Cell interactions in post-traumatic fibrosis

Models of reparative fibrosis, or wound healing, disclose a basic spatial relationship between inflammatory cells, fibroblasts, dividing fibroblasts and angiogenic endothelial cells. Many components of the extracellular fluid, especially steep gradients of PO2, PCO2, pH, glucose and lactate, have been measured. After components of coagulation play out their role in the first few days after injury, macrophages sense excitatory substances and signs of respiratory distress, and secrete chemoattractants for endothelial cells and fibroblasts. If excitatory substances (such as silica) are eliminated, active fibrosis ends with the restoration of the energy supply. Some of the mitogens and chemoattractants acting as intercellular messengers between these cells have been isolated and identified.