A model of wound-healing angiogenesis in soft tissue.
Pettet GJ., Byrne HM., McElwain DL., Norbury J.
Angiogenesis, or blood vessel growth, is a critical step in the wound-healing process, involving the chemotactic response of blood vessel endothelial cells to macrophage-derived factors produced in the wound space. In this article, we formulate a system of partial differential equations that model the evolution of the capillary-tip endothelial cells, macrophage-derived chemoattractants, and the new blood vessels during the tissue repair process. Chemotaxis is incorporated as a dominant feature of the model, driving the wave-like ingrowth of the wound-healing unit. The resulting model admits traveling wave solutions that exhibit many of the features characteristic of wound healing in soft tissue. The steady propagation of the healing unit through the wound space, the development of a dense band of fine, tipped capillaries near the leading edge of the wound-healing unit (the brush-border effect), and an elevated vessel density associated with newly healed wounds, prior to vascular remodeling, are all discernible from numerical simulations of the full model. Numerical simulations mimic not only the normal progression of wound healing but also the potential for some wounds to fail to heal. Through the development and analysis of a simplified model, insight is gained into how the balance between chemotaxis, tip proliferation, and tip death affects the structure and speed of propagation of the healing unit. Further, expressions defining the healed vessel density and the wavespeed in terms of known parameters lead naturally to the identification of a maximum wavespeed for the wound-healing process and to bounds on the healed vessel density. The implications of these results for wound-healing management are also discussed.