Narrative review of the mechanism of natural products and scar formation in wound repair

BACKGROUND AND OBJECTIVE: Wound healing is a complex and multifactorial response to the disruption of the normal anatomy and function of skin tissue, which mainly includes four progressive stages: hemostasis, inflammation, proliferation and remodeling. Wound healing is a complex process, and multiple conditions can lead to impaired wound healing and, consequently, scar formation. Natural products discovered and applied for a long time have always been the source of new drugs. With the deepening of research, the role of natural products in promoting wound repair has gradually been a focus. Some natural products and compound drugs are effective in promoting skin wound healing and in reducing adverse reactions after wound healing. METHODS: This article reviews the mechanism of natural products and some compound drugs in healing skin wounds from the following aspects: related cellular effects during wound repair and scar formation, regulation of growth factors, extracellular matrix (ECM), and collagen metabolism. KEY CONTENT AND FINDINGS: Proteolysis by proteolytic enzymes, such as plasmin, matrix metalloproteinases, and their activators and inhibitors, plays a critical role in wound repair. Some keratinocytes often express some matrix metalloproteinases and plasminogen activators, thus promoting the hydrolysis of components such as fibrin in blood clots to facilitate migration. CONCLUSIONS: In this paper, we review recent studies on the role and mechanism of some natural products on scar formation found in wound repair. We aim to provide a basis for the in-depth study of the intrinsic mechanism of natural products in repairing wounds and a reference for further development of drugs for wound repair with better efficacy and fewer side effects.