The Innate Immune System in Acute and Chronic Wounds.

Published

Journal Article (Review)

Significance: This review article provides an overview of the critical roles of the innate immune system to wound healing. It explores aspects of dysregulation of individual innate immune elements known to compromise wound repair and promote nonhealing wounds. Understanding the key mechanisms whereby wound healing fails will provide seed concepts for the development of new therapeutic approaches. Recent Advances: Our understanding of the complex interactions of the innate immune system in wound healing has significantly improved, particularly in our understanding of the role of antimicrobials and peptides and the nature of the switch from inflammatory to reparative processes. This takes place against an emerging understanding of the relationship between human cells and commensal bacteria in the skin. Critical Issues: It is well established and accepted that early local inflammatory mediators in the wound bed function as an immunological vehicle to facilitate immune cell infiltration and microbial clearance upon injury to the skin barrier. Both impaired and excessive innate immune responses can promote nonhealing wounds. It appears that the switch from the inflammatory to the proliferative phase is tightly regulated and mediated, at least in part, by a change in macrophages. Defining the factors that initiate the switch in such macrophage phenotypes and functions is the subject of multiple investigations. Future Directions: The review highlights processes that may be useful targets for further investigation, particularly the switch from M1 to M2 macrophages that appears to be critical as dysregulation of this switch occurs during defective wound healing.

Full Text

Duke Authors

Cited Authors

  • MacLeod, AS; Mansbridge, JN

Published Date

  • February 2016

Published In

Volume / Issue

  • 5 / 2

Start / End Page

  • 65 - 78

PubMed ID

  • 26862464

Pubmed Central ID

  • 26862464

Electronic International Standard Serial Number (EISSN)

  • 2162-1934

International Standard Serial Number (ISSN)

  • 2162-1918

Digital Object Identifier (DOI)

  • 10.1089/wound.2014.0608

Language

  • eng