Skin wound healing modulation by macrophages.

TLDR

Skin wound healing is a multi‑stage process involving keratinocytes, endothelial cells, fibroblasts, and inflammatory cells, with macrophages playing a central, early‑stage role that can both accelerate healing and promote fibrosis, and whose dysfunction is linked to healing defects. This review aims to synthesize current knowledge on wound‑associated macrophages and their interactions with other cell types that regulate reepithelialization, angiogenesis, and extracellular‑matrix remodeling, thereby highlighting potential therapeutic targets. The authors examine how wound‑associated macrophages coordinate with keratinocytes, endothelial cells, and fibroblasts to drive reepithelialization, angiogenesis, and extracellular‑matrix remodeling.

Abstract

Skin wound healing is a multi stage phenomenon that requires the activation, recruitment or activity of numerous cell types as keratinocytes, endothelial cells, fibroblast and inflammatory cells. Among the latter, macrophages appear to be central to this process. They colonize the wound at its very early stage and in addition to their protective immune role seem to organize the activity of other cell types at the following stages of the healing. Their benefit to this process is however controversial, as macrophages are described to promote the speed of healing but may also favour the fibrosis resulting from it in scars. Moreover wound healing defects are associated with abnormalities in the inflammatory phase. In this review, we summarise our knowledge on what are the Wound Associated Macrophages, and how they interact with the other cell types to control the reepithelisation, angiogenesis and the extracellular matrix remodelling. We believe this knowledge may open new avenues for therapeutic intervention on skin wounds.