prompted tremendous research efforts on the complex process known as "wound healing". Unfortunately, the weak relevance of modern wound healing research to human health continues to be a matter of concern. This review summarizes the current knowledge of the cellular mechanisms that mediate wound closure in the skin of humans and laboratory animals. The author highlights the anatomical singularities of human skin vs. the skin of other mammals commonly used for wound healing research (i.e. as mice, rats, rabbits, and pigs), and discusses the roles of stem cells, myofibroblasts, and the matrix environment in the repair process. The majority of this review focuses on reepithelialization and wound closure. Other aspects of wound healing (e.g. inflammation, fibrous healing) are referred to when relevant to the main topic. This review aims at providing the reader with a clear understanding of the similarities and differences that have been reported over the past 100 years between the healing of human wounds and that of other mammals.
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Affiliation(s)
- Laure Rittié
- Department of Dermatology, University of Michigan Medical School, 6447 Medical Building I, 1301 E. Catherine St., Ann Arbor, MI, 48109, USA.
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