Abstract
BACKGROUND: Wound healing is a process made up of several phases, including hemostasis/inflammation, proliferation, and scar formation/remodeling. An array of growth factors is produced during each of these phases that helps direct the repair process. THE PROBLEM: Most of the information we have about the biological actions of growth factors are from studies examining a growth factor in isolation. However, growth factors are known to interact with the extracellular matrix (ECM), and these associations influence cell behavior. Details about these interactions within the complex and continuously changing wound environment are not well understood and are likely to be very important during repair. BASIC/CLINICAL SCIENCE ADVANCES: Several types of growth factor/ECM interactions have been described that could impact wound healing. The ECM can interact directly with growth factors, offering protection from degradation and controlling bioactivity of the growth factor. Portions of the ECM can bind to growth factor receptors, and cell-ECM binding can influence growth factor receptor signaling. Growth factors can also control production and degradation of the ECM; therefore, the relationship between growth factors and ECM is bidirectional. CLINICAL CARE RELEVANCE: New information about the relationship between growth factors and ECM could be used to optimize growth factor-based therapies or lead to the development of novel treatment strategies for wound care. CONCLUSION: Growth factor-ECM interactions likely have a strong impact on the rate and quality of healing. A better understanding of the relationship between these classes of molecules and how it can be exploited to enhance healing is needed.