Department of Surgery, Stanford University School of Medicine , Stanford, California.
Physiol Rev. 2019 Jan 1;99(1):665-706. doi: 10.1152/physrev.00067.2017.
Wound healing is one of the most complex processes in the human body. It involves the spatial and temporal synchronization of a variety of cell types with distinct roles in the phases of hemostasis, inflammation, growth, re-epithelialization, and remodeling. With the evolution of single cell technologies, it has been possible to uncover phenotypic and functional heterogeneity within several of these cell types. There have also been discoveries of rare, stem cell subsets within the skin, which are unipotent in the uninjured state, but become multipotent following skin injury. Unraveling the roles of each of these cell types and their interactions with each other is important in understanding the mechanisms of normal wound closure. Changes in the microenvironment including alterations in mechanical forces, oxygen levels, chemokines, extracellular matrix and growth factor synthesis directly impact cellular recruitment and activation, leading to impaired states of wound healing. Single cell technologies can be used to decipher these cellular alterations in diseased states such as in chronic wounds and hypertrophic scarring so that effective therapeutic solutions for healing wounds can be developed.
伤口愈合是人体中最复杂的过程之一。它涉及到各种细胞类型的时空同步,这些细胞类型在止血、炎症、生长、再上皮化和重塑等阶段具有不同的作用。随着单细胞技术的发展,已经有可能揭示其中一些细胞类型内的表型和功能异质性。此外,还发现皮肤内存在罕见的、具有单向分化潜能的干细胞亚群,在未受伤的状态下它们是单向分化的,但在皮肤受伤后会变成多向分化。阐明这些细胞类型的作用及其相互作用对于理解正常伤口愈合的机制非常重要。微环境的变化,包括机械力、氧水平、趋化因子、细胞外基质和生长因子合成的改变,直接影响细胞的募集和激活,导致伤口愈合受损状态。单细胞技术可用于破译慢性伤口和增生性瘢痕等疾病状态下的这些细胞变化,以便开发有效的伤口愈合治疗方法。