Open AccessStudies in Fetal Wound Healing IV. Hyaluronic Acid-Stimulating Activity Distinguishes Fetal Wound Fluid from Adult Wound Fluid
Author(s) -
Michael T. Longaker,
Ernest S. Chiu,
Michael R. Harrison,
T. M. Crombleholme,
Jacob C. Langer,
Brian W. Duncan,
N. Scott Adzick,
Edward D. Verrier,
Robert Stern
Publication year - 1989
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-198911000-00016
Subject(s) - hyaluronic acid , wound healing , medicine , fetus , extracellular matrix , glycosaminoglycan , inflammation , pathology , microbiology and biotechnology , surgery , immunology , anatomy , pregnancy , biology , genetics
Recent clinical and experimental evidence suggests that the fetus responds to injury in a fashion fundamentally different from that of the adult. Our initial experience with human open fetal surgery reinforces experimental observations that the fetal wounds heal without the scarring, inflammation, and contraction that often accompany adult wounds. In this study we examine fetal wound fluid in an attempt to elucidate the control mechanisms that endow the fetus with unique healing properties. The extracellular matrix of fetal wounds is rich in hyaluronic acid, a glycosaminoglycan found in high concentrations whenever there is tissue proliferation, regeneration, and repair. We establish that wound fluid from the fetus contains high levels of hyaluronic acid-stimulating activity that may underlie the elevated deposition of hyaluronic acid in the fetal wound matrix. In contrast there was no hyaluronic acid-stimulating activity present in adult wound fluid. Hyaluronic acid, in turn, fosters an extracellular environment permissive for cell motility and proliferation that may account for the unique properties observed in fetal wound healing.