Lacina Lukáš, Kolář Michal, Pfeiferová Lucie, Gál Peter, Smetana Karel
Institute of Anatomy, First Faculty of Medicine, Charles, University, Prague, Czechia.
BIOCEV, First Faculty of Medicine, Charles University, Vestec, Czechia.
Front Immunol. 2024 Nov 29;15:1403570. doi: 10.3389/fimmu.2024.1403570. eCollection 2024.
Wound healing represents a complex and evolutionarily conserved process across vertebrates, encompassing a series of life-rescuing events. The healing process runs in three main phases: inflammation, proliferation, and maturation/remodelling. While acute inflammation is indispensable for cleansing the wound, removing infection, and eliminating dead tissue characterised by the prevalence of neutrophils, the proliferation phase is characterised by transition into the inflammatory cell profile, shifting towards the prevalence of macrophages. The proliferation phase involves development of granulation tissue, comprising fibroblasts, activated myofibroblasts, and inflammatory and endothelial cells. Communication among these cellular components occurs through intercellular contacts, extracellular matrix secretion, as well as paracrine production of bioactive factors and proteolytic enzymes. The proliferation phase of healing is intricately regulated by inflammation, particularly interleukin-6. Prolonged inflammation results in dysregulations during the granulation tissue formation and may lead to the development of chronic wounds or hypertrophic/keloid scars. Notably, pathological processes such as autoimmune chronic inflammation, organ fibrosis, the tumour microenvironment, and impaired repair following viral infections notably share morphological and functional similarities with granulation tissue. Consequently, wound healing emerges as a prototype for understanding these diverse pathological processes. The prospect of gaining a comprehensive understanding of wound healing holds the potential to furnish fundamental insights into modulation of the intricate dialogue between cancer cells and non-cancer cells within the cancer ecosystem. This knowledge may pave the way for innovative approaches to cancer diagnostics, disease monitoring, and anticancer therapy.
伤口愈合是一个复杂且在脊椎动物中进化保守的过程,涵盖了一系列拯救生命的事件。愈合过程主要分为三个阶段:炎症期、增殖期和成熟/重塑期。虽然急性炎症对于清洁伤口、清除感染以及清除以中性粒细胞为主的坏死组织是必不可少的,但增殖期的特征是炎症细胞谱发生转变,巨噬细胞逐渐占主导。增殖期涉及肉芽组织的形成,肉芽组织由成纤维细胞、活化的肌成纤维细胞、炎症细胞和内皮细胞组成。这些细胞成分之间的通讯通过细胞间接触、细胞外基质分泌以及生物活性因子和蛋白水解酶的旁分泌产生来实现。愈合的增殖期受到炎症,特别是白细胞介素-6的复杂调节。长时间的炎症会导致肉芽组织形成过程中的调节紊乱,并可能导致慢性伤口或肥厚性/瘢痕疙瘩瘢痕的形成。值得注意的是,自身免疫性慢性炎症、器官纤维化、肿瘤微环境以及病毒感染后修复受损等病理过程与肉芽组织在形态和功能上显著相似。因此,伤口愈合成为理解这些不同病理过程的一个范例。全面了解伤口愈合有望为深入了解癌症生态系统中癌细胞与非癌细胞之间复杂对话的调节提供基本见解。这些知识可能为癌症诊断、疾病监测和抗癌治疗的创新方法铺平道路。