Tissue Factor as a Link Between Wounding and Tissue Repair

  1. Jiang Chen12,
  2. Michael Kasper3,
  3. Tobias Heck1,
  4. Katsumi Nakagawa14,
  5. Per M. Humpert1,
  6. Ling Bai15,
  7. Gang Wu15,
  8. Youming Zhang1,
  9. Thomas Luther3,
  10. Martin Andrassy1,
  11. Stephan Schiekofer1,
  12. Andreas Hamann1,
  13. Michael Morcos1,
  14. Baoshen Chen5,
  15. David M. Stern6,
  16. Peter P. Nawroth1 and
  17. Angelika Bierhaus1
  1. 1Department of Medicine I, University of Heidelberg, Heidelberg, Germany
  2. 2Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas
  3. 3Institutes of Anatomy and Pathology, Technical University of Dresden, Dresden, Germany
  4. 4Medical Service Center Toji-in Kitamachi, Ritsumeikan University, Kita-ku, Kyoto, Japan
  5. 5Department of Biochemistry, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
  6. 6Dean’s Office, Medical College of Georgia, Augusta, Georgia
  1. Address correspondence and reprint requests to Angelika Bierhaus, PhD, University of Heidelberg, Department of Medicine I, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany. E-mail: angelika_bierhaus{at}med.uni-heidelberg.de


The initial phase of wound repair involves inflammation, induction of tissue factor (TF), formation of a fibrin matrix, and growth of new smooth muscle actin (α-SMA)-positive vessels. In diabetes, TF induction in response to cutaneous wounding, which ordinarily precedes increased expression of vascular endothelial growth factor (VEGF) and α-SMA transcription, is diminished, though not to a degree causing excessive local bleeding. Enhanced TF expression in wounds of diabetic mice caused by somatic TF gene transfer increased VEGF transcription and translation and, subsequently, enhanced formation of new blood vessels and elevated blood flow. Furthermore, increased levels of TF in wounds of diabetic mice enhanced wound healing; the time to achieve 50% wound closure was reduced from 5.5 days in untreated diabetic mice to 4.1 days in animals undergoing TF gene transfer (this was not statistically different from wound closure in nondiabetic mice). Thus, cutaneous wounds in diabetic mice display a relative deficiency of TF compared with nondiabetic controls, and this contributes to delayed wound repair. These data establish TF expression as an important link between the early inflammatory response to cutaneous wounding and reparative processes.


    • Accepted March 24, 2005.
    • Received July 12, 2003.
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