Year: 2025 | Month: August | Volume: 15 | Issue: 8 | Pages: 255-263
DOI: https://doi.org/10.52403/ijhsr.20250830
Reactive Oxygen Species in Wound Healing, Balancing Damage and Repair: A Literature Review
Rayyan Ramzan1, Nisali Mareena Muthugala2, Vidura Karunaratne3, Shaheena Amsadeen4, Nashali Shayara Manikkuge De Silva5, Shenuka Yevin Mannapperuma6
1Medical Student, Tbilisi State Medical University, 33 Vazha Pshavela Ave, Tbilisi 0186, Georgia
2Medical Student, Tbilisi State Medical University, 33 Vazha Pshavela Ave, Tbilisi 0186, Georgia
3Medical Student, Tbilisi State Medical University, 33 Vazha Pshavela Ave, Tbilisi 0186, Georgia
4Medical Student, Tbilisi State Medical University, 33 Vazha Pshavela Ave, Tbilisi 0186, Georgia
5Medical Student, Tbilisi State Medical University, 33 Vazha Pshavela Ave, Tbilisi 0186, Georgia
6Medical Student, Tbilisi State Medical University, 33 Vazha Pshavela Ave, Tbilisi 0186, Georgia
Corresponding Author: Rayyan Ramzan
ABSTRACT
Reactive oxygen species (ROS) are molecules produced intracellularly during mitochondrial respiration and through enzymatic activity such as NADPH oxidases, xanthine oxidases, and peroxisomes. During wound healing, ROS functions as both a signalling molecule and damages the tissues and this is termed “ROS paradox”. During the inflammatory phase of wound healing, NADPH oxidase produces ROS, strengthening the respiratory burst in macrophages and neutrophils for the clearance of microbes. To preserve wound sites, during hemostasis phase, ROS assists with vasoconstriction and aggregation of platelets. ROS can act as signalling molecules which enhances the activation of vascular endothelial growth factor (VEGF), leading to production of fibroblasts, angiogenesis and migration of kerationocytes. ROS plays an important part during the remodeling phase by controlling the tensile strength and scarring of tissues by being involved in collagen cross linking and extracellular matrix turnover. However, excess concentration of ROS slows the healing process and increases degradation of the ECM, lipid peroxidation, DNA damage and oxidation of protein leading to chronic wound states. Current treatment methods aim to regulate ROS through advanced delivery systems involving cerium oxide nanoparticles, antioxidant mediated therapies using compounds like circumin and N-acetylcysteine, and regulated pro-oxidant therapies like photodynamic therapy. By understanding and studying the dual nature of ROS, the mutual aim of emerging therapeutic approaches for optimal wound healing is to restore the redox equilibrium and a few examples include, antioxidants targeting mitochondria, redox responsive biomaterials and ROS scavenging hydrogels.
Key words: reactive oxygen species, wound healing, oxidative stress, redox signaling, antioxidants, chronic wounds.