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2017 ; 62
(ä): 353-364
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Macrophage Differentiation in Normal and Accelerated Wound Healing
#MMPMID28455716
Kotwal GJ
; Chien S
Results Probl Cell Differ
2017[]; 62
(ä): 353-364
PMID28455716
show ga
Chronic wounds pose considerable public health challenges and burden. Wound
healing is known to require the participation of macrophages, but mechanisms
remain unclear. The M1 phenotype macrophages have a known scavenger function, but
they also play multiple roles in tissue repair and regeneration when they
transition to an M2 phenotype. Macrophage precursors (mononuclear
cells/monocytes) follow the influx of PMN neutrophils into a wound during the
natural wound-healing process, to become the major cells in the wound. Natural
wound-healing process is a four-phase progression consisting of hemostasis,
inflammation, proliferation, and remodeling. A lag phase of 3-6 days precedes the
remodeling phase, which is characterized by fibroblast activation and finally
collagen production. This normal wound-healing process can be accelerated by the
intracellular delivery of ATP to wound tissue. This novel ATP-mediated
acceleration arises due to an alternative activation of the M1 to M2 transition
(macrophage polarization), a central and critical feature of the wound-healing
process. This response is also characterized by an early increased release of
pro-inflammatory cytokines (TNF, IL-1 beta, IL-6), a chemokine (MCP-1), an
activation of purinergic receptors (a family of plasma membrane receptors found
in almost all mammalian cells), and an increased production of platelets and
platelet microparticles. These factors trigger a massive influx of macrophages,
as well as in situ proliferation of the resident macrophages and increased
synthesis of VEGFs. These responses are followed, in turn, by rapid
neovascularization and collagen production by the macrophages, resulting in wound
covering with granulation tissue within 24 h.