Reactive Oxygen Species and Antioxidants in Wound Healing: Mechanisms and Therapeutic Potential

Abstract

Wound healing is a complex biological process encompassing haemostasis, inflammation, proliferation and matrix remodelling. Reactive oxygen species (ROS) play a pivotal role in regulating key events such as antimicrobial defence, platelet activation and angiogenesis. However, excessive ROS levels can induce oxidative stress (OS), disrupting the healing cascade and contributing to chronic wounds, inflammation and impaired tissue repair. Systemic conditions like diabetes, obesity, smoking and ageing further exacerbate OS, highlighting its clinical significance in wound management. Antioxidants (AOx), both endogenous and exogenous, have demonstrated therapeutic potential in mitigating OS, promoting wound closure and enhancing cellular recovery. Compounds like Vitamin E, curcumin, ferulic acid and resveratrol improve AOx enzyme activity, reduce oxidative damage and accelerate wound healing in multiple studies. Emerging evidence supports targeting oxidative pathways as a viable strategy to improve outcomes in chronic and systemic OS-related conditions. This review explores the dual role of ROS in wound healing, the impact of OS in systemic diseases, and the therapeutic potential of AOx in fostering optimal healing outcomes, advocating for robust clinical trials to establish standardised interventions.

Keywords: antioxidants; oxidative stress; reactive oxygen species; wound healing.

FIGURE 1

Summary of the generation of reactive oxygen and nitrogen species (ROS/RNS) in phagocytic cells, highlighting key enzymes such as NADPH oxidase, superoxide dismutase (SOD), and myeloperoxidase (MPO).

FIGURE 2

Summary of the role of oxidative stress in delayed wound healing and prolonged inflammation, and the confounding effect of systemic diseases like diabetes and obesity. Antioxidants such as vitamin E and resveratrol can help mitigate damage.