Abstract

The proliferation, differentiation, and migration of keratinocytes are essential in the early stages of wound healing. Hypoxia-Reoxygenation (H/R) injury to keratinocytes can occur in various stressful environments such as surgery, trauma, and various forms of ulcers. The effects of remifentanil on human keratinocytes under hypoxia-reoxygenation have not been fully studied. Therefore, we investigated the effects of remifentanil on the proliferation, apoptosis, and autophagic activation of human keratinocytes during hypoxic-reoxygenation. Human keratinocytes were cultured under 1% oxygen tension for 24 h. The cells were then treated with various concentrations of remifentanil (0.01, 0.1, 0.5, and 1 ng/mL) for 2 h. Thereafter, the cells were reoxygenated for 12 h at 37°C. We measured cell viability via MTT assay. Using quantitative real-time PCR and western blot analysis, we measured the expression levels of proteins associated with apoptosis and autophagy. Quantification of apoptotic cells was performed using flow cytometer analysis and autophagic vacuoles were observed under a fluorescence microscope. Remifentanil treatment brought about an increase in the proliferation of human keratinocytes damaged by hypoxia-reoxygenation and decreased the apoptotic cell death, enhancing autophagic activity. However, the autophagy pathway inhibitor 3-MA inhibited the protective effect of remifentanil in hypoxia-reoxygenation injury. In conclusion, the current study demonstrated that remifentanil treatment stimulated autophagy and reduced apoptotic cell death in a hypoxia-reoxygenation model of human keratinocytes. Our results provide additional insights into the relationship between apoptosis and autophagy.

Highlights

  • Wound healing is important for repairing the skin and for its beneficial effects on systemic physiological defenses

  • The object of the current study is to determine the beneficial effect of remifentanil on human keratinocytes in hypoxia-reoxygenation injury and to investigate whether autophagy is associated with the protective mechanism

  • We suggest that remifentanil treatment stimulated the endogenous cellular protective effect in human keratinocytes against hypoxia-reoxygenation injury through the activation of signaling pathways associated with autophagy

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Summary

Introduction

Wound healing is important for repairing the skin and for its beneficial effects on systemic physiological defenses. Re-epithelialization initiated during the early stages of healing is a critical factor in wound healing. This process includes the proliferation, differentiation, and migration of keratinocytes to the wound margins [1,2]. Diabetic, and varicose ulcers can give rise to hypoxiareoxygenation injury of keratinocytes [3,4,5]. Apoptosis has a major role in the elimination of inflammatory cells and formation of granulation tissue in the normal wound healing process. Apoptosis and autophagy in keratinocytes are inevitable during ischemia-reperfusion, induced by skin injury [6]

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