In addition, Jansen and colleagues have examined human articular tissue explants exposed to blood in tissue culture, and have demonstrated that coculture with the anti-inflammatory cytokine IL-10 was correlated with reduced production of IL-1β and TNF-α

from synovium, and with protection of cartilage [33]. Although it is GSI-IX unlikely that therapy to oppose inflammatory cytokines is a strategy that would be necessary for most individuals, such therapy may be appropriate in the future should tools or markers be developed to identify individuals who are particularly at risk for early joint deterioration. Haemostasis is often the first defensive response following tissue injury. It not only stops the loss of blood but also results in the production of a variety of mediators that can influence subsequent defences, including inflammation, immunity and tissue repair. When all goes well, the body can defend itself against further injury and restore tissue structure and function. However, wound healing can be delayed or defective for many reasons. Ageing, diabetes and vascular disease are well-recognized causes of impaired wound healing in the general population. Drugs, such as corticosteroids and cancer

chemotherapy can delay healing as well. While the literature is rather limited, there is also evidence that Regorafenib price conditions that impair haemostasis also impair wound healing. There are good theoretical reasons to support this theory. However, there is a limited amount of experimental data, and essentially no human data. Studies in

rabbits showed that healing after tooth extraction is delayed in anticoagulated animals [34]. However, closure of an excisional cutaneous wound is not delayed in mice lacking fibrinogen [35] or the thrombin-activatable fibrinolysis inhibitor (TAFI) [36]. The healed wounds in mice with defective fibrin clot formation or stability MCE公司 do, however, display histological abnormalities. The dermal defect is not always filled as it should be, but rather squamous epithelium tends to migrate down into the defect, leaving a cystic space or sinus tract. Thus, formation of an adequate fibrin clot provides a framework for appropriate formation of granulation tissue to fill a tissue defect. Our group has used a mouse model of haemophilia B (HB, coagulation factor IX knockout) to study healing of cutaneous punch biopsy wounds [22]. We found that healing is impaired as these mice only generate very low levels of thrombin at the site of injury. They do form a normal haemostatic platelet plug and deposit small amounts of fibrin around the periphery of the wound. However, the platelet plug is not adequately stabilized by a fibrin meshwork, which leads to delayed bleeding in the 12–24 h after wounding.