Greenhalgh D G
Department of Surgery, Shriners Hospitals for Children, Northern California, Sacramento, USA.
Int J Biochem Cell Biol. 1998 Sep;30(9):1019-30. doi: 10.1016/s1357-2725(98)00058-2.
Wound healing involves a series of rapid increases in specific cell populations that prepare the wound for repair, deposit new matrices and finally, mature the wound. Upon completing their tasks, these specific cell types must be eliminated from the wound prior to the progression to the next phase of healing. The most logical method of cellular down-regulation is through apoptosis. Apoptosis allows for the eliminations of entire populations without tissue damage or an inflammatory response. This review discusses which cells dominate the various phases of tissue repair and how the cellular pattern may vary after differing types of injury. The potential mechanisms involved in the down-regulation of inflammation and fibrosis are also covered. The studies that support the hypothesis that apoptosis is involved in the regulation of wound healing are discussed. The evidence supporting potential cell signals involved in the induction of apoptosis in tissue repair are examined. Finally, the review ends with a presentation of how dysregulation of apoptosis can lead to pathologic forms of healing such as excessive scarring and fibrosis. By understanding the mechanisms controlling apoptosis and tissue repair, one may eventually develop therapeutic modalities to minimize scarring, a final pathway for many disease processes.
伤口愈合涉及特定细胞群的一系列快速增加，这些细胞群为伤口修复做准备，沉积新的基质，最终使伤口成熟。完成任务后，这些特定的细胞类型必须在伤口进入下一愈合阶段之前从伤口中清除。最合理的细胞下调方法是通过细胞凋亡。细胞凋亡允许在不造成组织损伤或炎症反应的情况下清除整个细胞群。本综述讨论了哪些细胞在组织修复的各个阶段占主导地位，以及不同类型损伤后细胞模式可能如何变化。还涵盖了炎症和纤维化下调所涉及的潜在机制。讨论了支持细胞凋亡参与伤口愈合调节这一假说的研究。研究了支持组织修复中诱导细胞凋亡所涉及的潜在细胞信号的证据。最后，综述以阐述细胞凋亡失调如何导致诸如过度瘢痕形成和纤维化等病理性愈合形式而结束。通过了解控制细胞凋亡和组织修复的机制，人们最终可能开发出治疗方法，以尽量减少瘢痕形成，这是许多疾病过程的最终途径。
