2018, Number S1
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ABSTRACTObjective: provide a review on the main features of both acute and chronic cutaneous wound healing (WHR) and their relationship with myofibroblasts´ functions.
Materials and Methods: information was gathered from the pubmed database as well as from author´s publications.
Results: cutaneous WHR is a physiological process comprised of four sequential and overlapping stages: hemostasis, inflammation, proliferation and remodelling. Initial stages entail activation of fibroblasts, accumulation of immune cell infiltration including myofibroblasts, and altered local extracellular matrix (ECM). Later stages involve proliferation of myofibroblasts and epithelial cells and angiogenesis. Finally, wound closure and reorganisation of the ECM to an architecture resembling normal tissue occurs. In chronic wounds the normal WHR is stalled leading to static wounds. These are common in pathological conditions such as diabetic foot ulcerations. Myofibroblasts are key players in tissue repair and their evolution is linked to different stages of the wound healing response. Firstly, quiescent fibroblasts transdifferentiate into myofibroblasts that are that proliferating, fibrogenic, and contractile. The following cellular response is called perpetuation of the myofibroblast´s activated phenotype. At this stage, myofibroblasts can develop various responses including fibrogenesis, proliferation, contractility, release of proinflammatory cytokines, chemotaxis and matrix degradation. Finally, the resolution process involves the removal of accumulated ECM and myofibroblasts. Clearance of myofibroblasts can happen through three mechanisms: apoptosis, senescence and reversion to fibroblast´s phenotype. Resolution of myofi-broblast´s activation is an essential step in the restoration of tissue integrity.
Conclusions: we reviewed major characteristics and functions of cutaneous wound healing under physiological conditions or disease.
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