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Murakami T, Shigeki S. Pharmacotherapy for Keloids and Hypertrophic Scars. Int J Mol Sci 2024; 25:4674. [PMID: 38731893 PMCID: PMC11083137 DOI: 10.3390/ijms25094674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/19/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
Keloids (KD) and hypertrophic scars (HTS), which are quite raised and pigmented and have increased vascularization and cellularity, are formed due to the impaired healing process of cutaneous injuries in some individuals having family history and genetic factors. These scars decrease the quality of life (QOL) of patients greatly, due to the pain, itching, contracture, cosmetic problems, and so on, depending on the location of the scars. Treatment/prevention that will satisfy patients' QOL is still under development. In this article, we review pharmacotherapy for treating KD and HTS, including the prevention of postsurgical recurrence (especially KD). Pharmacotherapy involves monotherapy using a single drug and combination pharmacotherapy using multiple drugs, where drugs are administered orally, topically and/or through intralesional injection. In addition, pharmacotherapy for KD/HTS is sometimes combined with surgical excision and/or with physical therapy such as cryotherapy, laser therapy, radiotherapy including brachytherapy, and silicone gel/sheeting. The results regarding the clinical effectiveness of each mono-pharmacotherapy for KD/HTS are not always consistent but rather scattered among researchers. Multimodal combination pharmacotherapy that targets multiple sites simultaneously is more effective than mono-pharmacotherapy. The literature was searched using PubMed, Google Scholar, and Online search engines.
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Affiliation(s)
- Teruo Murakami
- Laboratory of Biopharmaceutics and Pharmacokinetics, Faculty of Pharmaceutical Sciences, Hiroshima International University, Higashi-Hiroshima 731-2631, Japan;
| | - Sadayuki Shigeki
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Higashi-Hiroshima 731-2631, Japan
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2
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Boo YC. Insights into How Plant-Derived Extracts and Compounds Can Help in the Prevention and Treatment of Keloid Disease: Established and Emerging Therapeutic Targets. Int J Mol Sci 2024; 25:1235. [PMID: 38279232 PMCID: PMC10816582 DOI: 10.3390/ijms25021235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 01/28/2024] Open
Abstract
Keloid is a disease in which fibroblasts abnormally proliferate and synthesize excessive amounts of extracellular matrix, including collagen and fibronectin, during the healing process of skin wounds, causing larger scars that exceed the boundaries of the original wound. Currently, surgical excision, cryotherapy, radiation, laser treatment, photodynamic therapy, pressure therapy, silicone gel sheeting, and pharmacotherapy are used alone or in combinations to treat this disease, but the outcomes are usually unsatisfactory. The purpose of this review is to examine whether natural products can help treat keloid disease. I introduce well-established therapeutic targets for this disease and various other emerging therapeutic targets that have been proposed based on the phenotypic difference between keloid-derived fibroblasts (KFs) and normal epidermal fibroblasts (NFs). We then present recent studies on the biological effects of various plant-derived extracts and compounds on KFs and NFs. Associated ex vivo, in vivo, and clinical studies are also presented. Finally, we discuss the mechanisms of action of the plant-derived extracts and compounds, the pros and cons, and the future tasks for natural product-based therapy for keloid disease, as compared with existing other therapies. Extracts of Astragalus membranaceus, Salvia miltiorrhiza, Aneilema keisak, Galla Chinensis, Lycium chinense, Physalis angulate, Allium sepa, and Camellia sinensis appear to modulate cell proliferation, migration, and/or extracellular matrix (ECM) production in KFs, supporting their therapeutic potential. Various phenolic compounds, terpenoids, alkaloids, and other plant-derived compounds could modulate different cell signaling pathways associated with the pathogenesis of keloids. For now, many studies are limited to in vitro experiments; additional research and development are needed to proceed to clinical trials. Many emerging therapeutic targets could accelerate the discovery of plant-derived substances for the prevention and treatment of keloid disease. I hope that this review will bridge past, present, and future research on this subject and provide insight into new therapeutic targets and pharmaceuticals, aiming for effective keloid treatment.
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Affiliation(s)
- Yong Chool Boo
- Department of Molecular Medicine, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu 41944, Republic of Korea;
- BK21 Plus KNU Biomedical Convergence Program, Department of Biomedical Science, The Graduate School, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu 41944, Republic of Korea
- Cell and Matrix Research Institute, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu 41944, Republic of Korea
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3
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Casadiego O, Macias O, García L, Sanabria-Chanaga E, Baay-Guzmán GJ, Mantilla JC, Escobar P. In-Silico Selection of Wound-Healing Plant Secondary Molecules and Their Pro-Healing Activities on Experimental Models. Chem Biodivers 2023; 20:e202300961. [PMID: 37966104 DOI: 10.1002/cbdv.202300961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 11/16/2023]
Abstract
This study explored the potential of plant-derived molecules (PDMs) as a medicinal treatment for skin wounds. To assess their healing properties, 34 potential drug molecules (PDMs) and ten therapeutic targets were subjected to molecular docking and dynamics analysis, with allantoin used as a standard compound. Although aristolochic acid had the most potent inhibitory effect, its toxicity made it unsuitable for testing on cells and mice. Therefore, β-caryophyllene (BC) and caryophyllene oxide (BCoxide) were chosen for further testing. The results showed that BC-treated HaCat cells had significantly improved scratch area closure, and both BC and BCoxide treatment produced positive effects such as reduced dermal cellularity and mast cells, decreased levels of inflammation markers IL-6 and TNF-α, and an increase in collagen deposition in mice tissues. However, these treatments did not accelerate wound healing. This study suggests that the PDMs selected based on in-silico results have significant potential for pro-healing abilities. It is essential to conduct further research to confirm our findings.
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Affiliation(s)
- Omar Casadiego
- Centro de Investigaciones en Enfermedades Tropicales, Escuela de Medicina, Universidad Industrial de Santander, Piedecuesta, Colombia
| | - Oscar Macias
- Centro de Investigaciones en Enfermedades Tropicales, Escuela de Medicina, Universidad Industrial de Santander, Piedecuesta, Colombia
- Semillero de Investigación en Enfermedades Tropicales (SINAT), CINTROP, Escuela de Medicina, Universidad Industrial de Santander, Piedecuesta, Colombia
| | - Laura García
- Centro de Investigaciones en Enfermedades Tropicales, Escuela de Medicina, Universidad Industrial de Santander, Piedecuesta, Colombia
| | - Elkin Sanabria-Chanaga
- Facultad de Ciencias Básicas, Departamento de Química, Universidad de Pamplona, Pamplona, Colombia
| | - Guillermina J Baay-Guzmán
- Unidad de Investigación en Enfermedades Oncológicas, Hospital Infantil de México Federico Gómez, México, México DF
| | - Julio Cesar Mantilla
- Departamento de Patología, Escuela de Medicina, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Patricia Escobar
- Centro de Investigaciones en Enfermedades Tropicales, Escuela de Medicina, Universidad Industrial de Santander, Piedecuesta, Colombia
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Widiatmoko A, Fitri LE, Endharti AT, Murlistyarini S, Brahmanti H, Yuniaswan AP, Ekasari DP, Rasyidi F, Nahlia NL, Safitri PR. Inhibition Effect of Physalis angulata Leaf Extract on Viability, Collagen Type I, and Tissue Inhibitor of Metalloproteinase 1 (TIMP-1) but Not Plasminogen Activator Inhibitor-1 (PAI-1) of Keloid Fibroblast Culture. Clin Cosmet Investig Dermatol 2023; 16:2365-2373. [PMID: 37667736 PMCID: PMC10475283 DOI: 10.2147/ccid.s425036] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/11/2023] [Indexed: 09/06/2023]
Abstract
Introduction Keloids are excessive fibroproliferative diseases that are caused by abnormal wound healing. The anti-proliferative activity of Physalis angulata compounds has potential as a keloid therapeutic agent. This study aimed to observe the effects of P. angulata on fibroblast viability and collagen type I, tissue inhibitor of metalloproteinase 1 (TIMP-1), and plasminogen activator inhibitor 1 (PAI-1) levels in human keloid fibroblasts. Methods We conducted an experimental study of P. angulata ethanol extract on three primary human keloid fibroblast 3 passage cultures with four replications. Fibroblast viability was measured using the MTT assay after incubation with 3, 5, and 10 µg/mL P. angulata. Concentrations of P. angulata used to observe effects on TIMP-1, PAI-1, and collagen type I levels were 10%, 20%, 30%, and 40% of inhibitory concentration 50 (IC50). The levels of collagen type I, TIMP-1, and PAI-1 were measured by ELISA. Mean comparisons between multiple treatment groups were analyzed using one-way ANOVA followed by post-hoc analysis. Results The 10 µg/mL P. angulata group had significantly lower fibroblast viability than the control group (p<0.05) with an IC50 6.3 µg/mL. The collagen type I level of 10% IC50 (0.63 µg/mL) P. angulata group was lower than control (12.910 vs 47.866 ng/mL) (p=0.042). Level of TIMP-1 in 40% IC50 (2.51 µg/mL) P. angulata group was lower than control (5.350 vs 9.972 ng/mL) (p=0.043). There was no significant difference in the PAI-1 levels. Conclusion This study showed the inhibitory effect of 10 µg/mL P. angulata extract on keloid fibroblast viability, with an IC50 of 6.3 µg/mL. This study also showed collagen type-1 and TIMP-1 inhibition, but not PAI-1 inhibition, after P. angulate treatment.
