Molecular and cellular regulation of wound healing; what goes wrong when wounds fail to heal or heal too much?

Published on October 7, 2014   45 min
0:00
Hello, everyone. I'm Gregory Schultz, a biochemist at the University of Florida, and Professor of Obstetrics and Gynecology, and Director of the Institute for Wound Research. This presentation will deal with the basic molecular and cellular regulation of normal wound healing. But in addition, we'll look at what goes wrong when wounds fail to heal, or heal too much.
0:27
A brief overview of the topics that we will discuss today includes considering wound healing as a spectrum of outcomes, that is normal scars, but in addition fibrotic scars or chronic wounds. We will begin by reviewing the sequential phases of normal wound healing, and I especially want to emphasize the beneficial effects of controlled information and protease activities. Because I will contrast the beneficial effects of controlled information and protease activities with the detrimental effects on healing that occurs when chronic inflammation is caused by planktonic, and especially biofilm bacteria. And I'll show you that these lead to elevated levels of protease activities, especially the matrix metalloproteinase, or MMPs. Because these proteases destroy proteins that are essential for healing, such as the Extracellular Matrix, or ECM proteins, growth factors, or their receptors. And especially we'll also learn about the key roles that Transforming Growth Factor Beta or TGFB and CTGF, or Connective Tissue Growth Factor, play in stimulating excessive scar formation, or known clinically as fibrosis. And we'll look at some new ways to try to reduce pathological scar formation.
1:51
So let's begin by thinking of wound healing as a spectrum of clinical outcomes. In normal wound healing, we can see in this image of a good scar that has formed in an injury that's close to the hairline. And you can probably just barely see the slight indentation and slight abnormal appearance of the skin. But this is a very good cosmetic and functional outcome for a typical acute injury. At one end of the spectrum of wound healing however, is excessive healing or fibrosis. And here you can see an example of another acute incision that was made near the hairline of this person. But instead of forming a normal looking scar, this has formed a hypertrophic scar, which has excessive amounts of scar tissue and has both impaired functional, as well as visual appearance. At the low end or the infrared range of the spectrum of wound healing is the inadequate healing, or chronic wound healing. Shown here is an example of a venous leg ulcer. And so what we'll do in this presentation is look at normal healing, and then look at the causes and effects of excessive or inadequate healing from a molecular and cellular perspective.
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Molecular and cellular regulation of wound healing; what goes wrong when wounds fail to heal or heal too much?

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