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Published in: American Journal of Clinical Dermatology 11/2003

01-11-2003 | Therapy in Practice

Potential Role of Estrogens in Wound Healing

Authors: Dr Gillian S. Ashcroft, Jason J. Ashworth

Published in: American Journal of Clinical Dermatology | Issue 11/2003

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Abstract

Estrogens play a vital role in the development of sexually dimorphic characteristics essential for reproduction. In recent years, insight has been gained into the role of estrogens in non-reproductive pathophysiological processes, including neoplasia, vascular disease and osteoporosis. Intriguingly, the skin appears to act as an end-organ target for estrogenic action; marked structural and functional skin changes occurring after the menopause can be related to altered hormonal profiles. One of the most important consequences of such hormonal changes is the age-related delay in cutaneous wound healing, leading to substantial morbidity and mortality, and increased costs to health services. Reduced estrogen levels have major downstream effects on cellular and tissue responses to injury; such downstream effects include impaired cytokine signal transduction, unchecked inflammation, and altered protein balance, and have a major impact on the rate of wound healing. Further understanding of the complex interaction between aging cells and the hormonal micro-environment is essential to develop focused therapeutic strategies to improve cutaneous wound healing in hypogonadal individuals, including the elderly.
Literature
1.
go back to reference Barrett-Connor E. Epidemiology and the menopause: a global overview. Int J Fertil Menopausal Stud 1993; 38 Suppl. 1: 6–14PubMed Barrett-Connor E. Epidemiology and the menopause: a global overview. Int J Fertil Menopausal Stud 1993; 38 Suppl. 1: 6–14PubMed
2.
go back to reference Couse JF, Lindzey J, Grandien K, et al. Tissue distribution and quantitative analysis of estrogen receptor-alpha (ERalpha) and estrogen receptor-beta (ERbeta) messenger ribonucleic acid in the wild-type and ERalpha-knockout mouse. Endocrinology 1997; 138: 4613–21PubMedCrossRef Couse JF, Lindzey J, Grandien K, et al. Tissue distribution and quantitative analysis of estrogen receptor-alpha (ERalpha) and estrogen receptor-beta (ERbeta) messenger ribonucleic acid in the wild-type and ERalpha-knockout mouse. Endocrinology 1997; 138: 4613–21PubMedCrossRef
3.
go back to reference Grohe C, Kahlert S, Lobbert K, et al. Cardiac myocytes and fibroblasts contain functional estrogen receptors. FEBS Lett 1997; 13: 107–12CrossRef Grohe C, Kahlert S, Lobbert K, et al. Cardiac myocytes and fibroblasts contain functional estrogen receptors. FEBS Lett 1997; 13: 107–12CrossRef
4.
go back to reference Erlandsson MC, Ohlsson C, Gustafsson J, et al. Role of estrogen receptors α and β in immune organ development and in oestrogen-mediated effects on thymus. Immunology 2001; 103: 17–25PubMedCrossRef Erlandsson MC, Ohlsson C, Gustafsson J, et al. Role of estrogen receptors α and β in immune organ development and in oestrogen-mediated effects on thymus. Immunology 2001; 103: 17–25PubMedCrossRef
5.
go back to reference Venkov CD, Rankin AB, Vaughn DE. Identification of authentic oestrogen receptor in cultured endothelial cells. Circulation 1996; 94: 727–33PubMedCrossRef Venkov CD, Rankin AB, Vaughn DE. Identification of authentic oestrogen receptor in cultured endothelial cells. Circulation 1996; 94: 727–33PubMedCrossRef
6.
go back to reference Gulshan S, McCruden AB, Stimson WH. Oestrogen receptors in macrophages. Scand J Immunol 1990; 31: 691–7PubMedCrossRef Gulshan S, McCruden AB, Stimson WH. Oestrogen receptors in macrophages. Scand J Immunol 1990; 31: 691–7PubMedCrossRef
7.
