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. 2013:2013:146764.
doi: 10.1155/2013/146764. Epub 2013 Jul 24.

Complements and the wound healing cascade: an updated review

Hani Sinno  1 , Satya Prakash
Affiliations

Complements and the wound healing cascade: an updated review

Hani Sinno et al. Plast Surg Int. 2013.

Abstract

Wound healing is a complex pathway of regulated reactions and cellular infiltrates. The mechanisms at play have been thoroughly studied but there is much still to learn. The health care system in the USA alone spends on average 9 billion dollars annually on treating of wounds. To help reduce patient morbidity and mortality related to abnormal or prolonged skin healing, an updated review and understanding of wound healing is essential. Recent works have helped shape the multistep process in wound healing and introduced various growth factors that can augment this process. The complement cascade has been shown to have a role in inflammation and has only recently been shown to augment wound healing. In this review, we have outlined the biology of wound healing and discussed the use of growth factors and the role of complements in this intricate pathway.

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Figures

Figure 1
Figure 1
Cytokines and complements involved in inflammation. The three phases of wound healing are associated with different growth factors and subsequent cellular infiltration. Although the complement system is involved in inflammation, its role in wound healing has never been proposed. Complements C3 and C5, epidermal growth factor (EGF), transforming growth factor (TGF), platelet-derived growth factor (PDGF), tumor necrosis factor (TNF), vascular endothelial growth factor (VEGF), and insulin-like growth factor (IGF).
Figure 2
Figure 2
Complement cascade. The complement system converges with the activation of complements C3 and C5 with the subsequent formation of the membrane attack complex. The C3a and C5a proteins are responsible for chemotaxis. The C3b and C5b are responsible for the continued proliferation of the complement cascade.
Figure 3
Figure 3
Cutaneous wound healing in time. A schematic representation of cutaneous wound healing and the growth factors and cellular participants in the first 72 hours of injury. The complement cascade appears to be involved in many stages of the wound healing. Platelets, macrophages, fibroblasts, and the formation of the fibrin clot are the major cellular players in early cutaneous, tendon, ligament, muscle, and bone healing.
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