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Affiliation(s)
- Arif Widiatmoko
- Doctoral Program in Medical Science, Faculty of Medicine Universitas Brawijaya, Malang, East Java, Indonesia
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Brawijaya, Dr. Saiful Anwar General Hospital, Malang, East Java, Indonesia
| | - Loeki Enggar Fitri
- Doctoral Program in Medical Science, Faculty of Medicine Universitas Brawijaya, Malang, East Java, Indonesia
- Department of Parasitology, Faculty of Medicine Universitas Brawijaya, Malang, East Java, Indonesia
| | - Agustina Tri Endharti
- Doctoral Program in Medical Science, Faculty of Medicine Universitas Brawijaya, Malang, East Java, Indonesia
- Department of Parasitology, Faculty of Medicine Universitas Brawijaya, Malang, East Java, Indonesia
| | - Sinta Murlistyarini
- Doctoral Program in Medical Science, Faculty of Medicine Universitas Brawijaya, Malang, East Java, Indonesia
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Brawijaya, Dr. Saiful Anwar General Hospital, Malang, East Java, Indonesia
| | - Herwinda Brahmanti
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Brawijaya, Dr. Saiful Anwar General Hospital, Malang, East Java, Indonesia
| | - Anggun Putri Yuniaswan
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Brawijaya, Dr. Saiful Anwar General Hospital, Malang, East Java, Indonesia
| | - Dhany Prafita Ekasari
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Brawijaya, Dr. Saiful Anwar General Hospital, Malang, East Java, Indonesia
| | - Faradiani Rasyidi
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Brawijaya, Dr. Saiful Anwar General Hospital, Malang, East Java, Indonesia
| | - Nurul Laili Nahlia
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Brawijaya, Dr. Saiful Anwar General Hospital, Malang, East Java, Indonesia
| | - Putri Rachma Safitri
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Brawijaya, Dr. Saiful Anwar General Hospital, Malang, East Java, Indonesia
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Kidzeru EB, Lebeko M, Sharma JR, Nkengazong L, Adeola HA, Ndlovu H, P Khumalo N, Bayat A. Immune cells and associated molecular markers in dermal fibrosis with focus on raised cutaneous scars. Exp Dermatol 2023; 32:570-587. [PMID: 36562321 PMCID: PMC10947010 DOI: 10.1111/exd.14734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 08/04/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022]
Abstract
Raised dermal scars including hypertrophic, and keloid scars as well as scalp-associated fibrosing Folliculitis Keloidalis Nuchae (FKN) are a group of fibrotic raised dermal lesions that mostly occur following cutaneous injury. They are characterized by increased extracellular matrix (ECM) deposition, primarily excessive collagen type 1 production by hyperproliferative fibroblasts. The extent of ECM deposition is thought to be proportional to the severity of local skin inflammation leading to excessive fibrosis of the dermis. Due to a lack of suitable study models, therapy for raised dermal scars remains ill-defined. Immune cells and their associated markers have been strongly associated with dermal fibrosis. Therefore, modulation of the immune system and use of anti-inflammatory cytokines are of potential interest in the management of dermal fibrosis. In this review, we will discuss the importance of immune factors in the pathogenesis of raised dermal scarring. The aim here is to provide an up-to-date comprehensive review of the literature, from PubMed, Scopus, and other relevant search engines in order to describe the known immunological factors associated with raised dermal scarring. The importance of immune cells including mast cells, macrophages, lymphocytes, and relevant molecules such as cytokines, chemokines, and growth factors, antibodies, transcription factors, and other immune-associated molecules as well as tissue lymphoid aggregates identified within raised dermal scars will be presented. A growing body of evidence points to a shift from proinflammatory Th1 response to regulatory/anti-inflammatory Th2 response being associated with the development of fibrogenesis in raised dermal scarring. In summary, a better understanding of immune cells and associated molecular markers in dermal fibrosis will likely enable future development of potential immune-modulated therapeutic, diagnostic, and theranostic targets in raised dermal scarring.
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Affiliation(s)
- Elvis Banboye Kidzeru
- Wound Healing And Keloid Scar Unit, Medical Research Council (South Africa), Hair and Skin Research Laboratory, Division of Dermatology, Department of MedicineUniversity of Cape TownCape TownSouth Africa
- Microbiology, Infectious Diseases, and Immunology Laboratory (LAMMII)Centre for Research on Health and Priority Pathologies (CRSPP)Institute of Medical Research and Medicinal Plant Studies (IMPM), Ministry of Scientific Research and InnovationYaoundéCameroon
| | - Maribanyana Lebeko
- Wound Healing And Keloid Scar Unit, Medical Research Council (South Africa), Hair and Skin Research Laboratory, Division of Dermatology, Department of MedicineUniversity of Cape TownCape TownSouth Africa
- Present address:
Cape Biologix Technologies (PTY, LTD)Cape TownSouth Africa
| | - Jyoti Rajan Sharma
- Wound Healing And Keloid Scar Unit, Medical Research Council (South Africa), Hair and Skin Research Laboratory, Division of Dermatology, Department of MedicineUniversity of Cape TownCape TownSouth Africa
- Biomedical Research and Innovation Platform, South African Medical Research Council, Francie van Zijl Drive, Parow ValleyCape TownSouth Africa
- Present address:
Biomedical Research and Innovation Platform, South African Medical Research Council, Francie van Zijl Drive, Parow ValleyCape TownSouth Africa
| | - Lucia Nkengazong
- Microbiology, Infectious Diseases, and Immunology Laboratory (LAMMII)Centre for Research on Health and Priority Pathologies (CRSPP)Institute of Medical Research and Medicinal Plant Studies (IMPM), Ministry of Scientific Research and InnovationYaoundéCameroon
| | - Henry Ademola Adeola
- Wound Healing And Keloid Scar Unit, Medical Research Council (South Africa), Hair and Skin Research Laboratory, Division of Dermatology, Department of MedicineUniversity of Cape TownCape TownSouth Africa
| | - Hlumani Ndlovu
- Department of Integrative Biomedical SciencesUniversity of Cape TownCape TownSouth Africa
| | - Nonhlanhla P Khumalo
- Wound Healing And Keloid Scar Unit, Medical Research Council (South Africa), Hair and Skin Research Laboratory, Division of Dermatology, Department of MedicineUniversity of Cape TownCape TownSouth Africa
| | - Ardeshir Bayat
- Wound Healing And Keloid Scar Unit, Medical Research Council (South Africa), Hair and Skin Research Laboratory, Division of Dermatology, Department of MedicineUniversity of Cape TownCape TownSouth Africa
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6
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Neves LMG, Wilgus TA, Bayat A. In Vitro, Ex Vivo, and In Vivo Approaches for Investigation of Skin Scarring: Human and Animal Models. Adv Wound Care (New Rochelle) 2023; 12:97-116. [PMID: 34915768 DOI: 10.1089/wound.2021.0139] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Significance: The cutaneous repair process naturally results in different types of scarring that are classified as normal or pathological. Affected individuals are often affected from an esthetic, physical (functional), and psychosocial perspective. The distinct nature of scarring in humans, particularly the formation of pathological scars, makes the study of skin scarring a challenge for researchers in this area. Several established experimental models exist for studying scar formation. However, the increasing development and validation of newly emerging models have made it possible to carry out studies focused on different variables that influence this unique process. Recent Advances: Experimental models such as in vitro, ex vivo, and in vivo models have obtained different degrees of success in the reproduction of the scar formation in its native milieu and true environment. These models also differ in their ability to elucidate the molecular, cellular, and structural mechanisms involved in scarring, as well as for testing new agents and approaches for therapies. The models reviewed here, including cells derived from human skin and in vivo animal models, have contributed to the advancement of skin scarring research. Critical Issues and Future Directions: The absence of experimental models that faithfully reproduce the typical characteristics of the different types of human skin scars makes the improvement of validated models and the establishment of new ones a critical unmet need. The fields of wound healing research combined with tissue engineering have offered newer alternatives for experimental studies with the potential to provide clinically useful knowledge about scar formation.
