Lorenz H P, Adzick N S
Department of Surgery, UCSF School of Medicine 94143-0570.
West J Med. 1993 Sep;159(3):350-5.
The ability of a fetus to heal without scar formation depends on its gestational age at the time of injury and the size of the wound defect. In general, linear incisions heal without scar until late in gestation whereas excisional wounds heal with scar at an earlier gestational age. The profiles of fetal proteoglycans, collagens, and growth factors are different from those in adult wounds. The less-differentiated state of fetal skin is probably an important characteristic responsible for scarless repair. There is minimal inflammation in fetal wounds. Fetal wounds are characterized by high levels of hyaluronic acid and its stimulator(s) with more rapid, highly organized collagen deposition. The roles of peptide growth factors such as transforming growth factor-beta and basic fibroblast growth factor are less prominent in fetal than in adult wound healing. Platelet-derived growth factor has been detected in scarless fetal skin wounds, but its role is unknown. An understanding of scarless tissue repair has possible clinical application in the modulation of adult fibrotic diseases and abnormal scar-forming conditions.
胎儿无瘢痕愈合的能力取决于受伤时的胎龄以及伤口缺损的大小。一般来说，线性切口在妊娠晚期前可无瘢痕愈合，而切除性伤口在较早的胎龄时愈合会形成瘢痕。胎儿蛋白聚糖、胶原蛋白和生长因子的情况与成人伤口不同。胎儿皮肤分化程度较低的状态可能是无瘢痕修复的一个重要特征。胎儿伤口的炎症反应极小。胎儿伤口的特点是透明质酸及其刺激物水平较高，胶原蛋白沉积更快且更有组织。与成人伤口愈合相比，肽生长因子如转化生长因子-β和碱性成纤维细胞生长因子在胎儿伤口愈合中的作用不那么突出。血小板衍生生长因子已在胎儿无瘢痕皮肤伤口中被检测到，但其作用尚不清楚。了解无瘢痕组织修复在调节成人纤维化疾病和异常瘢痕形成情况方面可能具有临床应用价值。