go back to reference Malet C, Grompel A, Yaneva H, et al. Oestradiol and progesterone receptors in cultured normal human breast epithelial cells and fibroblasts: immunocytochemical studies. J Clin Endocrin Metab 1991; 73: 8–17CrossRef Malet C, Grompel A, Yaneva H, et al. Oestradiol and progesterone receptors in cultured normal human breast epithelial cells and fibroblasts: immunocytochemical studies. J Clin Endocrin Metab 1991; 73: 8–17CrossRef
8.
go back to reference Brincat M, Moniz C, Studd J. Long term effects of the menopause and sex hormones on skin thickness. Br J Obstet Gynaecol 1985; 92: 256–9PubMedCrossRef Brincat M, Moniz C, Studd J. Long term effects of the menopause and sex hormones on skin thickness. Br J Obstet Gynaecol 1985; 92: 256–9PubMedCrossRef
9.
go back to reference Schmidt J, Binder M, Macheiner W, et al. Treatment of skin ageing symptoms in perimenopausal females with estrogen compounds: a pilot study. Maturitas 1994; 20: 25–30PubMedCrossRef Schmidt J, Binder M, Macheiner W, et al. Treatment of skin ageing symptoms in perimenopausal females with estrogen compounds: a pilot study. Maturitas 1994; 20: 25–30PubMedCrossRef
10.
go back to reference Brincat M, Versi E, Moniz C, et al. Skin collagen changes in postmenopausal women receiving different regimens of estrogen therapy. Obstet Gynecol 1987; 70: 123–7PubMed Brincat M, Versi E, Moniz C, et al. Skin collagen changes in postmenopausal women receiving different regimens of estrogen therapy. Obstet Gynecol 1987; 70: 123–7PubMed
12.
go back to reference Ashcroft GS, Dodsworth J, Boxtel E, et al. Estrogen accelerates cutaneous wound healing associated with an increase in TGF-β1 levels. Nat Med 1997; 3: 1209–15PubMedCrossRef Ashcroft GS, Dodsworth J, Boxtel E, et al. Estrogen accelerates cutaneous wound healing associated with an increase in TGF-β1 levels. Nat Med 1997; 3: 1209–15PubMedCrossRef
13.
14.
go back to reference Ashcroft GS, Horan MA, Herrick SE, et al. Age-related differences in the temporal and spatial regulation of matrix metalloproteinases (MMPs) in normal skin and acute cutaneous wounds of healthy humans. Cell Tissue Res 1997; 290: 581–91PubMedCrossRef Ashcroft GS, Horan MA, Herrick SE, et al. Age-related differences in the temporal and spatial regulation of matrix metalloproteinases (MMPs) in normal skin and acute cutaneous wounds of healthy humans. Cell Tissue Res 1997; 290: 581–91PubMedCrossRef
15.
go back to reference Leibovich SJ, Ross R. The role of the macrophage in wound repair: a study with hydrocortisone and antimacrophage serum. Am J Pathol 1975; 78: 71–100PubMed Leibovich SJ, Ross R. The role of the macrophage in wound repair: a study with hydrocortisone and antimacrophage serum. Am J Pathol 1975; 78: 71–100PubMed
16.
go back to reference Clarke RAF. Wound repair: overview and general considerations. In: Clark RAF, editor. The molecular and cellular biology of wound repair. New York (NY): Plenum, 1996: 3–50 Clarke RAF. Wound repair: overview and general considerations. In: Clark RAF, editor. The molecular and cellular biology of wound repair. New York (NY): Plenum, 1996: 3–50
17.
go back to reference Barrandon Y, Green H. Cell migration is essential for sustained growth of keratinocyte colonies: the roles of transforming growth factor alpha and epidermal growth factor. Cell 1987; 50: 1131–5PubMedCrossRef Barrandon Y, Green H. Cell migration is essential for sustained growth of keratinocyte colonies: the roles of transforming growth factor alpha and epidermal growth factor. Cell 1987; 50: 1131–5PubMedCrossRef
18.
go back to reference Werner S, Peters KG, Longaker MT, et al. Large induction of keratinocyte growth factor expression in the dermis during wound healing. Proc Natl Acad Sci U S A 1992; 89: 6896–900PubMedCrossRef Werner S, Peters KG, Longaker MT, et al. Large induction of keratinocyte growth factor expression in the dermis during wound healing. Proc Natl Acad Sci U S A 1992; 89: 6896–900PubMedCrossRef
19.
