Dermal-epidermal communication in wound healing

The anatomic discontinuity of the skin caused by physical, chemical, or the rmal insult is restored by a mechanism of partial regeneration. Wound heali ng is an orderly, integrated, dynamic process comprised of multiple tempora lly and spatially overlapping but distinct phases, namely inflammation, vas cularization, fibroplasia, reepithelialization, and remodeling. The biologi cal signals released during the initial clot formation and throughout the r epair modulate controlled migration, proliferation, and differentiation of cells actively involved in. this event leading to wound closure. This proce ss is completed by the synthesis of extracellular matrix proteins in approp riate quantity and quality. Considerable advances made in understanding cel l-cell and cell-matrix interactions in cutaneous wound healing provide evid ence for a critical role of matrix in influencing cell migration, polarity, and orientation. The formation of surface epithelium to close the wound is precisely orchestrated with the underlying dermal repair. This synchrony i s key to preventing either insufficient or excess wound repair. Though the importance of communication between the layers of skin-epidermis and dermis -is well realized, the mechanism underlying this marvelous event needs in-d epth study. Communication must occur between diverse cell types, many of wh ich are only transiently present, to recreate a structure that is formed pr edominantly by cells derived from diverse embryological origin, the epiderm is from the ectoderm, and the dermis from the mesodermal mesenchyme. This r eview focuses on the basic mechanisms underlying the interaction of dermal matrix with surface epithelial layer to facilitate normal wound healing.