Reoxygenation Modulates the Adverse Effects of Hypoxia on Wound Repair

Int J Mol Sci. 2022 Dec 13;23(24):15832. doi: 10.3390/ijms232415832.

Abstract

Hypoxia is a major stressor and a prominent feature of pathological conditions, such as bacterial infections, inflammation, wounds, and cardiovascular defects. In this study, we investigated whether reoxygenation has a protective effect against hypoxia-induced acute injury and burn using the C57BL/6 mouse model. C57BL/6 mice were exposed to hypoxia and treated with both acute and burn injuries and were in hypoxia until wound healing. Next, C57BL/6 mice were exposed to hypoxia for three days and then transferred to normoxic conditions for reoxygenation until wound healing. Finally, skin wound tissue was collected to analyze healing-related markers, such as inflammation, vascularization, and collagen. Hypoxia significantly increased inflammatory cell infiltration and decreased vascular and collagen production, and reoxygenation notably attenuated hypoxia-induced infiltration of inflammatory cells, upregulation of pro-inflammatory cytokine levels (IL-6 and TNF-α) in the wound, and remission of inflammation in the wound. Immunofluorescence analysis showed that reoxygenation increased the expression of the angiogenic factor α-SMA and decreased ROS expression in burn tissues compared to hypoxia-treated animals. Moreover, further analysis by qPCR showed that reoxygenation could alleviate the expression of hypoxic-induced inflammatory markers (IL-6 and TNF), increase angiogenesis (SMA) and collagen synthesis (Col I), and thus promote wound healing. It is suggested that oxygen can be further evaluated in combination with oxygen-releasing materials as a supplementary therapy for patients with chronic hypoxic wounds.

Keywords: ROS; burn; hypoxia; reoxygenation; wound healing.

MeSH terms

  • Animals
  • Burns* / pathology
  • Collagen
  • Hypoxia / complications
  • Inflammation / metabolism
  • Interleukin-6*
  • Mice
  • Mice, Inbred C57BL
  • Oxygen / pharmacology
  • Wound Healing

Substances

  • Interleukin-6
  • Collagen
  • Oxygen