title: Influence of acidic pH on keratinocyte function and re-epithelialisation of human in vitro wounds.
abstract: BACKGROUND
  Chronic wounds are one of the greatest challenges for the healthcare system. Today, a plethora of dressings are used in the treatment of these wounds, each with specific influence on the wound environment. Due to differences in the permeability of the dressings the use will result in differences in the pH balance in the wound bed. However, little is known about how changes in the pH in the wound environment affect the different phases of the healing process.
  
  
  OBJECTIVE
  The aim of the present study was to investigate the effects of acidic pH on the regeneration phase by studying keratinocyte function in vitro and re-epithelialisation in an in vitro model of human skin.
  
  
  RESULTS
  In vitro assays showed reduced viability and migration rates in human keratinocytes when pH was lowered. Real time PCR revealed differential expression of genes related to wound healing and environmental impairment. Tissue culture showed no re-epithelialisation of wounds subjected to pH 5.0 and moderate re-epithelialisation at pH 6.0, compared to controls at pH 7.4.
  
  
  CONCLUSIONS
  The results indicate that lowering pH down to pH 5.0 in wounds is counterproductive in aspect of keratinocyte function which is crucial for successful wound healing.
authors.affiliation: a 1 Division of Experimental Plastic Surgery, Department of Clinical and Experimental Medicine, Linköping University , Linköping, Sweden.
authors.forename: Susanna
authors.initials: S
authors.lastname: Lönnqvist
authors.affiliation: b 2 Department for Molecular Medicine and Surgery, Karolinska Institute , Stockholm, Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Emanuelsson
authors.affiliation: a 1 Division of Experimental Plastic Surgery, Department of Clinical and Experimental Medicine, Linköping University , Linköping, Sweden.|c 3 Department of Hand and Plastic Surgery, Linköping University , Linköping, Sweden.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Kratz
mesh_terms: D001707:Biopsy, Needle; D002465:Cell Movement / Q000502:physiology; D002470:Cell Survival; D002478:Cells, Cultured; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007150:Immunohistochemistry; D066298:In Vitro Techniques; D015603:Keratinocytes / Q000502:physiology*; D062326:Re-Epithelialization / Q000502:physiology*; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods; D012867:Skin / Q000166:cytology* / Q000473:pathology; D014945:Wound Healing / Q000502:physiology*; D014947:Wounds and Injuries / Q000503:physiopathology*
keywords: Keratinocyte; pH; re-epithelialisation; wound model