Abstract
Cutaneous wound healing ultimately functions to facilitate barrier restoration following
injury-induced loss of skin integrity. It is an evolutionarily conserved, multi-cellular,
multi-molecular process involving co-ordinated inter-play between complex signalling
networks. Cellular proliferation is recognised as the third stage of this sequence.
Within this phase, fibroplasia and angiogenesis are co-dependent processes which must
be successfully completed in order to form an evolving extracellular matrix and granulation
tissue. The resultant structures guide cellular infiltration, differentiation and
secretory profile within the wound environment and consequently have major influence
on the success or failure of wound healing. This review integrates in vitro, animal and human in vivo studies, to provide up to date descriptions of molecular and cellular interactions
involved in fibroplasia and angiogenesis. Significant molecular networks include adhesion
molecules, proteinases, cytokines and chemokines as well as a plethora of growth factors.
These signals are produced by, and affect behaviour of, cells including fibroblasts,
fibrocytes, keratinocytes, endothelial cells and inflammatory cells resulting in significant
cellular phenotypic and functional plasticity, as well as controlling composition
and remodelling of structural proteins including collagen and fibronectin. The interdependent
relationship between angiogenesis and fibroplasia relies on dynamic reciprocity between
cellular components, matrix proteins and bioactive molecules. Unbalanced regulation
of any one component can have significant consequences resulting in delayed healing,
chronic wounds or abnormal scar formation. Greater understanding of angiogenic and
fibroplastic mechanisms underlying chronic wound pathogenesis has identified novel
therapeutic targets and enabled development of improved treatment strategies including
topical growth factors and skin substitutes.
Keywords
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Article info
Publication history
Published online: August 19, 2013
Accepted:
July 18,
2013
Received in revised form:
July 12,
2013
Received:
April 5,
2013
Identification
Copyright
© 2013 Japanese Society for Investigative Dermatology. Published by Elsevier Inc. All rights reserved.