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Affiliation(s)
- Lia M G Neves
- Plastic & Reconstructive Surgery Research, Centre for Dermatology Research, Wound Healing Theme, NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester, England, United Kingdom
| | - Traci A Wilgus
- Department of Pathology, Ohio State University, Columbus, Ohio, USA
| | - Ardeshir Bayat
- Plastic & Reconstructive Surgery Research, Centre for Dermatology Research, Wound Healing Theme, NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester, England, United Kingdom.,Medical Research Council (MRC) Wound Healing Unit, Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
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Song Y, Wang T, Yang L, Wu J, Chen L, Fan X, Zhang Z, Yang Q, Yu Z, Song B. EGCG inhibits hypertrophic scar formation in a rabbit ear model. J Cosmet Dermatol 2023; 22:1382-1391. [PMID: 36606405 DOI: 10.1111/jocd.15587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 11/30/2022] [Accepted: 12/12/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Hypertrophic scarring is a common skin fibro-proliferative disease, but currently there has no satisfactory drugs for anti-scar treatments. Previous study showed that epigallocatechin gallate (EGCG), the main catechin in green tea, improved wound healing and tissue fibrosis in both rats and mice. In the present study, the therapeutic effects of EGCG on hypertrophic scar were analyzed using a rabbit ear hypertrophic scar model. MATERIALS A rabbit ear model of hypertrophic scarring was used. DMSO, 0.5 mg EGCG/wound, 1.0 mg EGCG/wound or triamcinolone were injected subcutaneously once a week for 4 weeks. The scar elevation index (SEI) was measured using HE staining images, the collagen fibers were examined by Masson' trichrome staining images, and the number of capillaries in hypertrophic scar were calculated by CD31 staining images. The mRNA levels in the scar tissues were detected by quantitative real-time polymerase chain reaction (qRT-PCR). RESULTS Gross observation and histological evaluation showed the inhibitory effects of EGCG on hypertrophic scar formation at both doses, and decreased scar height and SEI were detected. EGCG also attenuated the mean collagen area fraction and decreased the number of capillaries in scar tissues. qRT-PCR revealed that EGCG significantly inhibited the mRNA expression of TGF-β1, Col I, Col III, α-SMA, and eNOS. CONCLUSION EGCG may serve as a useful candidate therapeutic drug for hypertrophic scar via inhibiting fibrotic gene expression and suppressing angiogenesis.
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Affiliation(s)
- Yajuan Song
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Tong Wang
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Liu Yang
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Junzheng Wu
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Lin Chen
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Xiao Fan
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Zhe Zhang
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Qing Yang
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Zhou Yu
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Baoqiang Song
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
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Amazonian Guarana- and Açai-Conjugated Extracts Improve Scratched Fibroblast Healing and Eisenia fetida Surgical Tail Amputation by Modulating Oxidative Metabolism. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:3094362. [PMID: 35795860 PMCID: PMC9251138 DOI: 10.1155/2022/3094362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 06/09/2022] [Indexed: 11/26/2022]
Abstract
Background Previous studies have suggested that guarana (Paullinia cupana) and açai (Euterpe oleracea) have antioxidant, anti-inflammatory, and proliferative properties, indicating their potential therapeutic action in wound healing. We produced a conjugated guarana-açai (GA) extract and tested its healing action on earthworms (Eisenia fetida) subjected to tail amputation by surgical incision. Methods Extract from roasted guarana seeds and fresh açai seed berries was produced. The antioxidant and genoprotective capacity of GA extract was tested. The concentration with the most remarkable healing potential was used in subsequent tests. The last three posterior segments of the clitellate earthworm tail reared under standardized conditions were surgically amputated. Next, topical PBS or GA extract was applied to the surgical wound. The rate of cell migration and tissue regeneration at the local wound site was histologically evaluated after the procedure. Expression of the SOX4 gene that acts in epithelial-to-mesenchymal transition was determined by RT-qPCR. Results Sixteen bioactive molecules, including some previously described substances, were identified. All tested concentrations exhibited antioxidant and genoprotective effects. The GA extract accelerated the healing processes as observed through macroscopic and histological analyses and increased expression of SOX4. Conclusion The GA extract has a potential role in the healing of surgically induced wounds.
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9
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Ud-Din S, Bayat A. Controlling Inflammation Pre-Emptively or at the Time of Cutaneous Injury Optimises Outcome of Skin Scarring. Front Immunol 2022; 13:883239. [PMID: 35711461 PMCID: PMC9197255 DOI: 10.3389/fimmu.2022.883239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 04/21/2022] [Indexed: 11/13/2022] Open
Abstract
Inflammation plays an active role during the wound healing process. There is a direct association between the extent of injury as well as inflammation and the amount of subsequent cutaneous scarring. Evidence to date demonstrates that high levels of inflammation are associated with excessive dermal scarring and formation of abnormal pathological scars such as keloids and hypertrophic scars. In view of the multiple important cell types being involved in the inflammatory process and their influence on the extent of scar formation, many scar therapies should aim to target these cells in order to control inflammation and by association help improve scar outcome. However, most current treatment strategies for the management of a newly formed skin scar often adopt a watch-and-wait approach prior to commencing targeted anti-inflammatory therapy. Moreover, most of these therapies have been evaluated in the remodelling phase of wound healing and the evaluation of anti-inflammatory treatments at earlier stages of healing have not been fully explored and remain limited. Taken together, in order to minimise the risk of developing a poor scar outcome, it is clear that adopting an early intervention prior to skin injury would be optimal, however, the concept of pre-emptively priming the skin prior to injury has not yet been thoroughly evaluated. Therefore, the aim of this review was to evaluate the available literature regarding scar therapies that aim to target inflammation which are commenced prior to when a scar is formed or immediately after injury, with a particular focus on the role of pre-emptive priming of skin prior to injury in order to control inflammation for the prevention of poor scarring outcome.
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Affiliation(s)
- Sara Ud-Din
- Plastic and Reconstructive Surgery Research, National Institute for Health Research (NIHR) Manchester Biomedical Research Centre, University of Manchester, Manchester, United Kingdom
| | - Ardeshir Bayat
- Plastic and Reconstructive Surgery Research, National Institute for Health Research (NIHR) Manchester Biomedical Research Centre, University of Manchester, Manchester, United Kingdom.,Medical Research Council - South Africa (MRC-SA) Wound Healing Unit, Division of Dermatology, University of Cape Town, Cape Town, South Africa
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10
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Viaña‐Mendieta P, Sánchez ML, Benavides J. Rational selection of bioactive principles for wound healing applications: Growth factors and antioxidants. Int Wound J 2022; 19:100-113. [PMID: 33951280 PMCID: PMC8684881 DOI: 10.1111/iwj.13602] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/18/2021] [Accepted: 03/23/2021] [Indexed: 12/29/2022] Open
Abstract
Wound healing is a complex process of communication between growth factors, reactive species of oxygen, cells, signalling pathways, and cytokines in the extracellular matrix, in which growth factors are the key regulators. In humans, the main regulators of the cellular responses in wound healing are five growth factors, namely EGF, bFGF, VEGF, and TGF-β1. On the other hand, antioxidants such as astaxanthin, beta-carotene, epigallocatechin gallate, delphinidin, and curcumin have been demonstrated to stimulate cell proliferation, migration and angiogenesis, and control inflammation, to suggest a practical approach to design new strategies to treat non-healing cutaneous conditions. Based on the individual effects of growth factors and antioxidants, it may be envisioned that the use of both types of bioactives in wound healing formulations may have an additive or synergistic effect on the healing potential. This review addresses the effect of growth factors and antioxidants on wound healing-related processes. Furthermore, a prospective on their potential additive or synergistic effect on wound healing formulations, based on their individual effects, is presented. This may serve as a guide for the development of a new generation of wound healing formulations.
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Affiliation(s)
| | - Mirna Lorena Sánchez
- Laboratorio de Materiales Biotecnológicos Departamento de Ciencia y TecnologíaUniversidad Nacional de Quilmes, IMBICE‐ConicetBernalBuenos AiresArgentina
| | - Jorge Benavides
- Tecnologico de MonterreyEscuela de Ingeniería y CienciasMonterreyNuevo LeónMexico
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11
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Xu FW, Lv YL, Zhong YF, Xue YN, Wang Y, Zhang LY, Hu X, Tan WQ. Beneficial Effects of Green Tea EGCG on Skin Wound Healing: A Comprehensive Review. Molecules 2021; 26:6123. [PMID: 34684703 PMCID: PMC8540743 DOI: 10.3390/molecules26206123] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/02/2021] [Accepted: 10/04/2021] [Indexed: 12/18/2022] Open
Abstract
Epigallocatechin gallate (EGCG) is associated with various health benefits. In this review, we searched current work about the effects of EGCG and its wound dressings on skin for wound healing. Hydrogels, nanoparticles, micro/nanofiber networks and microneedles are the major types of EGCG-containing wound dressings. The beneficial effects of EGCG and its wound dressings at different stages of skin wound healing (hemostasis, inflammation, proliferation and tissue remodeling) were summarized based on the underlying mechanisms of antioxidant, anti-inflammatory, antimicrobial, angiogenesis and antifibrotic properties. This review expatiates on the rationale of using EGCG to promote skin wound healing and prevent scar formation, which provides a future clinical application direction of EGCG.
