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Tissue regeneration: Fetal to adult transition

2022; Mary Ann Liebert, Inc.; Linguagem: Inglês

10.1016/b978-0-12-824064-9.00020-4

1557-8690

Ajoy Aloysius,

Reconstructive Surgery and Microvascular Techniques

In adult humans and other mammals, wound healing occurs in a nonregenerative manner with fibrosis and scarring, which results in nonfunctional tissue, further perturbing the tissue homeostasis. However, at the early fetal stage (gestational age) regenerative scarless wound repair has proven to restore tissue architecture and function. The comprehensive mechanism for this transition in wound healing outcomes is not fully understood. Compared to adult scar wound healing, early gestational scarless wounds have unique differences in the inflammation process, extracellular matrix (ECM), tissue remodeling, inherent cellular properties, specific secretory molecules, and mechanical properties, all of which contribute to the fetal scarless regeneration. Though several studies have been carried out, the current knowledge is not sufficient to give a comprehensive understanding of this regeneration process and its transition during later age. Understanding these factors and mechanisms in detail will help in devising therapeutic strategies to induce fetal-like wound healing in adults to reduce scarring and fibrosis. This chapter discusses the current understanding of fundamental changes that occur during this transition of scarless regeneration to scar wound healing. The later part of the chapter covers current tissue engineering strategies which use fetal regeneration knowledge to ameliorate the normal adult and pathological wound healing.