Disruption of Interleukin-1 Signaling Improves the Quality of Wound Healing

In this study, we investigated the role of interleukin (IL)-1 signaling in wound healing. IL-1 receptor type I (IL-1R) knockout (KO) mice showed reduced fibrosis in both cutaneous and deep tissue wounds, which was accompanied by a reduction in inflammatory cellular infiltration in cutaneous but not in deep tissue wounds. There were no differences in either total collagenolytic activity or in the expression of selected matrix metalloproteinases or tissue inhibitors of metalloproteinases between the wound fluids from wild-type or IL-1R KO mice. However, wound fluids from IL-1R KO mice contained lower levels of IL-6 compared with wild-type controls. In addition, the infusion of IL-6 into wounds in IL-1R KO mice did not increase fibrosis. Skin wounds in IL-1R KO animals had lower levels of collagen and improved restoration of normal skin architecture compared with skin wounds in wild-type mice. However, neither the tensile strength of incisional skin wounds nor the rate of closure of excisional wounds differed between IL-1R KO and wild-type animals. The reduced fibrotic response in wounds from IL-1R KO mice could be reproduced by the administration of an IL-1R antagonist. These findings suggest that pharmacological interference with IL-1 signaling could have therapeutic value in the prevention of hypertrophic scarring and in the treatment of fibrotic diseases.Progress in the therapeutic management of abnormal wound healing has fallen short of expectations. The promise of molecular medicine to normalize impaired healing, as seen in diabetes, vascular insufficiency, or other chronic diseases, through the use of exogenous cytokines or growth factors has not been realized. At the other end of the abnormal wound healing spectrum, no reliable prophylactic or therapeutic measures exist to address the pathologies of excessive repair, exemplified by hypertrophic burn scars, keloids, and stenosing gastrointestinal or vascular anastomoses. The availability of effective therapies that allow for the modulation of the wound healing response would be of substantial clinical relevance. Recent reports demonstrate a markedly reduced cellular inflammatory response in models of sterile inflammation^1,2,3,4 and decreased scarring after experimental myocardial infarction in mice deficient in the interleukin (IL)-1 receptor type I (IL-1R).⁴The present studies tested the hypothesis that genetic or pharmacological interference with IL-1 signaling would modulate the inflammatory response in skin and deep tissue wounds and reduce scar formation. Results using IL-1R knockout (KO) mice demonstrated that signaling through the IL-1R is required for the constitution of a normal cellular inflammatory response in cutaneous but not in deep tissue wounds. Most importantly, the quality of wound healing was different in IL-1R KOs, with cutaneous wounds in these animals attaining better restoration of normal skin architecture and a marked reduction in fibrosis without compromise in tensile strength. Additionally, deep tissue wounds in IL-1R KO mice showed a substantial reduction in collagen content, an observation that was reproduced by the administration of a human recombinant IL-1 R antagonist.Findings demonstrate a role for the IL-1/IL-1R axis in the regulation of wound healing. They suggest that interference with IL-1 signaling through the use of an IL-1R antagonist may find a clinical application in the prevention of excessive or hypertrophic scar formation.