title: Uterine Wound Healing: A Complex Process Mediated by Proteins and Peptides.
abstract: Wound healing is the process by which a complex cascade of biochemical events is responsible of the repair the damage. In vivo, studies in humans and mice suggest that healing and post-healing heterogeneous behavior of the surgically wounded myometrium is both phenotype and genotype dependent. Uterine wound healing process involves many cells: endothelial cells, neutrophils, monocytes/macrophages, lymphocytes, fibroblasts, myometrial cells as well a stem cell population found in the myometrium, myoSP (side population of myometrial cells). Transforming growth factor beta (TGF-β) isoforms, connective tissue growth factor (CTGF), basic fibroblast growth factor (bFGF), platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), and tumor necrosis factor alpha (TNF-β) are involved in the wound healing mechanisms. The increased TGF- β1/β3 ratio reduces scarring and fibrosis. The CTGF altered expression may be a factor involved in the abnormal scars formation of low uterine segment after cesarean section and of the formation of uterine dehiscence. The lack of bFGF is involved in the reduction of collagen deposition in the wound site and thicker scabs. The altered expression of TNF-β, VEGF, and PDGF in human myometrial smooth muscle cells in case of uterine dehiscence, it is implicated in the uterine healing process. The over-and under-expressions of growth factors genes involved in uterine scarring process could represent patient's specific features, increasing the risk of cesarean scar complications.
authors.affiliation: Department of Biological and Environmental Sciences and Technologies, Section of Human Anatomy, University of Salento, Lecce, Italy.
authors.forename: Dario D
authors.initials: DD
authors.lastname: Lofrumento
authors.forename: Maria A
authors.initials: MA
authors.lastname: Di Nardo
authors.forename: Marianna
authors.initials: M
authors.lastname: De Falco
authors.forename: Andrea
authors.initials: A
authors.lastname: Di Lieto
mesh_terms: D000818:Animals; D002585:Cesarean Section; D055513:Connective Tissue Growth Factor / Q000235:genetics; D036861:Delivery, Obstetric; D042783:Endothelial Cells / Q000378:metabolism / Q000473:pathology; D005260:Female; D016222:Fibroblast Growth Factor 2 / Q000235:genetics; D005838:Genotype; D006801:Humans; D051379:Mice; D009215:Myometrium / Q000378:metabolism* / Q000473:pathology / Q000601:surgery*; D010982:Platelet-Derived Growth Factor / Q000235:genetics; D011247:Pregnancy; D016212:Transforming Growth Factor beta / Q000235:genetics; D014409:Tumor Necrosis Factor-alpha / Q000235:genetics; D063186:Uterine Myomectomy; D014599:Uterus / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D042461:Vascular Endothelial Growth Factor A / Q000235:genetics; D014945:Wound Healing / Q000235:genetics*
chemical_list: C526317:CCN2 protein, human; D010982:Platelet-Derived Growth Factor; D016212:Transforming Growth Factor beta; D014409:Tumor Necrosis Factor-alpha; D042461:Vascular Endothelial Growth Factor A; D016222:Fibroblast Growth Factor 2; D055513:Connective Tissue Growth Factor
keywords: Pregnancy; basic fibroblast growth factor; cesarean section; connective
  tissue growth factor; delivery; dystocia; labor; myomectomy; platelet-derived growth factor; transforming growth factor beta; tumor
  necrosis factor alpha; vascular endothelial growth factor; wound healing