go back to reference Ashcroft GS, Lei K, Jin W, et al. Secretory leukocyte protease inhibitor mediates non-redundant functions necessary for normal wound healing. Nat Med 2000; 6: 1147–53PubMedCrossRef Ashcroft GS, Lei K, Jin W, et al. Secretory leukocyte protease inhibitor mediates non-redundant functions necessary for normal wound healing. Nat Med 2000; 6: 1147–53PubMedCrossRef
20.
go back to reference Song Xy, Zeng L, Jin W, et al. Secretory leukocyte protease inhibitor suppresses the inflammation and joint damage of bacterial cell wall-induced arthritis. J Exp Med 1999; 190: 535–42CrossRef Song Xy, Zeng L, Jin W, et al. Secretory leukocyte protease inhibitor suppresses the inflammation and joint damage of bacterial cell wall-induced arthritis. J Exp Med 1999; 190: 535–42CrossRef
21.
go back to reference Ashcroft GS, Greenwell-Wild T, Horan MA, et al. Topical estrogen accelerates cutaneous wound healing in aged humans associated with an altered inflammatory response. Am J Pathol 1999; 155: 1137–46PubMedCrossRef Ashcroft GS, Greenwell-Wild T, Horan MA, et al. Topical estrogen accelerates cutaneous wound healing in aged humans associated with an altered inflammatory response. Am J Pathol 1999; 155: 1137–46PubMedCrossRef
22.
go back to reference Herrick S, Ashcroft GS, Ireland G, et al. Up-regulation of elastase in acute wounds of healthy aged humans and chronic venous leg ulcers is associated with matrix degradation. Lab Invest 1996; 77: 281–4 Herrick S, Ashcroft GS, Ireland G, et al. Up-regulation of elastase in acute wounds of healthy aged humans and chronic venous leg ulcers is associated with matrix degradation. Lab Invest 1996; 77: 281–4
23.
go back to reference Silverman EM, Silverman AG. Granulocyte adherence in the elderly. Am J Clin Pathol 1977; 67: 49–52PubMed Silverman EM, Silverman AG. Granulocyte adherence in the elderly. Am J Clin Pathol 1977; 67: 49–52PubMed
24.
go back to reference Iiyama M, Shimada Y, Kita T, et al. Effect of aging on macrophage adherence to extracellular matrix proteins. Mech Ageing Dev 1992; 66: 149–58PubMedCrossRef Iiyama M, Shimada Y, Kita T, et al. Effect of aging on macrophage adherence to extracellular matrix proteins. Mech Ageing Dev 1992; 66: 149–58PubMedCrossRef
25.
go back to reference Cohen BJ. Accelerated wound repair in old deer mice (peromyscus maniculatus) and white-footed mice (peromyscus leucopus). J Gerontol 1987; 42: 302–7PubMed Cohen BJ. Accelerated wound repair in old deer mice (peromyscus maniculatus) and white-footed mice (peromyscus leucopus). J Gerontol 1987; 42: 302–7PubMed
26.
go back to reference Fagiolo U, Cossarizza A, Santacaterina S, et al. Aging and cellular defence mechanisms. Ann N Y Acad Sci 1992; 663: 490–3PubMedCrossRef Fagiolo U, Cossarizza A, Santacaterina S, et al. Aging and cellular defence mechanisms. Ann N Y Acad Sci 1992; 663: 490–3PubMedCrossRef
27.
go back to reference Magnusson U, Einarsson S. Effects of exogenous oestradiol on the number and functional capacity of circulating mononuclear and polymorphonuclear leukocytes in the sow. Vet Immunol Immunopath 1990; 25: 235–47CrossRef Magnusson U, Einarsson S. Effects of exogenous oestradiol on the number and functional capacity of circulating mononuclear and polymorphonuclear leukocytes in the sow. Vet Immunol Immunopath 1990; 25: 235–47CrossRef
28.
