Wound healing epithelialization

The model concerning wound healing occurs in two phases (1) pro-inflammatory responses (Glaser and Kiecolt-Glaser 2005 Moore 1999 Tidball 2005 Whelan et al. 2005) which are needed to ensure adequate clearance of pathogen at the site of tissue injury, as well as, (2) re-epithelialization and neovascularization events (Frantz et al. 2005 Moore 1999 Naldini and Carraro 2005 Olah and Caldwell 2003 Whelan et al. 2005) to ensure proper wound closure. It is important to note that the resolution of pathogen clearance is essential in order for the wound closure processes to take place (Robson 1997). 

HS Geggel, J Friend, RA Thoft. (1984). Conjunctival epithelial wound healing. Invest Ophthalmol Vis Sci 25 860-863. 

AJW Huang, SCG Tseng. (1991). Corneal epithelial wound healing in the absence of limbal epithelium. Invest Ophthalmol Vis Sci 32 96-105. 

Dastgheib KA, Clinch TE, Manche EE, Hersh P, Ramsey J. Sloughing of corneal epithelium and wound healing complications associated with laser in situ keratomileusis in patients with epithelial basement membrane dystrophy. Am J Ophthalmol 130 297-303 (2000). 

Recently, the activities of host defense peptides related to the resolution of infection have been suggested to result in part from nondirect antimicrobial activities. It has been postulated that immunomodulation may represent the primary action of these peptides in vivo as the immunomodulatory activities are retained under physiological conditions in contrast to the direct antimicrobial activities of most natural mammalian host defense peptides. These immunomodulatory activities include, but are not limited to, direct chemotactic activity, induction of chemokines and other immune mediators, stimulation of leukocyte degranulation and other microbicidal activities, effects on leukocyte and epithelial cell survival and apoptosis, stimulation of epithelial and endothelial cell proliferation, promotion of wound healing and angiogenesis, antiendotoxic and anti-inflammatory activities, and adjuvant fiinctions. These will be described in detail in the following sections and a summary is found in Table 1. 

TGF-P — Fibrosis and wound healing in vivo, influences integrin expression and differentiation — Macrophages, T cells, B cells, epithelial cells... 

EGF — Angiogenesis, wound healing, proliferation/ differentiation of basal epithelial cells — Epithelial cells... 

Skin wound healing was investigated in a riboflavin-deficient rat model epithelialization was prolonged, wound contraction slowed and total collagen content reduced by 25%.114... 

TGF-p Cell-cycle arrest in epithelial and haematopoietic cells. Control of growth and differentiation of the mesenchyme. Wound healing. Formation of extracellular matrix. Immunosuppression... 

When wound healing studies were conducted on SM wounds in weanling pigs, it was observed that re-epitheli-alization was nearly complete with petrolatum and scarlet red dressings. The use of cultured epithelial allograft material, Xeroform Petrolatum and Scarlet Red Ointment dressings, is an effective and inexpensive treatment for SM injuries (Graham et al, 2006). 

Corticosteroids Decreased epithelial wound healing, increased risk for infection (decreased tear lysozyme)... 

Delayed corneal epithelial wound healing, PSC, decreased resistance to infection, decreased tear lysozyme, eyelid and conjunctiva hyperemia/edema/angioneurotic edema, subconjunctival hemorrhage, translucent blue sclera, increased lOP, myopia, exophthalmos, intracranial hypertension causing papilledema, diplopia, EOM paresis and eyelid ptosis, retinal hemorrhages (secondary to injection), central serous choroidopathy, abnormal ERGA EP, retinal embolic phenomenon (injection). 

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