The Bigger Picture: Why Oral Mucosa Heals Better Than Skin

Biomolecules. 2021 Aug 6;11(8):1165. doi: 10.3390/biom11081165.

Abstract

Wound healing is an essential process to restore tissue integrity after trauma. Large skin wounds such as burns often heal with hypertrophic scarring and contractures, resulting in disfigurements and reduced joint mobility. Such adverse healing outcomes are less common in the oral mucosa, which generally heals faster compared to skin. Several studies have identified differences between oral and skin wound healing. Most of these studies however focus only on a single stage of wound healing or a single cell type. The aim of this review is to provide an extensive overview of wound healing in skin versus oral mucosa during all stages of wound healing and including all cell types and molecules involved in the process and also taking into account environmental specific factors such as exposure to saliva and the microbiome. Next to intrinsic properties of resident cells and differential expression of cytokines and growth factors, multiple external factors have been identified that contribute to oral wound healing. It can be concluded that faster wound closure, the presence of saliva, a more rapid immune response, and increased extracellular matrix remodeling all contribute to the superior wound healing and reduced scar formation in oral mucosa, compared to skin.

Keywords: cytokines; growth factors; microbiome; oral; saliva; scar; skin; wound healing.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Cytokines / genetics
  • Cytokines / immunology
  • Extracellular Matrix / chemistry
  • Extracellular Matrix / immunology*
  • Fibroblasts / immunology
  • Fibroblasts / microbiology
  • Gene Expression Regulation
  • Humans
  • Intercellular Signaling Peptides and Proteins / genetics
  • Intercellular Signaling Peptides and Proteins / immunology
  • Keratinocytes / immunology
  • Keratinocytes / microbiology
  • Macrophages / immunology
  • Macrophages / microbiology
  • Microbiota / immunology*
  • Mouth Mucosa / immunology
  • Mouth Mucosa / injuries*
  • Mouth Mucosa / microbiology
  • Mouth Mucosa / pathology
  • Neutrophils / immunology
  • Neutrophils / microbiology
  • Organ Specificity
  • Saliva / immunology
  • Saliva / microbiology
  • Signal Transduction
  • Skin / immunology
  • Skin / injuries*
  • Skin / microbiology
  • Skin / pathology
  • Wound Healing / immunology*

Substances

  • Cytokines
  • Intercellular Signaling Peptides and Proteins