Influence of an epidermal cell extract on skin healing and scar formation

We have examined the possible regulatory role of epidermal cell extract(s) (ECE) on skin cells, namely fibroblasts and keratinocytes, both in vivo and in vitro with particular reference to modification of scar formation. In an experimental wound model in pigs, it was found that extracts of cultured human and pig keratinocytes stimulated replication of epidermal cells and their migration from wound edges and remnants of hair follicles and sebaceous glands, together with hair growth, but at the same time suppressed fibroblast proliferation in the dermis. Sections of healing skin wounds that had been treated with ECE showed the presence of a thick layer of epidermal cells lying on relatively sparse dermis. There was little or no contraction in treated wounds and scarring was minimal. Clinical studies of granulomatous lesions of horses and ulcerated wounds in dogs that had been treated with ECE supported these findings. In contrast to its apparently general stimulation of keratinocytes in vivo, ECE had a highly selective effect in vitro on epidermal cells plated at low density in the absence of a feeder layer, which suggests that its action in vivo may be confined to a specific sub-population of rapidly proliferating keratinocytes or alternatively mediated through a second messenger from another type of cell. The inhibitory effect of epidermal cell extract on fibroblasts in vitro was shown by its ability to prevent the contraction of collagen sponges by fibroblasts. These results suggest an important role for epidermal factors in the growth regulation of both epidermal and dermal cells during wound healing.