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Affiliation(s)
- Fa-Wei Xu
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou 310016, China; (F.-W.X.); (Y.-F.Z.); (Y.-N.X.); (Y.W.); (L.-Y.Z.); (X.H.)
| | - Ying-Li Lv
- Tea Research Institute, College of Agriculture and Biotechnology, Zhejiang University, Hangzhou 310013, China;
| | - Yu-Fan Zhong
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou 310016, China; (F.-W.X.); (Y.-F.Z.); (Y.-N.X.); (Y.W.); (L.-Y.Z.); (X.H.)
| | - Ya-Nan Xue
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou 310016, China; (F.-W.X.); (Y.-F.Z.); (Y.-N.X.); (Y.W.); (L.-Y.Z.); (X.H.)
| | - Yong Wang
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou 310016, China; (F.-W.X.); (Y.-F.Z.); (Y.-N.X.); (Y.W.); (L.-Y.Z.); (X.H.)
| | - Li-Yun Zhang
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou 310016, China; (F.-W.X.); (Y.-F.Z.); (Y.-N.X.); (Y.W.); (L.-Y.Z.); (X.H.)
| | - Xian Hu
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou 310016, China; (F.-W.X.); (Y.-F.Z.); (Y.-N.X.); (Y.W.); (L.-Y.Z.); (X.H.)
| | - Wei-Qiang Tan
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou 310016, China; (F.-W.X.); (Y.-F.Z.); (Y.-N.X.); (Y.W.); (L.-Y.Z.); (X.H.)
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12
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Ud-Din S, Wilgus TA, McGeorge DD, Bayat A. Pre-Emptive Priming of Human Skin Improves Cutaneous Scarring and Is Superior to Immediate and Delayed Topical Anti-Scarring Treatment Post-Wounding: A Double-Blind Randomised Placebo-Controlled Clinical Trial. Pharmaceutics 2021; 13:510. [PMID: 33917842 PMCID: PMC8068279 DOI: 10.3390/pharmaceutics13040510] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/25/2021] [Accepted: 03/31/2021] [Indexed: 11/30/2022] Open
Abstract
The concept of pre-emptive priming of skin pre-surgery offers a novel approach in optimizing cutaneous scarring outcome. We previously showed an anti-scarring topical (epigallocatechin-3-gallate (EGCG)) is effective in improving skin scarring when applied post-surgery. The objective was to deliver an active compound at the optimal time in order to maximize its impact and improve cutaneous scarring. Therefore, pre-emptive application of anti-scarring topical pre-surgery compared with post-surgery can potentially be superior on scarring outcome. This double-blinded randomized placebo-controlled trial compares the effects of pre-emptive priming of skin with an anti-scarring topical pre-surgery versus post-surgery. Healthy volunteers (n = 40) were split into 4-groups; each undergoing different modes of application versus placebo: Group-1 = priming (7Days) pre-injury, Group-2 = priming (3D) pre-injury, Group-3 = immediate (0D) day-of-injury, Group-4 = delayed application (14D) post-injury. Excisional skin-biopsies in upper-arms were evaluated weekly with multiple quantitative devices over 8-weeks. Histological, immunohistochemical, mRNA sequencing and QRT-PCR studies were performed on tissue-biopsies. EGCG reduced mast cells at weeks-4 and 8 by gene and protein analyses (p < 0.01). Group 1 was superior to other groups (p < 0.01) in both clinical (blood flow) and laboratory parameters (elastin and immune marker expression). Additionally, there was down-regulation of angiogenic-markers by mRNA-sequencing and of CD31 and VEGF-A at weeks-4 and 8 (p < 0.01) by immunohistochemistry and at week-4 (p < 0.05) by QRT-PCR. EGCG increased antioxidant levels (HO-1) at week-4 (p < 0.01) plus elastin at week-8 (p < 0.01). In conclusion, pre-emptive priming of skin pre-injury has significant beneficial effects on surgically induced skin scarring shown by reducing mast cells, blood flow and angiogenesis plus increasing elastin content. This clinical trial was registered with ISRCTN (ISRCTN70155584).
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Affiliation(s)
- Sara Ud-Din
- Plastic and Reconstructive Surgery Research, NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester M13 9PT, UK;
| | - Traci A. Wilgus
- Department of Pathology, Wexner Medical Center, Ohio State University, Columbus, OH 43210, USA;
| | | | - Ardeshir Bayat
- Plastic and Reconstructive Surgery Research, NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester M13 9PT, UK;
- MRC-SA Wound Healing Unit, Division of Dermatology, University of Cape Town, Cape Town 7925, South Africa
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13
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Ud-Din S, Wilgus TA, McGeorge DD, Bayat A. Pre-Emptive Priming of Human Skin Improves Cutaneous Scarring and Is Superior to Immediate and Delayed Topical Anti-Scarring Treatment Post-Wounding: A Double-Blind Randomised Placebo-Controlled Clinical Trial. Pharmaceutics 2021. [PMID: 33917842 DOI: 10.3390/pharmaceutics13040510.pmid:33917842;pmcid:pmc8068279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
The concept of pre-emptive priming of skin pre-surgery offers a novel approach in optimizing cutaneous scarring outcome. We previously showed an anti-scarring topical (epigallocatechin-3-gallate (EGCG)) is effective in improving skin scarring when applied post-surgery. The objective was to deliver an active compound at the optimal time in order to maximize its impact and improve cutaneous scarring. Therefore, pre-emptive application of anti-scarring topical pre-surgery compared with post-surgery can potentially be superior on scarring outcome. This double-blinded randomized placebo-controlled trial compares the effects of pre-emptive priming of skin with an anti-scarring topical pre-surgery versus post-surgery. Healthy volunteers (n = 40) were split into 4-groups; each undergoing different modes of application versus placebo: Group-1 = priming (7Days) pre-injury, Group-2 = priming (3D) pre-injury, Group-3 = immediate (0D) day-of-injury, Group-4 = delayed application (14D) post-injury. Excisional skin-biopsies in upper-arms were evaluated weekly with multiple quantitative devices over 8-weeks. Histological, immunohistochemical, mRNA sequencing and QRT-PCR studies were performed on tissue-biopsies. EGCG reduced mast cells at weeks-4 and 8 by gene and protein analyses (p < 0.01). Group 1 was superior to other groups (p < 0.01) in both clinical (blood flow) and laboratory parameters (elastin and immune marker expression). Additionally, there was down-regulation of angiogenic-markers by mRNA-sequencing and of CD31 and VEGF-A at weeks-4 and 8 (p < 0.01) by immunohistochemistry and at week-4 (p < 0.05) by QRT-PCR. EGCG increased antioxidant levels (HO-1) at week-4 (p < 0.01) plus elastin at week-8 (p < 0.01). In conclusion, pre-emptive priming of skin pre-injury has significant beneficial effects on surgically induced skin scarring shown by reducing mast cells, blood flow and angiogenesis plus increasing elastin content. This clinical trial was registered with ISRCTN (ISRCTN70155584).
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Affiliation(s)
- Sara Ud-Din
- Plastic and Reconstructive Surgery Research, NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester M13 9PT, UK
| | - Traci A Wilgus
- Department of Pathology, Wexner Medical Center, Ohio State University, Columbus, OH 43210, USA
| | | | - Ardeshir Bayat
- Plastic and Reconstructive Surgery Research, NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester M13 9PT, UK
- MRC-SA Wound Healing Unit, Division of Dermatology, University of Cape Town, Cape Town 7925, South Africa
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14
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A Review of the Evidence for and against a Role for Mast Cells in Cutaneous Scarring and Fibrosis. Int J Mol Sci 2020; 21:ijms21249673. [PMID: 33353063 PMCID: PMC7766369 DOI: 10.3390/ijms21249673] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/01/2020] [Accepted: 12/12/2020] [Indexed: 12/15/2022] Open
Abstract
Scars are generated in mature skin as a result of the normal repair process, but the replacement of normal tissue with scar tissue can lead to biomechanical and functional deficiencies in the skin as well as psychological and social issues for patients that negatively affect quality of life. Abnormal scars, such as hypertrophic scars and keloids, and cutaneous fibrosis that develops in diseases such as systemic sclerosis and graft-versus-host disease can be even more challenging for patients. There is a large body of literature suggesting that inflammation promotes the deposition of scar tissue by fibroblasts. Mast cells represent one inflammatory cell type in particular that has been implicated in skin scarring and fibrosis. Most published studies in this area support a pro-fibrotic role for mast cells in the skin, as many mast cell-derived mediators stimulate fibroblast activity and studies generally indicate higher numbers of mast cells and/or mast cell activation in scars and fibrotic skin. However, some studies in mast cell-deficient mice have suggested that these cells may not play a critical role in cutaneous scarring/fibrosis. Here, we will review the data for and against mast cells as key regulators of skin fibrosis and discuss scientific gaps in the field.
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15
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Wilgus TA. Inflammation as an orchestrator of cutaneous scar formation: a review of the literature. PLASTIC AND AESTHETIC RESEARCH 2020; 7:54. [PMID: 33123623 PMCID: PMC7592345 DOI: 10.20517/2347-9264.2020.150] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Inflammation is a key phase in the cutaneous wound repair process. The activation of inflammatory cells is critical for preventing infection in contaminated wounds and results in the release of an array of mediators, some of which stimulate the activity of keratinocytes, endothelial cells, and fibroblasts to aid in the repair process. However, there is an abundance of data suggesting that the strength of the inflammatory response early in the healing process correlates directly with the amount of scar tissue that will eventually form. This review will summarize the literature related to inflammation and cutaneous scar formation, highlight recent discoveries, and discuss potential treatment modalities that target inflammation to minimize scarring.
