4.4 Article

The Role of Fibrin(ogen) in Wound Healing and Infection Control

Journal

SEMINARS IN THROMBOSIS AND HEMOSTASIS
Volume 48, Issue 2, Pages 174-187

Publisher

THIEME MEDICAL PUBL INC
DOI: 10.1055/s-0041-1732467

Keywords

fibrinogen; wound healing; infection

Funding

  1. BHF [RG/18/11/34036]
  2. Wellcome Trust [204951/B/16/Z]
  3. Sir Henry Wellcome Postdoctoral Fellowship [215861/Z/19/Z]
  4. Wellcome Trust [215861/Z/19/Z] Funding Source: Wellcome Trust

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Fibrinogen plays a crucial role in wound healing by supporting cell migration and growth factors storage, while also protecting the host against bacterial infection. Understanding the dual roles of fibrinogen could lead to novel therapeutic strategies for improving wound recovery and preventing infection from highly virulent bacterial strains.
Fibrinogen, one of the most abundant plasma proteins playing a key role in hemostasis, is an important modulator of wound healing and host defense against microbes. In the current review, we address the role of fibrin(ogen) throughout the process of wound healing and subsequent tissue repair. Initially fibrin(ogen) acts as a provisional matrix supporting incoming leukocytes and acting as reservoir for growth factors. It later goes on to support re-epithelialization, angiogenesis, and fibroplasia. Importantly, removal of fibrin(ogen) from the wound is essential for wound healing to progress. We also discuss how fibrin(ogen) functions through several mechanisms to protect the host against bacterial infection by providing a physical barrier, entrapment of bacteria in fibrin(ogen) networks, and by directing immune cell function. The central role of fibrin(ogen) in defense against bacterial infection has made it a target of bacterial proteins, evolved to interact with fibrin(ogen) to manipulate clot formation and degradation for the purpose of promoting microbial virulence and survival. Further understanding of the dual roles of fibrin(ogen) in wound healing and infection could provide novel means of therapy to improve recovery from surgical or chronic wounds and help to prevent infection from highly virulent bacterial strains, including those resistant to antibiotics.

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