A Snapshot of Direct Cell-Cell Communications in Wound Healing and Scarring.

SIGNIFICANCE: The repair of wounds usually terminates with a scar. The healing from a severe tissue loss can create a new clinical problem, excessive scarring. Approaches to prevent excessive scarring will optimize the repair process. Controlling gap-junction communications between cells and/or the transport of the proteins that form gap junctions offers new approaches for controlling this problem. RECENT ADVANCES: Gap-junctional intercellular communication (GJIC) requires hemichannels, connexon structures, embedded in the plasma membrane of coupled cells. The connexon is composed of six proteins from the connexin (Cx) family. The docking of connexons between the neighboring cells forms a gated channel, where small molecules can pass directly between the cytoplasm of cells. In wound repair, GJIC between fibroblasts in granulation tissue advances wound repair. Also, the GJIC between mast cells and fibroblasts during the remodeling phase of repair may explain how mast cells promote excessive scarring. In addition, Cx can affect transforming growth factor beta (TGF-β) intracellular signaling through its shared binding site on microtubules within fibroblasts. CRITICAL ISSUES: Can excessive scarring be controlled through limiting the local amassing of mast cells or preventing their interactions with wound fibroblasts through GJIC? FUTURE DIRECTIONS: The prevention of the accumulation of mast cells in granulation tissue or interfering with their communications via GJIC with fibroblasts offers new approaches for preventing excess scarring. The association of Cx with microtubules altering TGF-β signaling presents a new target for improving the quality of repair as well as the deposition of unnecessary fibrosis.