Burns are some of the most common injuries sustained at home and in the workplace, and while some injuries require no more than basic first aid, a majority of cases need professional treatment. Every year in the U.S., it is estimated that over 1 million burn injuries require medical attention. In some burn injuries, skin grafts are performed to prevent infection and replace the damaged skin. While skin grafts have been around for years, the procedure is far from perfect as the replacement skin often lacks some of the original skin’s characteristics. Fortunately, a recent research carried out at the University of Colorado at Boulder may help improve the skin healing process as it takes a look at how skin is formed in utero.

The Problem With Skin Grafts

To understand the significance of the research’s findings, it is essential to know how skin grafting works and why it needs further improvement. To perform a skin graft, doctors remove the skin from one part of the body and transplant it to the burnt or affected area. There are two types of skin grafts—split-thickness grafts, which involves taking skin from the buttocks or back to cover large areas; and full-thickness grafts, which are taken from the abdomen, groin, or forearm and are used to cover small wounds on highly visible parts of the body.

Of the two, the latter yields better results because when the grafts heal, they blend in quite well with the surrounding skin. As for split-thickness grafts, they tend to look shinier than the adjoining skin, and children who have them may require another graft when they’re older. Another problem that was pointed out in the research is that transplanted skin often lacks features such as nerve endings, hair follicles, and sweat glands. These are issues that have to be resolved in order to improve a patient’s skin and overall well-being.

Understanding How Skin Begins Can Play A Role In Skin Regeneration

Skin grafts are often done by harvesting some of the patient’s healthy skin or getting grafts from a donor. However, researchers are looking into new technology which will allow the skin to fully regenerate.

In the study which was published on Sept. 18, 2018 in the journal Developmental Cell, researchers used mice for the experiment, observing them during the period wherein skin is formed in a typical 19-day mouse gestation. It was found that p63, a type of protein that can read information from the genome, may be instrumental in the advancement of skin regeneration technology.

In an interesting twist, the protein that has the potential to heal skin has been shown to cause birth defects in people who have it in their genes. The research points out that humans with p63 mutations are often born with cleft lips or other malformations. It was also noted that while findings will allow researchers to develop new prenatal tests and innovative treatments for skin-related birth defects, it can also help to develop new methods that can lead to successful skin regeneration.

The Promising Future Of Skin Regeneration

Although the presence of p63 in one’s genes may lead to health problems, it was also found that the same protein is responsible for switching on over 500 genes and signaling pathways to help the skin heal by itself. These include the Eda pathway, which helps in the formation of the hair follicles, teeth, and sweat glands, and the Wnt pathway, which is essential in follicle formation. The research indicates that due to this discovery, adult cells may be encouraged to behave like embryonic cells, resulting in a full skin regeneration.

Rui Yi, an associate professor of Molecular, Cellular, and Developmental Biology and the senior author of the research, said that instead of simply grafting a piece of skin to cover the affected areas of the body, new methods to allow skin to “regenerate as if it were going through development for the first time” may be possible in the future. But while Yi and his team are currently working on skin regeneration techniques, the expert admits that they still have a long way to go before they can come close to duplicating real skin.

Hope For A Scar-Free Tomorrow

Prior to the University of Colorado study, a previous research may also help to address scars in the future through skin regeneration. In the 2017 study done at the Perelman School of Medicine at the University of Pennsylvania, it was found that fat cells may allow new skin to regenerate over a wound. Those involved in the study said that the key is to regenerate the hair follicles first, and after that, the fat will respond to the signals from the follicles. As the University of Colorado study has unlocked the relation between p63 and the pathway to hair follicle growth, it looks like future generations, especially those who experienced serious burns, may be able to look forward to a scar-free tomorrow. For now, Yi and his associates will continue taking a closer look at what happens in utero in order to achieve a significant medical breakthrough.

“The overarching goal is to someday be able to regenerate fully functional skin, and to do that, we have to know fundamentally, what happens at the beginning,” said Yi.

Sources:

1. Burns, CDC, https://www.cdc.gov/masstrauma/factsheets/public/burns.pdf

2. Skin Graft, Healthline, https://www.healthline.com/health/skin-graft

3. How Skin Begins: New research could improve skin grafts, and more, https://www.sciencedaily.com/releases/2018/09/180914084848.htm

4. The End of Scars: Scientists Discovered How To Regenerate Human Skin, https://futurism.com/the-end-of-scars-scientists-discovered-how-to-regenerate-human-skin/
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