Dura Mater Healing and Regeneration: A Narrative Review of Physiological and Molecular Mechanisms

Joandre Fauza; Muslim Akmal; Mustanir Mustanir; Prihartini Widiyanti; Asyraf Muzaffar; Cut Safira Apriliza; Nisrina Alya Wibowo

doi:10.2991/978-94-6239-836-8_14

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Dura Mater Healing and Regeneration: A Narrative Review of Physiological and Molecular Mechanisms

Authors

Joandre Fauza¹^{, 2}, Muslim Akmal³^{, *}, Mustanir Mustanir⁴, Prihartini Widiyanti⁵, Asyraf Muzaffar⁶, Cut Safira Apriliza⁶, Nisrina Alya Wibowo⁶

¹Graduate School of Mathematics and Applied Sciences, Universitas Syiah Kuala, Banda Aceh, Indonesia

²Faculty of Medicine, Universitas Malikussaleh, North Aceh, Indonesia

³Laboratory of Histology, Faculty of Veterinary Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia

⁴Chemistry Department, Universitas Syiah Kuala, Banda Aceh, Indonesia

⁵Master of Biomedical Engineering Study Program, Faculty of Science and Technology, Universitas Airlangga, Surabaya, Indonesia

⁶Medical Research Unit, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia

^*Corresponding author. Email: akmal_kh@usk.ac.id

Corresponding Author

Muslim Akmal

Available Online 11 November 2026.

DOI: 10.2991/978-94-6239-836-8_14 How to use a DOI?
Keywords: Dura mater; dural healing; neodura; extracellular matrix; tissue remodeling
Abstract: The dura mater is the outermost meningeal layer of the central nervous system and plays an essential role in neural protection and cerebrospinal fluid homeostasis. Impaired dural healing after trauma or neurosurgical intervention may result in cerebrospinal fluid leakage, pseudomeningocele, infection, pathological adhesion, and delayed wound recovery. This focused narrative review summarizes the physiological, cellular, and molecular mechanisms involved in dura mater healing, with emphasis on their relevance to dural substitute design. Dural repair occurs through overlapping phases of hemostasis, inflammation, proliferation, neodura formation, and remodeling. Early sealing is initiated by platelet activation, fibrin clot formation, and provisional matrix development. The subsequent inflammatory response may support constructive repair when appropriately regulated, but persistent macrophage activation, foreign-body reaction, and excessive fibrotic signaling may impair regeneration. Fibroblast migration, angiogenesis, extracellular matrix deposition, and collagen remodeling contribute to functional neodura formation. Key pathways, including nuclear factor-kappa B-mediated inflammation, transforming growth factor-beta/Smad-related fibrosis, vascular endothelial growth factor-associated angiogenesis, and matrix metalloproteinase/tissue inhibitor of metalloproteinase-mediated matrix turnover, may influence the quality of repair. Therefore, successful dural substitutes should be evaluated not only by immediate watertight closure, but also by immune modulation, fibrovascular integration, organized remodeling, anti-adhesion performance, and long-term restoration of meningeal function.
Open Access: Open Access This chapter is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

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Volume Title: Proceedings of the3rd Malikussaleh International Conference on Health and Disaster Medicine 2026 (MICOHEDMED 2026)
Series: Advances in Health Sciences Research
Publication Date: 11 November 2026
ISBN: 978-94-6239-836-8
ISSN: 2468-5739
DOI: 10.2991/978-94-6239-836-8_14 How to use a DOI?
Open Access: Open Access This chapter is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

Cite this article

ris enw bib

TY  - CONF
AU  - Joandre Fauza
AU  - Muslim Akmal
AU  - Mustanir Mustanir
AU  - Prihartini Widiyanti
AU  - Asyraf Muzaffar
AU  - Cut Safira Apriliza
AU  - Nisrina Alya Wibowo
PY  - 2026
DA  - 2026/11/11
TI  - Dura Mater Healing and Regeneration: A Narrative Review of Physiological and Molecular Mechanisms
BT  - Proceedings of the3rd Malikussaleh International Conference on Health and Disaster Medicine 2026  (MICOHEDMED 2026)
PB  - Atlantis Press
SP  - 149
EP  - 161
SN  - 2468-5739
UR  - https://doi.org/10.2991/978-94-6239-836-8_14
DO  - 10.2991/978-94-6239-836-8_14
ID  - Fauza2026
ER  -

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