go back to reference Jansson G. Oestrogen-induced enhancement of myeloperoxidase activity in human polymorphonuclear leukocytes. Free Radic Res Commun 1991; 14: 195–208PubMedCrossRef Jansson G. Oestrogen-induced enhancement of myeloperoxidase activity in human polymorphonuclear leukocytes. Free Radic Res Commun 1991; 14: 195–208PubMedCrossRef
29.
go back to reference Holt DR, Kirk SJ, Regan MC, et al. Effect of age on wound healing in healthy human beings. Surgery 1992; 112: 293–8PubMed Holt DR, Kirk SJ, Regan MC, et al. Effect of age on wound healing in healthy human beings. Surgery 1992; 112: 293–8PubMed
30.
go back to reference Ashcroft GS, Mills SJ. Androgen receptor mediated inhibition of cutaneous wound healing. J Clin Invest 2002; 110: 615–24PubMed Ashcroft GS, Mills SJ. Androgen receptor mediated inhibition of cutaneous wound healing. J Clin Invest 2002; 110: 615–24PubMed
31.
go back to reference Ashcroft GS, Horan MA, Ferguson M. Ageing is associated with reduced deposition of specific extracellular matrix components, an up-regulation of angiogenesis, and an altered inflammatory response in a murine incisional wound healing model. J Invest Derm 1997; 108: 430–7PubMedCrossRef Ashcroft GS, Horan MA, Ferguson M. Ageing is associated with reduced deposition of specific extracellular matrix components, an up-regulation of angiogenesis, and an altered inflammatory response in a murine incisional wound healing model. J Invest Derm 1997; 108: 430–7PubMedCrossRef
32.
go back to reference Ashcroft GS, Horan MA, Ferguson M. The effects of ageing on wound healing: immunolocalisation of growth factors and their receptors in a murine incisional model. J Anat 1997; 190: 351–65PubMedCrossRef Ashcroft GS, Horan MA, Ferguson M. The effects of ageing on wound healing: immunolocalisation of growth factors and their receptors in a murine incisional model. J Anat 1997; 190: 351–65PubMedCrossRef
33.
go back to reference Morales DE, McGowan KA, Grant DS, et al. Oestrogen promotes angiogenic activity in human umbilical vein endothelial cells in vitro and in a murine model. Circulation 1995; 91: 755–63PubMedCrossRef Morales DE, McGowan KA, Grant DS, et al. Oestrogen promotes angiogenic activity in human umbilical vein endothelial cells in vitro and in a murine model. Circulation 1995; 91: 755–63PubMedCrossRef
34.
go back to reference Shanker G, Sorci-Thomas M, Adams MR. Oestrogen modulates the inducible expression of platelet derived growth factor mRNA by monocytes/macrophages. Life Sci 1995; 56: 499–507PubMedCrossRef Shanker G, Sorci-Thomas M, Adams MR. Oestrogen modulates the inducible expression of platelet derived growth factor mRNA by monocytes/macrophages. Life Sci 1995; 56: 499–507PubMedCrossRef
35.
go back to reference Sato T, Ito A, Mori Y, et al. Hormonal regulation of collagenolysis in uterine cervical fibroblasts. Biochem J 1991; 275: 645–50PubMed Sato T, Ito A, Mori Y, et al. Hormonal regulation of collagenolysis in uterine cervical fibroblasts. Biochem J 1991; 275: 645–50PubMed
36.
go back to reference Nishihira J, Koyama Y, Mizue Y. Identification of macrophage migration inhibitory factor (MIF) in human vascular endothelial cells and its induction by lipopolysaccharide. Cytokine 1998; 10: 199–205PubMedCrossRef Nishihira J, Koyama Y, Mizue Y. Identification of macrophage migration inhibitory factor (MIF) in human vascular endothelial cells and its induction by lipopolysaccharide. Cytokine 1998; 10: 199–205PubMedCrossRef
37.
go back to reference Abe R, Shimizu T, Ohkawara A, et al. Enhancement of macrophage migration inhibitory factor (MIF) expression in injured epidermis and cultured fibroblasts. Biochim Biophys Acta 2000; 1500: 1–9PubMedCrossRef Abe R, Shimizu T, Ohkawara A, et al. Enhancement of macrophage migration inhibitory factor (MIF) expression in injured epidermis and cultured fibroblasts. Biochim Biophys Acta 2000; 1500: 1–9PubMedCrossRef
38.
