Liu W, Cao Y, Longaker M T
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Second Medical University, 639 Zhizaoju Road, Shanghai, 200011, P.R.China.
Yonsei Med J. 2001 Dec;42(6):634-45. doi: 10.3349/ymj.2001.42.6.634.
Cutaneous wounding in adult humans and higher vertebrate animals results in scar formation. In contrast, both human and animal fetuses, at early gestational ages, exhibit skin wound healing without scarring. This distinction suggests that the repair of adult wounds by skin regeneration, rather than by fibrosis, may be achieved if adult wounds can be modified to mimic the healing process of fetal wounds. The development of gene therapy offers the possibility to specifically enhance or block the gene expression of cytokines and extracellular molecules, and thus convert adult wound healing into a healing process more similar to tissue regeneration. This article reviews the characteristics of fetal wound repair focusing on cytokine profiles and the inflammatory response to dermal injury. Also included are new developments in gene transfer techniques as well as their application in wound healing. Finally, the authors propose possible strategies of wound gene therapy, to reduce wound scarring and to promote tissue regeneration.
成年人类和高等脊椎动物的皮肤创伤会导致瘢痕形成。相比之下，人类和动物胎儿在妊娠早期，皮肤伤口愈合时不会形成瘢痕。这种差异表明，如果能将成年伤口进行改造以模仿胎儿伤口的愈合过程，那么通过皮肤再生而非纤维化来修复成年伤口或许是可以实现的。基因治疗的发展为特异性增强或阻断细胞因子和细胞外分子的基因表达提供了可能，从而将成年伤口愈合转变为更类似于组织再生的愈合过程。本文综述了胎儿伤口修复的特点，重点关注细胞因子谱以及对皮肤损伤的炎症反应。还包括基因转移技术的新进展及其在伤口愈合中的应用。最后，作者提出了伤口基因治疗的可能策略，以减少伤口瘢痕形成并促进组织再生。
