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The effect of expressive writing on wound healing: Immunohistochemistry analysis of skin tissue two weeks after punch biopsy wounding

Robinson, Hayley; Jarrett, Paul; Vedhara, Kavita; Tarlton, John; Whiting, Christine; Law, Mikaela; Broadbent, Elizabeth

The effect of expressive writing on wound healing: Immunohistochemistry analysis of skin tissue two weeks after punch biopsy wounding Thumbnail


Authors

Hayley Robinson

Paul Jarrett

KAVITA VEDHARA KAVITA.VEDHARA@NOTTINGHAM.AC.UK
Professor in Applied Psychology

John Tarlton

Christine Whiting

Mikaela Law

Elizabeth Broadbent



Abstract

Objective: To investigate the effects of expressive writing and its timing (pre or post wounding) on re-epithelialisation and leucocyte subsets within healing tissue. We previously showed expressive writing pre-wounding improved re-epithelialisation. Here we investigate cellular processes in the wound. Methods: In a 2(writing content) x 2(writing timing) randomized trial, 122 participants were randomized to perform either expressive or control writing, before or after a 4 mm punch biopsy wound. On day 14 post-wounding, participants had a 5 mm punch biopsy of the initial wound. Seven of 16 primary registered outcomes were analysed, including re-epithelialisation from two photographs of the 4 mm biopsy (previously reported). This paper reports immunohistochemistry analysis of five primary outcomes - Langerhans cells, immune cell activation (HLA and CD3+), and macrophages (CD68 and MPO) - in the 5 mm biopsies in a random sample of 96 participants. Results: Participants who performed either writing task pre-wounding had greater Langerhans cell infiltration, than those who wrote post-wounding (F(1,85) = 7.86, p = .006, ηp2 = 0.08). Those who performed expressive writing also had greater Langerhans cell infiltration than those who performed control writing (F(1,85) = 4.00, p = .049, ηp2 = 0.04). There were no significant group or interaction effects on immune cell activation or macrophages. Healed wounds on day 10 had lower levels of macrophages (z = −1.96, p = .050), and CD3+ cells (z = −1.99, p = .046) than non-healed wounds. Conclusion: Langerhans cells in the healing skin are affected by the timing and topic of writing. More research is needed to further explore timing and corroborate these results. Clinical Trials Registration: Registered at https://www.anzctr.org.au/ (Trial ID: ACTRN12614000971639).

Citation

Robinson, H., Jarrett, P., Vedhara, K., Tarlton, J., Whiting, C., Law, M., & Broadbent, E. (2022). The effect of expressive writing on wound healing: Immunohistochemistry analysis of skin tissue two weeks after punch biopsy wounding. Journal of Psychosomatic Research, 161, Article 110987. https://doi.org/10.1016/j.jpsychores.2022.110987

Journal Article Type Article
Acceptance Date Jul 7, 2022
Online Publication Date Jul 30, 2022
Publication Date Oct 1, 2022
Deposit Date Aug 16, 2022
Publicly Available Date Jul 31, 2023
Journal Journal of Psychosomatic Research
Print ISSN 0022-3999
Electronic ISSN 1879-1360
Publisher Elsevier BV
Peer Reviewed Peer Reviewed
Volume 161
Article Number 110987
DOI https://doi.org/10.1016/j.jpsychores.2022.110987
Keywords Psychiatry and Mental health; Clinical Psychology
Public URL https://nottingham-repository.worktribe.com/output/10076532
Publisher URL https://www.sciencedirect.com/science/article/abs/pii/S0022399922002720
Additional Information This article is maintained by: Elsevier; Article Title: The effect of expressive writing on wound healing: Immunohistochemistry analysis of skin tissue two weeks after punch biopsy wounding; Journal Title: Journal of Psychosomatic Research; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.jpsychores.2022.110987