Fetal skin wound healing.
The developing fetus has the ability to heal wounds by regenerating normal epidermis and dermis with restoration of the extracellular matrix (ECM) architecture, strength, and function. In contrast, adult wounds heal with fibrosis and scar. Scar tissue remains weaker than normal skin with an altered ECM composition. Despite extensive investigation, the mechanism of fetal wound healing remains largely unknown. We do know that early in gestation, fetal skin is developing at a rapid pace and the ECM is a loose network facilitating cellular migration. Wounding in this unique environment triggers a complex cascade of tightly controlled events culminating in a scarless wound phenotype of fine reticular collagen and abundant hyaluronic acid. Comparison between postnatal and fetal wound healing has revealed differences in inflammatory response, cellular mediators, cytokines, growth factors, and ECM modulators. Investigation into cell signaling pathways and transcription factors has demonstrated differences in secondary messenger phosphorylation patterns and homeobox gene expression. Further research may reveal novel genes essential to scarless repair that can be manipulated in the adult wound and thus ameliorate scar.
Division Plastic Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California 94305, USA. edward.p.buchanan@gmail.com
Edward P
EP
Buchanan
Michael T
MT
Longaker
H Peter
HP
Lorenz
D000818:Animals; D015815:Cell Adhesion Molecules / Q000276:immunology / Q000378:metabolism; D003094:Collagen / Q000502:physiology; D016207:Cytokines / Q000276:immunology / Q000378:metabolism; D005109:Extracellular Matrix / Q000276:immunology / Q000378:metabolism; D005315:Fetal Diseases / Q000473:pathology / Q000503:physiopathology*; D005333:Fetus / Q000473:pathology / Q000502:physiology / Q000503:physiopathology*; D006412:Hematopoietic Stem Cells / Q000276:immunology / Q000378:metabolism; D006801:Humans; D006820:Hyaluronic Acid / Q000276:immunology / Q000378:metabolism; D018836:Inflammation Mediators / Q000276:immunology / Q000378:metabolism; D036341:Intercellular Signaling Peptides and Proteins / Q000276:immunology / Q000378:metabolism; D012867:Skin / Q000196:embryology* / Q000473:pathology; D012871:Skin Diseases / Q000473:pathology / Q000503:physiopathology*; D014945:Wound Healing / Q000276:immunology / Q000502:physiology*
D015815:Cell Adhesion Molecules; D016207:Cytokines; D018836:Inflammation Mediators; D036341:Intercellular Signaling Peptides and Proteins; D006820:Hyaluronic Acid; D003094:Collagen