go back to reference Nathan C, Karnovsky M, David J. Alterations of macrophage functions by mediators from lymphocytes. J Exp Med 1971; 133: 1356–76PubMedCrossRef Nathan C, Karnovsky M, David J. Alterations of macrophage functions by mediators from lymphocytes. J Exp Med 1971; 133: 1356–76PubMedCrossRef
39.
go back to reference Calvin M, Dyson M, Rymer J, et al. The effects of ovarian hormone deficiency on macrophage infiltration during the inflammatory phase of wound healing in a rat model. Wounds: Compend Res Clin Prac 1998; 10: 158–63 Calvin M, Dyson M, Rymer J, et al. The effects of ovarian hormone deficiency on macrophage infiltration during the inflammatory phase of wound healing in a rat model. Wounds: Compend Res Clin Prac 1998; 10: 158–63
40.
41.
go back to reference Peacocke M, Yaar M, Gilchrest BA. Interferon and the epidermis: implications for cellular senescence. Exp Gerontol 1989; 24: 415–21PubMedCrossRef Peacocke M, Yaar M, Gilchrest BA. Interferon and the epidermis: implications for cellular senescence. Exp Gerontol 1989; 24: 415–21PubMedCrossRef
42.
go back to reference Butcher EO, Klingsberg J. Age, gonadectomy and wound healing in palatal mucosa of the rat. Oral Surg 1963; 16: 482–92CrossRef Butcher EO, Klingsberg J. Age, gonadectomy and wound healing in palatal mucosa of the rat. Oral Surg 1963; 16: 482–92CrossRef
43.
go back to reference Lundgren D. Influence of estrogen and progesterone on exudation, inflammatory cell migration and granulation tissue formation in preformed cavities. Scand J Plast Reconstr Surg 1973; 7: 10–4PubMedCrossRef Lundgren D. Influence of estrogen and progesterone on exudation, inflammatory cell migration and granulation tissue formation in preformed cavities. Scand J Plast Reconstr Surg 1973; 7: 10–4PubMedCrossRef
44.
go back to reference Jorgensen O, Schmidt A. Influence of sex hormones on granulation tissue formation and on healing of linear wounds. Acta Chir Scand 1962; 124: 1–10PubMed Jorgensen O, Schmidt A. Influence of sex hormones on granulation tissue formation and on healing of linear wounds. Acta Chir Scand 1962; 124: 1–10PubMed
45.
go back to reference Pallin B, Ahonen J, Zederfeldt B. Granulation tissue formation in oophorectomized rats treated with female sex hormones: II. Acta Chir Scand 1975; 141: 710–4 Pallin B, Ahonen J, Zederfeldt B. Granulation tissue formation in oophorectomized rats treated with female sex hormones: II. Acta Chir Scand 1975; 141: 710–4
46.
go back to reference Calvin M, Dyson M, Rymer J, et al. The effects of ovarian hormone deficiency on wound contraction in a rat model. Br J Obstet Gynaecol 1998; 105: 223–7PubMedCrossRef Calvin M, Dyson M, Rymer J, et al. The effects of ovarian hormone deficiency on wound contraction in a rat model. Br J Obstet Gynaecol 1998; 105: 223–7PubMedCrossRef
47.
go back to reference Hu SK, Mitcho YL, Rath NC. Effect of oestradiol on interleukin 1 synthesis by macrophages. Int J Immunopharm 1988; 10: 247–52CrossRef Hu SK, Mitcho YL, Rath NC. Effect of oestradiol on interleukin 1 synthesis by macrophages. Int J Immunopharm 1988; 10: 247–52CrossRef
48.
go back to reference Claesson-Welsh L. Mechanism of action of platelet-derived growth factor. Int J Biochem Cell Biol 1996; 28: 373–85PubMedCrossRef Claesson-Welsh L. Mechanism of action of platelet-derived growth factor. Int J Biochem Cell Biol 1996; 28: 373–85PubMedCrossRef
49.
