Stress-mediated increases in systemic and local epinephrine impair skin wound healing: Potential new indication for beta blockers
2009

Stress and Wound Healing: The Role of Epinephrine

publication Evidence: high

Author Information

Author(s): Sivamani Raja K, Pullar Christine E, Manabat-Hidalgo Catherine G, Rocke David M, Carlsen Richard C, Greenhalgh David G, Isseroff R. Rivkah

Primary Institution: University of California, Davis, School of Medicine

Hypothesis

Does stress-induced elevation of epinephrine impair skin wound healing?

Conclusion

Stress-induced elevation of epinephrine impairs wound healing, but treatment with beta blockers can improve the healing process.

Supporting Evidence

  • Epinephrine levels in the culture medium reduced keratinocyte migration by 76%.
  • Burn wounds in high epinephrine environments showed delayed re-epithelialization by 23%.
  • Systemic treatment with beta blockers increased burn wound re-epithelialization by 44%.

Takeaway

When people are stressed, their bodies make a chemical called epinephrine that can slow down how fast cuts and burns heal. Using certain medicines called beta blockers can help wounds heal faster.

Methodology

The study used in vitro, ex vivo, and in vivo models to assess the effects of epinephrine on keratinocyte migration and wound healing.

Limitations

The study primarily used animal models and human skin samples, which may not fully represent human responses in all contexts.

Statistical Information

P-Value

p < 0.00000001

Confidence Interval

95% CI 27%–61%

Statistical Significance

p < 0.001

Digital Object Identifier (DOI)

10.1371/journal.pmed.1000012

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