075 Wound Healing is Delayed in Women and in the Aged: A Potential Role for the HPA Axis

Abstract

Both senescence and psychological stress have been shown to alter numerous immune components including inflammatory processes. However, whether such effects can be dissociated by gender is largely unknown. To determine the effects of gender and age on wound healing, a 3.5 mm round wound was placed under local anesthesia on the hard palates of 88 younger (18–35 years) and 56 older (50+ years) male and female volunteers. Immediately prior to wounding and 15, 30 and 60 min afterwards, blood was drawn from which cortisol and ACTH levels were determined, as both are immunosuppressive. Wounds were photographed and measured daily until healed. Preliminary analyses revealed that older individuals healed 25.6% slower than younger individuals (P < .001), and women healed 14.0% slower than men (P < .05). These results may have involved alterations in HPA activity, as blood work revealed significant differences in baseline hormone levels: cortisol levels were lower in the older group (P < .05), and ACTH levels were lower in females (P < .01). Furthermore, in women only, faster healing rates were related to both increased anxiety at the time of wounding (P < .05), and higher cortisol levels at all time points (P < .01). Moreover, preliminary results indicated that, in women, higher anxiety was also related to lowered release of IL‐1β in the first 24 h. In men these relationships were not evident, although higher ACTH levels were related to faster healing times (P < .01). Taken together, these findings indicate that aging delays oral wound healing and provide evidence for a previously unreported gender difference in wound healing rates in favor of males. Furthermore, the effects of anxiety on wound healing seem to be sexually differentiated and transient activation of the HPA axis, especially in women, appears to be associated with healing rates.