The Unique Roles of Adipose Tissue in Wound Healing

SIGNIFICANCE: Recognized for its role in energy storage and thermal insulation, white adipose tissue (WAT) has garnered increasing attention given its functions beyond metabolism. In particular, dermal and subcutaneous WATs have been shown to play critical roles in wound healing and scarring. This review proposes that dermal and subcutaneous adipose tissues are not passive bystanders but active regulators of wound healing and fibrosis. RECENT ADVANCES: Significant advances in wound healing biology have identified critical roles and signaling pathways that immune cells and fibroblasts are involved with in wound healing; however, fewer investigations have studied adipocytes in this context. This review focuses on the roles of WAT and specifically white adipocytes at different stages of wound healing: inflammation, proliferation, and remodeling. We also discuss applications of WAT and its derivatives as therapeutic strategies for improved wound healing. CRITICAL ISSUES AND FUTURE DIRECTIONS: With multiple fibrotic conditions associated with decreased adipose tissue, understanding the different ways by which adipocyte subpopulations and WAT participate in repair and fibrotic processes will help shed light on how we can modulate cellular response for future therapeutic applications.