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Affiliation(s)
- Traci A Wilgus
- Department of Pathology, Ohio State University, Columbus, OH 43210, USA
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16
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Ud-Din S, Wilgus TA, Bayat A. Mast Cells in Skin Scarring: A Review of Animal and Human Research. Front Immunol 2020; 11:552205. [PMID: 33117341 PMCID: PMC7561364 DOI: 10.3389/fimmu.2020.552205] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 08/27/2020] [Indexed: 01/05/2023] Open
Abstract
Mast cells (MCs) are an important immune cell type in the skin and play an active role during wound healing. MCs produce mediators that can enhance acute inflammation, stimulate re-epithelialisation as well as angiogenesis, and promote skin scarring. There is also a link between MCs and abnormal pathological cutaneous scarring, with increased numbers of MCs found in hypertrophic scars and keloid disease. However, there has been conflicting data regarding the specific role of MCs in scar formation in both animal and human studies. Whilst animal studies have proved to be valuable in studying the MC phenomenon in wound healing, the appropriate translation of these findings to cutaneous wound healing and scar formation in human subjects remains crucial to elucidate the role of these cells and target treatment effectively. Therefore, this perspective paper will focus on evaluation of the current evidence for the role of MCs in skin scarring in both animals and humans in order to identify common themes and future areas for translational research.
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Affiliation(s)
- Sara Ud-Din
- Plastic and Reconstructive Surgery Research, Centre for Dermatology Research, NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester, United Kingdom
| | - Traci A Wilgus
- Department of Pathology, Wexner Medical Center, The Ohio State University, Columbus, OH, United States
| | - Ardeshir Bayat
- Plastic and Reconstructive Surgery Research, Centre for Dermatology Research, NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester, United Kingdom.,MRC-SA Wound Healing Unit, Division of Dermatology, University of Cape Town, Cape Town, South Africa
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17
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Huang C, Ogawa R. Systemic factors that shape cutaneous pathological scarring. FASEB J 2020; 34:13171-13184. [DOI: 10.1096/fj.202001157r] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 07/29/2020] [Accepted: 08/07/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Chenyu Huang
- Department of Dermatology Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University Beijing China
| | - Rei Ogawa
- Department of Plastic, Reconstructive and Aesthetic Surgery Nippon Medical School Tokyo Japan
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18
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Hsieh JC, Joshi CJ, Wan R, Galiano RD. The Northwestern Abdominoplasty Scar Model: A Tool for High-Throughput Assessment of Scar Therapeutics. Adv Wound Care (New Rochelle) 2020; 9:396-404. [PMID: 32320363 DOI: 10.1089/wound.2018.0900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Significance: Scar management is an important concern in plastic surgery. Scar models that best mimic in vivo human scarring are essential for understanding scar development and progression, assessing the efficacy of therapeutics, and providing reliable and valid research outcomes. Recent Advances: In 2016, Lanier et al. proposed a new in vivo patient model, the Northwestern Abdominoplasty Scar Model, that overcomes the prior limitations of both animal and human models, with greater representativeness of the human scarring process, expedited recruitment, smaller sample requirements, and greater flexibility in the types and number of interventions that can be studied simultaneously. Critical Issues: Existing animal models suffer from limitations that impede generalization to human scars. Human scar studies are difficult to conduct and rarely used due to recruitment difficulties, ethical concerns regarding purposeful wounding, and inherent variability based on location, type of scar, and the heterogeneity of the host response between humans. Although overcoming many of these hurdles, the Northwestern Abdominoplasty Scar Model still has a few limitations. In addition, there remains a need for further study of and comparison between the Northwestern Abdominoplasty Scar Model and existing human and animal models, to inspire more widespread acceptance of a standardized human scar model. Future Directions: The Northwestern Abdominoplasty Scar Model is a critical stepping stone toward better human scar models. This model hopefully will inspire other in vivo patient models utilizing elective surgery to overcome recruitment and ethical concerns.
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Affiliation(s)
- Ji-Cheng Hsieh
- Department of Plastic and Reconstructive Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Chitang J. Joshi
- Department of Plastic and Reconstructive Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Rou Wan
- Department of Plastic and Reconstructive Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Robert D. Galiano
- Department of Plastic and Reconstructive Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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19
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Limandjaja GC, Niessen FB, Scheper RJ, Gibbs S. The Keloid Disorder: Heterogeneity, Histopathology, Mechanisms and Models. Front Cell Dev Biol 2020; 8:360. [PMID: 32528951 PMCID: PMC7264387 DOI: 10.3389/fcell.2020.00360] [Citation(s) in RCA: 136] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 04/22/2020] [Indexed: 12/22/2022] Open
Abstract
Keloids constitute an abnormal fibroproliferative wound healing response in which raised scar tissue grows excessively and invasively beyond the original wound borders. This review provides a comprehensive overview of several important themes in keloid research: namely keloid histopathology, heterogeneity, pathogenesis, and model systems. Although keloidal collagen versus nodules and α-SMA-immunoreactivity have been considered pathognomonic for keloids versus hypertrophic scars, conflicting results have been reported which will be discussed together with other histopathological keloid characteristics. Importantly, histopathological keloid abnormalities are also present in the keloid epidermis. Heterogeneity between and within keloids exists which is often not considered when interpreting results and may explain discrepancies between studies. At least two distinct keloid phenotypes exist, the superficial-spreading/flat keloids and the bulging/raised keloids. Within keloids, the periphery is often seen as the actively growing margin compared to the more quiescent center, although the opposite has also been reported. Interestingly, the normal skin directly surrounding keloids also shows partial keloid characteristics. Keloids are most likely to occur after an inciting stimulus such as (minor and disproportionate) dermal injury or an inflammatory process (environmental factors) at a keloid-prone anatomical site (topological factors) in a genetically predisposed individual (patient-related factors). The specific cellular abnormalities these various patient, topological and environmental factors generate to ultimately result in keloid scar formation are discussed. Existing keloid models can largely be divided into in vivo and in vitro systems including a number of subdivisions: human/animal, explant/culture, homotypic/heterotypic culture, direct/indirect co-culture, and 3D/monolayer culture. As skin physiology, immunology and wound healing is markedly different in animals and since keloids are exclusive to humans, there is a need for relevant human in vitro models. Of these, the direct co-culture systems that generate full thickness keloid equivalents appear the most promising and will be key to further advance keloid research on its pathogenesis and thereby ultimately advance keloid treatment. Finally, the recent change in keloid nomenclature will be discussed, which has moved away from identifying keloids solely as abnormal scars with a purely cosmetic association toward understanding keloids for the fibroproliferative disorder that they are.
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Affiliation(s)
- Grace C Limandjaja
- Department of Molecular Cell Biology and Immunology, Amsterdam University Medical Center (location VUmc), Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Frank B Niessen
- Department of Plastic Surgery, Amsterdam University Medical Center (location VUmc), Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Rik J Scheper
- Department of Pathology, Amsterdam University Medical Center (location VUmc), Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Susan Gibbs
- Department of Molecular Cell Biology and Immunology, Amsterdam University Medical Center (location VUmc), Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Department of Oral Cell Biology, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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20
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Yan L, Wang LZ, Xiao R, Cao R, Pan B, Lv XY, Jiao H, Zhuang Q, Sun XJ, Liu YB. Inhibition of microRNA-21-5p reduces keloid fibroblast autophagy and migration by targeting PTEN after electron beam irradiation. J Transl Med 2020; 100:387-399. [PMID: 31558773 DOI: 10.1038/s41374-019-0323-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 08/14/2019] [Accepted: 08/22/2019] [Indexed: 01/17/2023] Open
Abstract
Electron beam (EB) irradiation is useful to reduce the recurrence of keloids; however, the underlying mechanism remains unknown. MicroRNA-21 (miR-21), which regulates autophagy during cancer radiation therapy, was identified as a potential therapeutic target for keloids. Here, we investigate the regulatory mechanism(s) of miR-21-5p on keloid fibroblast autophagy and migration after EB irradiation. The microRNA expression profile of the keloid dermis was examined by performing a microRNA microarray. Levels of LC3B and Beclin-1 were detected by immunohistochemical and western blot analysis in the keloid dermis and fibroblasts. Autophagy and apoptosis were tested in keloid fibroblasts after EB irradiation or transfection with an miR-21-5p inhibitor using electron microscopy, a Cyto-ID Green Autophagy Detection Kit, and an Annexin V PE Apoptosis Detection Kit. Migration was analyzed by an in vitro scratch-wound healing assay. Mechanistic tests were performed using small interfering RNAs to phosphatase and tensin homolog (siPTEN). Levels of miR-21-5p, PTEN, programmed cell death 4 (PDCD4), p-AKT, and apoptosis- and autophagy-associated genes were examined by qRT-PCR and western blotting. LC3B expression and migration ability were enhanced in fibroblasts and the keloid margin dermis compared with those in the adjacent normal skin. Both EB irradiation and an miR-21-5p inhibitor reduced keloid fibroblast autophagy, which was accompanied by decreased expression of miR-21-5p, p-AKT, and LC3B-II and increased expression of PTEN, PDCD4, and apoptosis-related genes. MiR-21-5p downregulation inhibited migration and suppressed LC3B expression and this was reversed by PTEN reduction. In conclusion, with increasing apoptosis, EB irradiation inhibits autophagy in keloid fibroblasts by reducing miR-21-5p, which regulates migration and LC3B expression via PTEN/AKT signaling. These data suggest a potential mechanism wherein miR-21-5p inhibition regulates autophagy and migration in EB-irradiated keloid fibroblasts, effectively preventing local invasion and recurrence. Therefore, miR-21-5p could be a new therapeutic target, to replace EB irradiation, and control keloid relapse.
