Figure 2.
Imbalanced wound-healing response. For successful wound healing, a regulated response is maintained through negative feedback loops and a balance of catabolising and regenerative processes. Several imbalances may develop and lead a normal healing response into a fibrotic cascade. Excessive inflammation and the production of inflammatory and fibroblast-activating cytokines, through a breakdown in anti-inflammatory mechanisms can develop. Over-production of angiogenic CXC ELR+ chemokines, the recruitment of fibrocytes and increased frequency of α-SMA+ cells in the injury site can result in too much collagen deposition. Resetting the balance with targeted therapeutics (i.e., cytokine-blocking antibodies) may help slow the progression of fibrosis.