Mechanisms of tissue repair: From wound healing to fibrosis

To set the scene for this Directed Issue on Mechanisms of Tissue Repair of The international Journal of Biochemistry aad Cell Biology, this introductory overview briefly describes the process of wound healing and highlights some of the key recent advances in this field of research. It emphasizes the importance of cell-cell and cell-matrix interactions, particularly relating to the role of cell surface adhesion molecules, and describes developments that have led to a better understanding of the dynamic nature of matrix turnover with reference to negative and positive mediators that regulate procollagen gene expression and protein production. An important component of this Directed Issue is concerned with the development of tissue fibrosis, which accompanies a number of disease states and demonstrates remarkable parallels with the normal wound healing process; excessive amounts of matrix are laid down but the resolution of scarring, which would be anticipated in wound healing, is impaired. The possible mechanisms involved in fibrosis are discussed here. Since cytokines play an important role in regulating cell function such as proliferation, migration and matrix synthesis, it is the balance of these mediators which is likely to play a key role in regulating the initiation, progression and resolution of wounds. Finally, this review highlights areas of tissue repair research in which recent developments have important clinical implications that may lead to novel therapeutic strategies. (C) 1997 Published by Elsevier Science Ltd.