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Growth Factors

A vast and rapidly growing literature abounds on a class of peptides commonly called growth factors. Accelerated healing of skin wounds has been reported after local application of several growth factors.

After injury, the platelets travel to the wound site, form a clot, and hemostasis is obtained. Platelets secrete peptides such as platelet-derived growth factor (PDGF) and transforming growth factor-beta (TGF-β). Both PDGF and TGF-β play an important role in the initiation of repair processes after injury. These factors are chemotoxic for inflammatory cells and appear to regulate proliferation and differentiation of fibroblasts . Inflammatory cells at the wound site then release other peptides such as basic fibroblast growth factor (bFGF) and epidermal growth factor (EGF).

bFGF is multifunctional, since it can either stimulate proliferation and induce or delay differentiation. Most importantly, bFGF has demonstrated stimulatory effects on angiogenesis, urokinase-type plasminogen activator (implicated in the neovascular response), and wound healing.

Because the synovial fluid washes clots away from the ligament injury site, it is hypothesized that a deficiency of growth factor exists at the wound site. Without the necessary stimulus from growth factors and other clot-derived substances, the response to injury is poor.

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