Barrientos Stephan, Stojadinovic Olivera, Golinko Michael S, Brem Harold, Tomic-Canic Marjana
University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
Wound Repair Regen. 2008 Sep-Oct;16(5):585-601. doi: 10.1111/j.1524-475X.2008.00410.x.
Wound healing is an evolutionarily conserved, complex, multicellular process that, in skin, aims at barrier restoration. This process involves the coordinated efforts of several cell types including keratinocytes, fibroblasts, endothelial cells, macrophages, and platelets. The migration, infiltration, proliferation, and differentiation of these cells will culminate in an inflammatory response, the formation of new tissue and ultimately wound closure. This complex process is executed and regulated by an equally complex signaling network involving numerous growth factors, cytokines and chemokines. Of particular importance is the epidermal growth factor (EGF) family, transforming growth factor beta (TGF-beta) family, fibroblast growth factor (FGF) family, vascular endothelial growth factor (VEGF), granulocyte macrophage colony stimulating factor (GM-CSF), platelet-derived growth factor (PDGF), connective tissue growth factor (CTGF), interleukin (IL) family, and tumor necrosis factor-alpha family. Currently, patients are treated by three growth factors: PDGF-BB, bFGF, and GM-CSF. Only PDGF-BB has successfully completed randomized clinical trials in the Unites States. With gene therapy now in clinical trial and the discovery of biodegradable polymers, fibrin mesh, and human collagen serving as potential delivery systems other growth factors may soon be available to patients. This review will focus on the specific roles of these growth factors and cytokines during the wound healing process.
伤口愈合是一个进化上保守的、复杂的多细胞过程,在皮肤中,其目的是恢复屏障功能。这个过程涉及多种细胞类型的协同作用,包括角质形成细胞、成纤维细胞、内皮细胞、巨噬细胞和血小板。这些细胞的迁移、浸润、增殖和分化最终会引发炎症反应、形成新组织并最终实现伤口闭合。这个复杂的过程由一个同样复杂的信号网络执行和调控,该网络涉及众多生长因子、细胞因子和趋化因子。特别重要的是表皮生长因子(EGF)家族、转化生长因子β(TGF-β)家族、成纤维细胞生长因子(FGF)家族、血管内皮生长因子(VEGF)、粒细胞巨噬细胞集落刺激因子(GM-CSF)、血小板衍生生长因子(PDGF)、结缔组织生长因子(CTGF)、白细胞介素(IL)家族和肿瘤坏死因子-α家族。目前,患者使用三种生长因子进行治疗:PDGF-BB、bFGF和GM-CSF。只有PDGF-BB在美国成功完成了随机临床试验。随着基因治疗目前正在进行临床试验,以及可生物降解聚合物、纤维蛋白网和人胶原蛋白作为潜在递送系统的发现,其他生长因子可能很快可供患者使用。本综述将重点关注这些生长因子和细胞因子在伤口愈合过程中的具体作用。