go back to reference Circolo A, Welgus HG, Pierce GF, et al. Differential regulation of the expression of proteinases/antiproteinases in fibroblasts: effects of interleukin-1 and platelet-derived growth factor. J Biol Chem 1991; 266: 12283–8PubMed Circolo A, Welgus HG, Pierce GF, et al. Differential regulation of the expression of proteinases/antiproteinases in fibroblasts: effects of interleukin-1 and platelet-derived growth factor. J Biol Chem 1991; 266: 12283–8PubMed
50.
go back to reference Battegay EJ, Rupp J, Iruela-Arispe L, et al. PDGF-BB modulates endothelial proliferation and angiogenesis in vitro via PDGF β receptors. J Cell Biol 1994; 125: 917–28PubMedCrossRef Battegay EJ, Rupp J, Iruela-Arispe L, et al. PDGF-BB modulates endothelial proliferation and angiogenesis in vitro via PDGF β receptors. J Cell Biol 1994; 125: 917–28PubMedCrossRef
52.
go back to reference Niesler CU, Ferguson MWJ. TGF-beta superfamily cytokines in wound healing. In: Breit SN, Wahl SM, editors. TGF-beta and related cytokines in inflammation. Basel: Birkhauser, 2001: 173–98CrossRef Niesler CU, Ferguson MWJ. TGF-beta superfamily cytokines in wound healing. In: Breit SN, Wahl SM, editors. TGF-beta and related cytokines in inflammation. Basel: Birkhauser, 2001: 173–98CrossRef
53.
go back to reference Swift ME, Burns AL, Gray KL, et al. Age-related alterations in the inflammatory response to dermal injury. J Invest Dermatol 2001; 117: 1027–35PubMedCrossRef Swift ME, Burns AL, Gray KL, et al. Age-related alterations in the inflammatory response to dermal injury. J Invest Dermatol 2001; 117: 1027–35PubMedCrossRef
54.
55.
go back to reference Nyman S, Lindhe J, Zederfeldt B. The vascularity of wounded areas in estradiol and progesterone treated female rabbits. Acta Chir Scand 1971; 137: 631–7PubMed Nyman S, Lindhe J, Zederfeldt B. The vascularity of wounded areas in estradiol and progesterone treated female rabbits. Acta Chir Scand 1971; 137: 631–7PubMed
56.
go back to reference Lundgren D. Influence of estrogen and progesterone on vascularization of granulation tissue in preformed cavities. Scand J Plast Reconstr Surg 1973; 7: 85–90PubMedCrossRef Lundgren D. Influence of estrogen and progesterone on vascularization of granulation tissue in preformed cavities. Scand J Plast Reconstr Surg 1973; 7: 85–90PubMedCrossRef
57.
go back to reference Pirila E, Ramamurthy N, Maisi P, et al. Wound healing in ovariectomized rats: effects of chemically modified tetracycline (CMT-8) and estrogen on matrix metalloproteinases-8, -13 and type I collagen expression. Curr Med Chem 2001; 8: 281–94PubMedCrossRef Pirila E, Ramamurthy N, Maisi P, et al. Wound healing in ovariectomized rats: effects of chemically modified tetracycline (CMT-8) and estrogen on matrix metalloproteinases-8, -13 and type I collagen expression. Curr Med Chem 2001; 8: 281–94PubMedCrossRef
58.
go back to reference Wahl SM. Transforming growth factor beta. In: Gallin J, Snyderman R, editors. Inflammation: basic principles and clinical correlates. 3rd ed. Philadelphia (PA): Lippincott-Raven Publishers, 1999: 883–92 Wahl SM. Transforming growth factor beta. In: Gallin J, Snyderman R, editors. Inflammation: basic principles and clinical correlates. 3rd ed. Philadelphia (PA): Lippincott-Raven Publishers, 1999: 883–92
59.
Metadata
Title
Potential Role of Estrogens in Wound Healing
Authors
Dr Gillian S. Ashcroft
Jason J. Ashworth
Publication date
01-11-2003
Publisher
Springer International Publishing
Published in
American Journal of Clinical Dermatology / Issue 11/2003
Print ISSN: 1175-0561
Electronic ISSN: 1179-1888
DOI
https://doi.org/10.2165/00128071-200304110-00002

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