Abstract

Macrophages play key roles in all phases of adult wound healing, which are inflammation, proliferation, and remodeling. As wounds heal, the local macrophage population transitions from predominantly pro-inflammatory (M1-like phenotypes) to anti-inflammatory (M2-like phenotypes). Non-healing chronic wounds, such as pressure, arterial, venous, and diabetic ulcers indefinitely remain in inflammation-the first stage of wound healing. Thus, local macrophages retain pro-inflammatory characteristics. This review discusses the physiology of monocytes and macrophages in acute wound healing and the different phenotypes described in the literature for both <i>in vitro</i> and <i>in vivo</i> models. We also discuss aberrations that occur in macrophage populations in chronic wounds, and attempts to restore macrophage function by therapeutic approaches. These include endogenous M1 attenuation, exogenous M2 supplementation and endogenous macrophage modulation/M2 promotion via mesenchymal stem cells, growth factors, biomaterials, heme oxygenase-1 (HO-1) expression, and oxygen therapy. We recognize the challenges and controversies that exist in this field, such as standardization of macrophage phenotype nomenclature, definition of their distinct roles and understanding which phenotype is optimal in order to promote healing in chronic wounds.

Keywords

Wound healingMacrophageInflammationMedicinePhenotypeRegeneration (biology)PopulationM2 MacrophageChronic woundImmunologyMesenchymal stem cellPathologyBiologyCell biologyIn vitro

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Publication Info

Year
2018
Type
review
Volume
9
Pages
419-419
Citations
1364
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Paulina Krzyszczyk, Rene Schloss, Andre F. Palmer et al. (2018). The Role of Macrophages in Acute and Chronic Wound Healing and Interventions to Promote Pro-wound Healing Phenotypes. Frontiers in Physiology , 9 , 419-419. https://doi.org/10.3389/fphys.2018.00419

Identifiers

DOI
10.3389/fphys.2018.00419