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Affiliation(s)
- Li Yan
- Research Center of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-Da-Chu Road 33#, 100144, Beijing, P.R. China
| | - Lian-Zhao Wang
- Comprehensive Treatment Center of Scar, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-Da-Chu Road 33#, 100144, Beijing, P.R. China
| | - Ran Xiao
- Research Center of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-Da-Chu Road 33#, 100144, Beijing, P.R. China
| | - Rui Cao
- Research Center of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-Da-Chu Road 33#, 100144, Beijing, P.R. China
| | - Bo Pan
- Auricular Plastic and Reconstructive Surgery Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-Da-Chu Road 33#, 100144, Beijing, P.R. China
| | - Xiao-Yan Lv
- Research Center of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-Da-Chu Road 33#, 100144, Beijing, P.R. China
| | - Hu Jiao
- Research Center of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-Da-Chu Road 33#, 100144, Beijing, P.R. China
| | - Qiang Zhuang
- Research Center of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-Da-Chu Road 33#, 100144, Beijing, P.R. China
| | - Xue-Jian Sun
- Research Center of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-Da-Chu Road 33#, 100144, Beijing, P.R. China
| | - Yuan-Bo Liu
- Department of Plastic and Reconstructive Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-Da-Chu Road 33#, 100144, Beijing, P.R. China.
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21
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Sharma JR, Lebeko M, Kidzeru EB, Khumalo NP, Bayat A. In Vitro and Ex Vivo Models for Functional Testing of Therapeutic Anti-scarring Drug Targets in Keloids. Adv Wound Care (New Rochelle) 2019; 8:655-670. [PMID: 31827980 PMCID: PMC6904937 DOI: 10.1089/wound.2019.1040] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 09/09/2019] [Indexed: 01/08/2023] Open
Abstract
Significance: Keloids are benign fibro-proliferative raised dermal lesions that spread beyond the original borders of the wound, continue to grow, rarely regress, and are the most common in pigmented individuals after an abnormal wound healing response. The current treatment failure and respective challenges involved highlighting the underlying issue that the etiopathogenesis of keloids is still not well understood. Disease models are required to better understand the disease pathogenesis. It is not possible to establish keloids in animals because of the uniqueness of this disease to human skin. To address this challenge, along these lines, non-animal reproducible models are vital in investigating molecular mechanisms of keloid pathogenesis and therapeutics development. Recent Advances: Various non-animal models have been developed to better understand the molecular mechanisms involved in keloid scarring and aid in identifying and evaluating the therapeutic potential of novel drug candidates. In this scenario, the current review aims at describing in vitro monocultures, co-cultures, organotypic cultures, and ex vivo whole skin keloid tissue organ culture models. Critical Issues and Future Directions: Current treatment options for keloids are far from securing a cure or preventing disease recurrence. Identifying universally accepted effective therapy for keloids has been hampered by the absence of appropriate disease model systems. Animal models do not accurately mimic the disease, thus non-animal model systems are pivotal in keloid research. The use of these models is essential not only for a better understanding of disease biology but also for identifying and evaluating novel drug targets.
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Affiliation(s)
- Jyoti R. Sharma
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Maribanyana Lebeko
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Elvis B. Kidzeru
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
- Centre for Medical Research, Institute of Medical Research and Medical Plant Studies, Ministry of Scientific Research and Innovation, Yaoundé, Cameroon
| | - Nonhlanhla P. Khumalo
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Ardeshir Bayat
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
- Plastic and Reconstructive Surgery Research, Division of Musculoskeletal & Dermatological Sciences, NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
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22
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Wound Healing and the Use of Medicinal Plants. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:2684108. [PMID: 31662773 PMCID: PMC6778887 DOI: 10.1155/2019/2684108] [Citation(s) in RCA: 130] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 05/03/2019] [Accepted: 09/01/2019] [Indexed: 02/06/2023]
Abstract
Cutaneous wound healing is the process by which skin repairs itself. It is generally accepted that cutaneous wound healing can be divided into 4 phases: haemostasis, inflammation, proliferation, and remodelling. In humans, keratinocytes re-form a functional epidermis (reepithelialization) as rapidly as possible, closing the wound and reestablishing tissue homeostasis. Dermal fibroblasts migrate into the wound bed and proliferate, creating “granulation tissue” rich in extracellular matrix proteins and supporting the growth of new blood vessels. Ultimately, this is remodelled over an extended period, returning the injured tissue to a state similar to that before injury. Dysregulation in any phase of the wound healing cascade delays healing and may result in various skin pathologies, including nonhealing, or chronic ulceration. Indigenous and traditional medicines make extensive use of natural products and derivatives of natural products and provide more than half of all medicines consumed today throughout the world. Recognising the important role traditional medicine continues to play, we have undertaken an extensive survey of literature reporting the use of medical plants and plant-based products for cutaneous wounds. We describe the active ingredients, bioactivities, clinical uses, formulations, methods of preparation, and clinical value of 36 medical plant species. Several species stand out, including Centella asiatica, Curcuma longa, and Paeonia suffruticosa, which are popular wound healing products used by several cultures and ethnic groups. The popularity and evidence of continued use clearly indicates that there are still lessons to be learned from traditional practices. Hidden in the myriad of natural products and derivatives from natural products are undescribed reagents, unexplored combinations, and adjunct compounds that could have a place in the contemporary therapeutic inventory.
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Ud-Din S, Foden P, Mazhari M, Al-Habba S, Baguneid M, Bulfone-Paus S, McGeorge D, Bayat A. A Double-Blind, Randomized Trial Shows the Role of Zonal Priming and Direct Topical Application of Epigallocatechin-3-Gallate in the Modulation of Cutaneous Scarring in Human Skin. J Invest Dermatol 2019; 139:1680-1690.e16. [DOI: 10.1016/j.jid.2019.01.030] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 01/13/2019] [Accepted: 01/14/2019] [Indexed: 01/19/2023]
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Sami DG, Heiba HH, Abdellatif A. Wound healing models: A systematic review of animal and non-animal models. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.wndm.2018.12.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Chao L, Hua-Yu Z, Wen-Dong B, Mei S, Bin X, Da-Hai H, Yi L. miR-96 promotes collagen deposition in keloids by targeting Smad7. Exp Ther Med 2018; 17:773-781. [PMID: 30651862 PMCID: PMC6307430 DOI: 10.3892/etm.2018.7008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 09/28/2018] [Indexed: 12/14/2022] Open
Abstract
The abnormal upregulation of transforming growth factor-β (TGF-β) signaling has been demonstrated to initiate keloid formation and progression. Keloid is a type of benign skin tumor that may occur following sustaining skin injury. microRNA-96 (miR-96) serves an important role in the progression of various malignant diseases. Using reverse transcription quantitative polymerase chain reaction (RT-qPCR), the present study demonstrated that miR-96 was overexpressed in keloid-derived fibroblasts (KFs). Luciferase reporter assay revealed mothers against decapentaplegic homolog (Smad)7, which is one of the important inhibitory factors in the TGF-β pathway, as a direct target of miR-96. miR-96 was initially observed to be correlated with the deposition of type I collagen in KFs in vitro. The miR-96 antagomir, was directly added into the keloid organ culture (OC) to find its significant antifibrotic potential, such as keloid OC shrinkage, exhibited by its dry weight loss and improved dermis architecture, exhibited by Masson's staining. Following miR-96 antagomir treatment, a reduction in the mRNA and protein expression levels of collagen type I α 1 chain and collagen type 3 α 1 chain within keloid OC tissues was observed. The present study revealed that miR-96 serves an important role in pathogenic keloid formation, suggesting that miR-96 antagomir has the potential to prevent keloid progression.
