Wound healing: insights into autoimmunity, ageing, and cancer ecosystems through inflammation and IL-6 modulation

Front Immunol. 2024 Nov 29:15:1403570. doi: 10.3389/fimmu.2024.1403570. eCollection 2024.

Abstract

Wound healing represents a complex and evolutionarily conserved process across vertebrates, encompassing a series of life-rescuing events. The healing process runs in three main phases: inflammation, proliferation, and maturation/remodelling. While acute inflammation is indispensable for cleansing the wound, removing infection, and eliminating dead tissue characterised by the prevalence of neutrophils, the proliferation phase is characterised by transition into the inflammatory cell profile, shifting towards the prevalence of macrophages. The proliferation phase involves development of granulation tissue, comprising fibroblasts, activated myofibroblasts, and inflammatory and endothelial cells. Communication among these cellular components occurs through intercellular contacts, extracellular matrix secretion, as well as paracrine production of bioactive factors and proteolytic enzymes. The proliferation phase of healing is intricately regulated by inflammation, particularly interleukin-6. Prolonged inflammation results in dysregulations during the granulation tissue formation and may lead to the development of chronic wounds or hypertrophic/keloid scars. Notably, pathological processes such as autoimmune chronic inflammation, organ fibrosis, the tumour microenvironment, and impaired repair following viral infections notably share morphological and functional similarities with granulation tissue. Consequently, wound healing emerges as a prototype for understanding these diverse pathological processes. The prospect of gaining a comprehensive understanding of wound healing holds the potential to furnish fundamental insights into modulation of the intricate dialogue between cancer cells and non-cancer cells within the cancer ecosystem. This knowledge may pave the way for innovative approaches to cancer diagnostics, disease monitoring, and anticancer therapy.

Keywords: IL-6; cancer-associated fibroblasts; granulation tissue; myofibroblasts; wound healing.

Publication types

  • Review

MeSH terms

  • Aging* / immunology
  • Animals
  • Autoimmunity*
  • Humans
  • Inflammation* / immunology
  • Interleukin-6* / immunology
  • Interleukin-6* / metabolism
  • Neoplasms* / immunology
  • Neoplasms* / metabolism
  • Neoplasms* / pathology
  • Tumor Microenvironment* / immunology
  • Wound Healing* / immunology

Substances

  • Interleukin-6

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by the project National Institute for Cancer Research (Programme EXCELES, ID Project No. LX22NPO5102) funded by the European Union – Next Generation EU. The Ministry of Health of the Czech Republic project No. NU22-03-00318, Charles University project COOPERATIO-Onco, and Charles University Grant Agency project No. 342522 also supported this study. The authors also appreciate the Grant Agency of the Ministry of Education, Science, Research and Sport of the Slovak Republic (under contracts Nos. 1/0455/22 and 1/0262/24), and the Slovak Research and Development Agency (under contracts Nos. APVV-20-0017 and APVV-22-0006) for support. This research was also partly supported by the European Union under the Next Generation EU recovery plan (under contract No. 09I03-03-V04-00075). The project “Center for Tumor Ecology - Research of the Cancer Microenvironment Supporting Cancer Growth and Spread” (reg. No. CZ.02.1.01/0.0/0.0/16_019/0000785) supported by the Operational Programme Research, Development and Education in the regimen of sustainability is also appreciated.