Endothelial-mesenchymal transition as a novel mechanism for generating myofibroblasts during wound healing and scarring

J Cosmet Dermatol. 2023 Feb;22(2):661-668. doi: 10.1111/jocd.15466. Epub 2022 Oct 31.

Abstract

Background: The endothelial-mesenchymal transition (EndMT) is an important mechanism in tissue regeneration and the development of organ fibrosis. Whether EndMT occurs in wound healing and scarring remains unknown.

Materials and methods: The isolated cells from the normal dermal tissue and the wound tissue of mouse with full-thickness skin wound, and human scar tissue sections were performed with CD31/factorVII and α-SMA immunohistochemical staining and H and E staining. The ratio of factor VII or CD31/α-SMA double-positive cells in factor VII-positive cells was assessed in the isolated cells and in scar tissues.

Results: In this study, we found that approximately 27-60% of ECs coexpressed VII factor and α-SMA in the isolated cells from the wound tissues of mice, which was significantly higher than that of normal dermal tissue cells. Accordingly, the number of CD31/α-SMA double-positive cells in mouse wound tissue sections was also significantly more than that in normal dermal tissue sections. In scar tissues, in addition to high-density microvessels, a large number of proliferative ECs in scar strama and CD31/α-SMA double-positive cells were also found. Approximately 46.82 to 84.11% of ECs and 68.77 to 95.25% of myofibroblasts coexpressed VII factor and α-SMA, and these two values in hypertrophic scars were significantly higher than those in keloids.

Conclusion: These results confirmed that ECs might contribute to the emergence of myofibroblasts in the wound and scar tissue via the process of EndMT.

Keywords: endothelial cells; endothelial-mesenchymal transition; microvessel; pathological scars; wound healing.

MeSH terms

  • Animals
  • Cicatrix, Hypertrophic* / pathology
  • Factor VII
  • Humans
  • Keloid*
  • Mice
  • Myofibroblasts / pathology
  • Wound Healing

Substances

  • Factor VII