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Affiliation(s)
- Li Chao
- Burns and Plastic Surgery Center of People's Liberation Army, Lanzhou General Hospital of Chinese People's Liberation Army, Lanzhou, Gansu 730050, P.R. China
| | - Zhu Hua-Yu
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Bai Wen-Dong
- Department of Hematology, Urumqi General Hospital of Chinese People's Liberation Army, Urumqi, Xinjiang 830000, P.R. China
| | - Song Mei
- Burns and Plastic Surgery Center of People's Liberation Army, Lanzhou General Hospital of Chinese People's Liberation Army, Lanzhou, Gansu 730050, P.R. China
| | - Xiao Bin
- Burns and Plastic Surgery Center of People's Liberation Army, Lanzhou General Hospital of Chinese People's Liberation Army, Lanzhou, Gansu 730050, P.R. China
| | - Hu Da-Hai
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Liu Yi
- Burns and Plastic Surgery Center of People's Liberation Army, Lanzhou General Hospital of Chinese People's Liberation Army, Lanzhou, Gansu 730050, P.R. China
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Wang X, Ma Y, Gao Z, Yang J. Human adipose-derived stem cells inhibit bioactivity of keloid fibroblasts. Stem Cell Res Ther 2018; 9:40. [PMID: 29467010 PMCID: PMC5822616 DOI: 10.1186/s13287-018-0786-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 12/29/2017] [Accepted: 01/22/2018] [Indexed: 11/10/2022] Open
Abstract
Background A keloid is a fibroproliferative disorder occurring in wounds characterized by an exaggerated response to injury. To date, no effective cure has been identified. As multipotent stem cells, human adipose-derived stem cells (ADSCs) may show the possibility for curing diseases such as fibrosis. This study sought to explore the potential role of human ADSCs in curing keloids. Methods After culture in conditioned medium, gene and protein expression of keloid fibroblasts was examined using real-time polymerase chain reaction (RT-PCR) and Western blotting, while analysis of the cell cycle was used to measure the proliferative properties of the cells. Furthermore, ex vivo explant cultures were used to test the effects of ADSC-conditioned medium (ADSC-CM) on CD31+ and CD34+ expression in keloid tissue. Results Our experimental results show that ADSC-CM was able to attenuate extracellular matrix-related gene expression as well as decrease protein expression. Cell proliferation was significantly suppressed in our study. CD31+ and CD34+ vessels in ex vivo explants were reduced by 55% and 57% in treatment groups compared with control groups. Conclusions Human ADSC-CM significantly inhibited keloid fibroblast-related bioactivities.
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Affiliation(s)
- Xiuxia Wang
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, 200011, China
| | - Yan Ma
- Division of Plastic Surgery, Xinjiang Korla Bazhou People's Hospital, Xinjiang, China
| | - Zhen Gao
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, 200011, China.
| | - Jun Yang
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, 200011, China.
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Glinos GD, Verne SH, Aldahan AS, Liang L, Nouri K, Elliot S, Glassberg M, Cabrera DeBuc D, Koru-Sengul T, Tomic-Canic M, Pastar I. Optical coherence tomography for assessment of epithelialization in a human ex vivo wound model. Wound Repair Regen 2018; 25:1017-1026. [PMID: 29235208 DOI: 10.1111/wrr.12600] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 11/22/2017] [Indexed: 12/24/2022]
Abstract
The ex vivo human skin wound model is a widely accepted model to study wound epithelialization. Due to a lack of animal models that fully replicate human conditions, the ex vivo model is a valuable tool to study mechanisms of wound reepithelialization, as well as for preclinical testing of novel therapeutics. The current standard for assessment of wound healing in this model is histomorphometric analysis, which is labor intensive, time consuming, and requires multiple biological and technical replicates in addition to assessment of different time points. Optical coherence tomography (OCT) is an emerging noninvasive imaging technology originally developed for noninvasive retinal scans that avoids the deleterious effects of tissue processing. This study investigated OCT as a novel method for assessing reepithelialization in the human ex vivo wound model. Excisional ex vivo wounds were created, maintained at air-liquid interface, and healing progression was assessed at days 4 and 7 with OCT and histology. OCT provided adequate resolution to identify the epidermis, the papillary and reticular dermis, and importantly, migrating epithelium in the wound bed. We have deployed OCT as a noninvasive tool to produce, longitudinal "optical biopsies" of ex vivo human wound healing process, and we established an optimal quantification method of re-epithelialization based on en face OCT images of the total wound area. Pairwise statistical analysis of OCT and histology based quantifications for the rate of epithelialization have shown the feasibility and superiority of OCT technology for noninvasive monitoring of human wound epithelialization. Furthermore, we have utilized OCT to evaluate therapeutic potential of allogeneic adipose stem cells revealing their ability to promote reepithelialization in human ex vivo wounds. OCT technology is promising for its applications in wound healing and evaluation of novel therapeutics in both the laboratory and the clinical settings.
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Affiliation(s)
- George D Glinos
- Department of Dermatology and Cutaneous Surgery, Wound Healing and Regenerative Medicine Research Program, Miami, Florida
| | - Sebastian H Verne
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Adam S Aldahan
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Liang Liang
- Department of Dermatology and Cutaneous Surgery, Wound Healing and Regenerative Medicine Research Program, Miami, Florida
| | - Keyvan Nouri
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Sharon Elliot
- Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Marilyn Glassberg
- Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida.,Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida
| | - Delia Cabrera DeBuc
- Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida
| | - Tulay Koru-Sengul
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Marjana Tomic-Canic
- Department of Dermatology and Cutaneous Surgery, Wound Healing and Regenerative Medicine Research Program, Miami, Florida
| | - Irena Pastar
- Department of Dermatology and Cutaneous Surgery, Wound Healing and Regenerative Medicine Research Program, Miami, Florida
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Liu J, Ren J, Su L, Cheng S, Zhou J, Ye X, Dong Y, Sun S, Qi F, Liu Z, Pleat J, Zhai H, Zhu N. Human adipose tissue-derived stem cells inhibit the activity of keloid fibroblasts and fibrosis in a keloid model by paracrine signaling. Burns 2017; 44:370-385. [PMID: 29029852 DOI: 10.1016/j.burns.2017.08.017] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 08/23/2017] [Accepted: 08/25/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Human adipose tissue-derived mesenchymal stem cells (ASCs) have potential utility as modulators of the regeneration of tissue that is inflamed or scarred secondary to injuries such as burns or trauma. However, the effect of ASCs on one particular type of scarring, keloidal disease, remains unknown. The absence of an optimal model for investigation has hindered the development of an effective therapy using ASCs for keloids. OBJECTIVE To investigate the influence of ASCs on angiogenesis, extracellular matrix deposition, and inflammatory cell influx in keloids. METHODS We analyzed the proliferation, migration, and apoptosis of human keloid-derived fibroblasts treated with a starvation-induced, conditioned medium from ASCs (ASCs-CM). This was achieved by Brdu proliferation assay, a validated co-culture migration assay, and flow cytometry, respectively. To assess the change in phenotype to a pro-fibrotic state, fibroblasts were analyzed by real-time PCR and contraction assay. A keloid implantation animal model was used to assess the paracrine effect of ASCs histochemically and immunohistochemically on scar morphology, collagen deposition, inflammatory cell composition, and blood vessel density. In tandem, an antibody-based array was used to identify protein concentration in the presence of ASCs-CM at time point 0, 24, and 48h. RESULTS ASCs-CM inhibited the proliferation and collagen synthesis of human keloid-derived fibroblasts. ASCs-CM was associated with reduced inflammation and fibrosis in the keloid implantation model. Thirty-four cytokines were differentially regulated by ASCs-CM at 24h. These included molecules associated with apoptosis, matrix metalloproteases, and their inhibitors. The same molecules were present at relatively higher concentrations at the 48h timepoint. CONCLUSION These results suggest that ASCs are associated with the inhibition of fibrosis in keloids by a paracrine effect. This phenomenon may have utility as a therapeutic approach in the clinical environment.
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Affiliation(s)
- Jianlan Liu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, China; Department of Plastic, Reconstructive and Burns Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Jie Ren
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, China; Department of Plastic, Reconstructive and Burns Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Lina Su
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, China; Department of Plastic, Reconstructive and Burns Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Shimeng Cheng
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, China; Department of Plastic, Reconstructive and Burns Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Jing Zhou
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, China; Department of Plastic, Reconstructive and Burns Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Xiaolu Ye
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, China; Department of Plastic, Reconstructive and Burns Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Yabin Dong
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, China; Department of Plastic, Reconstructive and Burns Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Silei Sun
- Department of Emergency Intensive Care Unit, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Fazhi Qi
- Department of Plastic Surgery, Zhongshan Hospital, Shanghai, China
| | - Zhifei Liu
- Plastic Surgery Department, Peking Union Medical Hospital, Chinese Academy of Medical Sciences, Beijing 100032, China
| | - Jonathon Pleat
- Department of Plastic, Reconstructive and Burns Surgery, Southmead Hospital & University of Bristol, Bristol, UK
| | - Hongjun Zhai
- Anshan Hospital of The First Hospital of China Medical University, China.
| | - Ningwen Zhu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, China; Department of Plastic, Reconstructive and Burns Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China.
