Stress impairs wound healing of cutaneous lesions; however, the mechanism is still unclear. The aim of this study was to evaluate the effects of rotational stress on cutaneous wound healing in mice and propose a mechanism. Male mice were spun at 45 rpm for 15 min every hour beginning 3 days before wounding until euthanasia. Control animals were not subjected to stress. To confirm that catecholamines participate in stress-induced delay of wound healing, mice were treated daily with propranolol. An excisional lesion was created and measured. Seven and 14 days later, animals were killed and lesions collected. Sections were stained with hematoxylin-eosin and immunostained for alpha-smooth muscle actin and proliferating cell nuclear antigen. Matrix metalloproteinase (MMP)-2 and -9 activity, nitrite levels, and tumor necrosis factor-alpha (TNF-alpha) expression were measured in the wounds. In addition, murine skin fibroblast cultures were treated with high levels of epinephrine and fibroblast activity was evaluated. Stressed mice exhibited reduced locomotor activity and increased normetanephrine plasma levels. Rotational stress was associated with decreased wound contraction, reduced re-epithelialization, reduced MMP-2 and MMP-9 activation, but with strongly increased nitrite levels. Furthermore, inflammatory cell infiltration, TNF-alpha expression, myofibroblastic differentiation, and angiogenesis were all delayed in the stress group. Propranolol administration reversed the deleterious effects of stress on wound contraction and re-epithelialization. High epinephrine concentrations increased murine skin fibroblast proliferation and nitric oxide synthesis, and strongly inhibited skin fibroblast migration and both pro- and active MMP-2. In conclusion, rotational stress impairs cutaneous wound healing due to epinephrine increased levels.

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Hypertrophic scars and keloids are two forms of excessive cutaneous scarring. Considering the importance of extracellular matrix elements in tissue repair, a morphological and quantitative analysis of the elastic system components (fibrillin-1 and elastin) was performed in normal skin, normal scars, hypertrophic scars, and keloids. In superficial and deep dermis, fibrillin-1 volume density was significantly higher in normal skin compared with normal scars, hypertrophic scars, and keloids. The fibrillin-1 volume density did not show differences between hypertrophic scars and keloids in superficial or deep dermis. In superficial dermis, elastin volume density was higher in normal skin compared with normal scars, hypertrophic scars, and keloids. In deep dermis, the elastin volume density was higher in keloids compared with normal skins, normal scars, and hypertrophic scars. We showed that the distribution of fibrillin-1 and elastin is disrupted in all kinds of scars analyzed, but there are two patterns: one for normal scars and another for excessive scars.

Stress impairs cutaneous wound healing; however, it is unclear how beta-adrenoceptors participates in alterations induced by stress on skin wound repair. Therefore, the aim of this study was to investigate the effects of propranolol, a non-selective beta-blocker, administration on cutaneous wound healing of chronically stressed mice. Male mice were spun at 115 rpm for 15 min every hour from three days before wounding until euthanasia. Control animals were not submitted to stress. Stressed and control animals were treated with propranolol dissolved in water; controls received only water. Propranolol administration began one day before wounding and was continued daily until euthanasia. A full-thickness excisional lesion was performed. Seven and fourteen days later, animals were killed, and lesions were formalin-fixed and paraffin-embedded. Sections were stained with hematoxylin-eosin and immunostained against F4/80 to quantify macrophages, alpha-smooth muscle actin to quantify the myofibroblast density and proliferating cell nuclear antigen to quantify the cell proliferation. Furthermore, matrix metalloproteinases (MMP)-2 and MMP-9 activity, nitrite and hydroxyproline levels and tumor necrosis factor-alpha (TNF-alpha) expression were measured in wound. Stress and control + propranolol groups presented a delay in wound contraction, re-epithelialization, F4/80-positive macrophages, neutrophils and mast cells infiltration, cellular proliferation, angiogenesis, myofibroblastic differentiation, MMP-2 and MMP-9 activation and TNF-alpha expression, whereas an increase in the nitrite levels. Stress + propranolol group presented results similar to control group. In conclusion, stress impairs cutaneous wound healing in mice through beta1- adrenoceptors and beta2-adrenoceptors activation.

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1. The participation of sympathetic efferent fibres in wound healing is not well understood. The aim of the present study was to investigate the effects of beta(1)- and beta(2)-adrenoceptor blockade on rat excisional cutaneous wound healing. 2. Male rats were treated orally with propranolol dissolved in drinking water (50 mg/kg per day), whereas the control group received drinking water without propranolol. Propranolol was administered daily until rats were killed. A full-thickness excisional lesion was performed. The lesion area was measured to evaluate wound contraction. After rats had been killed, lesion and adjacent normal skin were formol fixed and paraffin embedded. Sections were stained with haematoxylin-eosin, Sirius red or Toluidine blue and immunostained for a-smooth muscle actin or proliferating cell nuclear antigen. 3. Propranolol-treated rats presented delayed wound contraction and epidermal healing and decreased hydroxyproline levels, collagen density and neo-epidermis thickness. Blockade of beta(1)- and beta(2)-adrenoceptors increased epidermal and connective tissue cell proliferation, polymorphonuclear leucocyte migration, myofibroblast density and mast cell migration. The volume density of blood vessels was increased and vessels were more dilated in propranolol-treated animals. 4. Thus, we conclude that beta(1)- and beta(2)-adrenoceptor blockade impairs cutaneous wound healing. This information should be considered by physicians during the treatment of patients who present with hypertension and problems in the healing process (such as venous ulcers).

Prolonged wound healing is a complication that contributes to morbidity and mortality. Overweight people regularly undergo surgery and trauma, and often develop chronic wounds, but the effects of the adipose tissue excess on cutaneous wound healing are not well understood. This study tested the hypothesis that overweight induced by a high-fat diet impairs rat cutaneous wound healing. Male Wistar rats were fed with either a high-fat or a standard (control) diet. After 15 weeks, an excisional lesion was done and the animals were killed 21 d later. Wound contraction and re-epithelialization, blood pressure, glucose and retroperitoneal fat were evaluated. After killing, lesion and adjacent normal skin were formol-fixed and paraffin-embedded. Inflammatory infiltrate, myofibroblasts, collagen fibres and cellular proliferation were analysed and blood vessels were evaluated using stereological methods. There was no difference in blood pressure and glucose, but retroperitoneal fat increased in the high-fat diet group. Animals fed with the high-fat diet presented delayed wound contraction and re-epithelialization. It was found that 21 d after wounding, overweight induced by a high-fat diet increased the inflammatory infiltrate and delayed myofibroblastic differentiation, collagen deposition, epithelial and connective tissue cell proliferation, and angiogenesis. These findings support the hypothesis that a high-fat diet exerts negative effects on rat cutaneous wound healing, due mainly to the prolongation of the inflammatory phase.

Topical application of GSNO-containing hydrogel during the early phases of rat cutaneous wound repair accelerates wound closure and re-epithelialization and affects granulation tissue organization.