Mast Cells as an Active Component of Wound Repair Process
The successes of modern surgery of wounds are impossible without understanding the changes in intercellular and cell-matrix interactions, in this connection the latest data on the role of mast cells in various pathological states deserve special attention. Mast cells play a key role in tissue repair. Their maximum representation is found in the skin, mucous membranes of the respiratory system, gastrointestinal tract. Mast cells are activated immediately after skin damage and are involved in all phases of the wound process. When tissue damage or adverse effects from mast cells are released, a whole arsenal of inflammatory mediators, proteases, growth factors that trigger a cascade of reactions, including the inflammatory process. Serine proteases efficiently remodel elements of the extracellular matrix, which is necessary for the transition to the next stage of wound healing. The multifunctionality of mast cells is manifested by the release of both proinflammatory and anti-inflammatory and immunosuppressive cytokines, which is an important clinical aspect, since an incorrect treatment tactic contributes to the chronic wound process. Synthesis of collagen by fibroblasts and angiogenesis are the result of complex molecular-cell events with the direct involvement of mast cells. In the late stages of the wound process during re-epithelialization, their mediators can stimulate keratinocytes to restore the epidermal barrier. Studying the effects of mast cells with slow regeneration due to diabetes mellitus, ischemia, tissue denervation, and microcirculation disturbance opens up prospects in the treatment of long-term non-healing wounds with socially significant diseases. Thus, already known data and further fundamental studies of mast cells allow us to consider them as a biomarker of the dynamics and severity of the wound process, and as a target for regulating the wound process at different stages.