[Current aspects of epidermal wound healing]

Abstract

The multilayered cornifying epithelium of mammalian skin provides a barrier protecting the organism against external damage and preventing loss from the internal milieu. The unique features of the epidermis are responsible for its regenerative capacity. Basal keratinocytes are the stem cells for a vertical differentiation pathway during which an undifferentiated keratinocyte undergoes extensive changes into a keratinized flake of the horny layer. During epithelial repair the cells change their normal pattern of differentiation. Migratory activity and proliferation are the basis for the horizontal migration of the epidermal cells, which is inhibited by cell contact and completed by differentiation and keratinization. The mechanisms of cell activation and migration are currently under intense investigation. A large number of peptide growth factors have been shown experimentally to be active in wound healing. A better understanding of the molecular basis provides new perspectives for a more specific therapy in wound healing. Keratinocyte culturing has first been used in the treatment of large burns. Modifications try to include also dermal elements. Recent developments in molecular and cell biology indicate a perspective of cultured epithelial sheets containing genetically engineered keratinocytes for epithelial gene therapy.