title: Hyaluronan in wound healing: rediscovering a major player.
abstract: Wound healing involves a series of carefully modulated steps, from initial injury and blood clot to the final reconstituted tissue or scar. A dynamic reciprocity exists throughout between the wound, blood elements, extracellular matrix, and cells that participate in healing. Multiple cytokines and signal transduction pathways regulate these reactions. A major component throughout most of the process is hyaluronan, a straight-chain carbohydrate extracellular matrix polymer. Hyaluronan occurs in multiple forms, chain length being the only distinguishing characteristic between them. Levels of hyaluronan in its high-molecular-weight form are prominent in the earliest stages of wound repair. Progressively more fragmented forms occur in a manner not previously appreciated. We outline here steps in the wound healing cascade in which hyaluronan participates, as well as providing a review of its metabolism. Although described by necessity in a series of quantum steps, the healing process is constituted by a smooth continuum of overlapping reactions. The prevalence of hyaluronan in the wound (initially termed "hexosamine-containing mucopolysaccharide"), particularly in its early stages, was pointed out over half a century ago by the Harvard surgeon J. Engelbert Dunphy. It appears we are now returning to where we started.
authors.affiliation: Department of Basic Biomedical Sciences, Touro College of Osteopathic Medicine, New York, New York.
authors.forename: Kessiena L
authors.initials: KL
authors.lastname: Aya
authors.forename: Robert
authors.initials: R
authors.lastname: Stern
mesh_terms: D006801:Humans; D006820:Hyaluronic Acid / Q000378:metabolism / Q000502:physiology*; D015398:Signal Transduction; D014945:Wound Healing / Q000502:physiology*
chemical_list: D006820:Hyaluronic Acid