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Huang C, Liu L, You Z, Zhao Y, Dong J, Du Y, Ogawa R. Endothelial dysfunction and mechanobiology in pathological cutaneous scarring: lessons learned from soft tissue fibrosis. Br J Dermatol 2017; 177:1248-1255. [PMID: 28403507 DOI: 10.1111/bjd.15576] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2017] [Indexed: 12/13/2022]
Affiliation(s)
- C. Huang
- Department of Dermatology Beijing Tsinghua Changgung Hospital Tsinghua University Beijing 102218 China
- Department of Plastic Surgery Meitan General Hospital Beijing 100028 China
| | - L. Liu
- Department of Biomedical Engineering School of Medicine Tsinghua University Beijing 100084 China
| | - Z. You
- Department of Biomedical Engineering School of Medicine Tsinghua University Beijing 100084 China
| | - Y. Zhao
- Department of Dermatology Beijing Tsinghua Changgung Hospital Tsinghua University Beijing 102218 China
| | - J. Dong
- Department of Hepatobiliary Surgery Beijing Tsinghua Changgung Hospital Tsinghua University Beijing 102218 China
| | - Y. Du
- Department of Biomedical Engineering School of Medicine Tsinghua University Beijing 100084 China
| | - R. Ogawa
- Department of Plastic, Reconstructive and Aesthetic Surgery Nippon Medical School Tokyo 113‐8603 Japan
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30
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Agirbasli M, Göktay F, Peker I, Gunes P, Aker FV, Akkiprik M. Enhanced mRNA expression of plasminogen activator inhibitor-1 in livedoid vasculopathy lesions. Cardiovasc Ther 2017; 35. [DOI: 10.1111/1755-5922.12255] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 01/24/2017] [Accepted: 02/06/2017] [Indexed: 01/11/2023] Open
Affiliation(s)
- Mehmet Agirbasli
- Department of Cardiology; Faculty of Medicine; Medeniyet University; Istanbul Turkey
| | - Fatih Göktay
- Department of Dermatology; Haydarpasa Numune Training and Research Hospital, University of Health Sciences; Istanbul Turkey
| | - Irem Peker
- Department of Medical Biology; Faculty of Medicine; Marmara University; Istanbul Turkey
| | - Pembegul Gunes
- Department of Pathology; Haydarpasa Numune Training and Research Hospital, University of Health Sciences; Istanbul Turkey
| | - Fugen Vardar Aker
- Department of Pathology; Haydarpasa Numune Training and Research Hospital, University of Health Sciences; Istanbul Turkey
| | - Mustafa Akkiprik
- Department of Medical Biology; Faculty of Medicine; Marmara University; Istanbul Turkey
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31
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Ud-Din S, Bayat A. Non-animal models of wound healing in cutaneous repair: In silico, in vitro, ex vivo, and in vivo models of wounds and scars in human skin. Wound Repair Regen 2017; 25:164-176. [DOI: 10.1111/wrr.12513] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 12/15/2016] [Indexed: 01/08/2023]
Affiliation(s)
- Sara Ud-Din
- Plastic and Reconstructive Surgery Research, Centre for Dermatology Research; University of Manchester; Manchester United Kingdom
| | - Ardeshir Bayat
- Plastic and Reconstructive Surgery Research, Centre for Dermatology Research; University of Manchester; Manchester United Kingdom
- Bioengineering Research Group, School of Materials, Faculty of Engineering & Physical Sciences; The University of Manchester; Manchester United Kingdom
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Finnerty CC, Jeschke MG, Branski LK, Barret JP, Dziewulski P, Herndon DN. Hypertrophic scarring: the greatest unmet challenge after burn injury. Lancet 2016; 388:1427-1436. [PMID: 27707499 PMCID: PMC5380137 DOI: 10.1016/s0140-6736(16)31406-4] [Citation(s) in RCA: 355] [Impact Index Per Article: 44.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 08/05/2016] [Accepted: 08/09/2016] [Indexed: 12/21/2022]
Abstract
Improvements in acute burn care have enabled patients to survive massive burns that would have once been fatal. Now up to 70% of patients develop hypertrophic scars after burns. The functional and psychosocial sequelae remain a major rehabilitative challenge, decreasing quality of life and delaying reintegration into society. Approaches to optimise healing potential of burn wounds use targeted wound care and surgery to minimise the development of hypertrophic scarring. Such approaches often fail, and modulation of the established scar is continued although the optimal indication, timing, and combination of therapies have yet to be established. The need for novel treatments is paramount, and future efforts to improve outcomes and quality of life should include optimisation of wound healing to attenuate or prevent hypertrophic scarring, well-designed trials to confirm treatment efficacy, and further elucidation of molecular mechanisms to allow development of new preventive and therapeutic strategies.
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Affiliation(s)
- Celeste C Finnerty
- Department of Surgery, The University of Texas Medical Branch, Galveston, TX, USA; The Institute for Translational Sciences, The University of Texas Medical Branch, Galveston, TX, USA; the Sealy Center for Molecular Medicine, The University of Texas Medical Branch, Galveston, TX, USA; Shriners Hospitals for Children, Galveston, TX, USA.
| | - Marc G Jeschke
- Sunnybrook Research Institute, Toronto, ON, Canada; Division of Plastic Surgery Department of Surgery and Immunology, University of Toronto, ON, Canada; Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Ludwik K Branski
- Department of Surgery, The University of Texas Medical Branch, Galveston, TX, USA; Shriners Hospitals for Children, Galveston, TX, USA
| | - Juan P Barret
- Department of Plastic Surgery and Burns, University Hospital Vall d'Hebron, Barcelona, Spain
| | - Peter Dziewulski
- St Andrew's Centre for Burns and Plastic Surgery, Broomfield Hospital, Chelmsford, UK; StAAR Research Unit, Faculty of Medical Sciences, Anglia Ruskin University, Chelmsford, UK
| | - David N Herndon
- Department of Surgery, The University of Texas Medical Branch, Galveston, TX, USA; The Institute for Translational Sciences, The University of Texas Medical Branch, Galveston, TX, USA; Shriners Hospitals for Children, Galveston, TX, USA
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Bagabir RA, Syed F, Shenjere P, Paus R, Bayat A. Identification of a Potential Molecular Diagnostic Biomarker in Keloid Disease: Syndecan-1 (CD138) Is Overexpressed in Keloid Scar Tissue. J Invest Dermatol 2016; 136:2319-2323. [PMID: 27424317 DOI: 10.1016/j.jid.2016.06.623] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 06/18/2016] [Accepted: 06/20/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Rania A Bagabir
- Plastic and Reconstructive Surgery Research, University of Manchester, Manchester, UK; The Dermatology Centre, Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK; Department of Hematology and Immunology, Medical Faculty, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Farhatullah Syed
- Plastic and Reconstructive Surgery Research, University of Manchester, Manchester, UK; The Dermatology Centre, Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK; Institute of Child Health, Molecular and Cellular Immunology Unit, UCL, London, UK
| | - Patrick Shenjere
- Department of Histopathology, the Christie NHS Foundation Trust, Christie Hospital, Manchester, UK
| | - Ralf Paus
- The Dermatology Centre, Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Ardeshir Bayat
- Plastic and Reconstructive Surgery Research, University of Manchester, Manchester, UK; The Dermatology Centre, Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
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Functional testing of topical skin formulations using an optimised ex vivo skin organ culture model. Arch Dermatol Res 2016; 308:297-308. [PMID: 27086034 PMCID: PMC4902832 DOI: 10.1007/s00403-016-1645-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 02/25/2016] [Accepted: 03/30/2016] [Indexed: 12/11/2022]
Abstract
A number of equivalent-skin models are available for investigation of the ex vivo effect of topical application of drugs and cosmaceuticals onto skin, however many have their drawbacks. With the March 2013 ban on animal models for cosmetic testing of products or ingredients for sale in the EU, their utility for testing toxicity and effect on skin becomes more relevant. The aim of this study was to demonstrate proof of principle that altered expression of key gene and protein markers could be quantified in an optimised whole tissue biopsy culture model. Topical formulations containing green tea catechins (GTC) were investigated in a skin biopsy culture model (n = 11). Punch biopsies were harvested at 3, 7 and 10 days, and analysed using qRT-PCR, histology and HPLC to determine gene and protein expression, and transdermal delivery of compounds of interest. Reduced gene expression of α-SMA, fibronectin, mast cell tryptase, mast cell chymase, TGF-β1, CTGF and PAI-1 was observed after 7 and 10 days compared with treated controls (p < 0.05). Histological analysis indicated a reduction in mast cell tryptase and chymase positive cell numbers in treated biopsies compared with untreated controls at day 7 and day 10 (p < 0.05). Determination of transdermal uptake indicated that GTCs were detected in the biopsies. This model could be adapted to study a range of different topical formulations in both normal and diseased skin, negating the requirement for animal models in this context, prior to study in a clinical trial environment.
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35
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Bao Z, Gao P, Xia G, Wang Z, Kong M, Feng C, Cheng X, Liu Y, Chen X. A thermosensitive hydroxybutyl chitosan hydrogel as a potential co-delivery matrix for drugs on keloid inhibition. J Mater Chem B 2016; 4:3936-3944. [DOI: 10.1039/c6tb00378h] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A thermosensitive hydroxybutyl chitosan hydrogel could be used as a potential co-delivery matrix for drugs on keloid inhibition.
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Affiliation(s)
- Zixian Bao
- College of Marine Life Science
- Ocean University of China
- Qingdao 266003
- China
| | - Ping Gao
- College of Marine Life Science
- Ocean University of China
- Qingdao 266003
- China
| | - Guixue Xia
- College of Marine Life Science
- Ocean University of China
- Qingdao 266003
- China
| | - Zhiguo Wang
- Department of Plastic Surgery
- The Affiliated Hospital of Medical College Qingdao University
- Qingdao 266013
- China
| | - Ming Kong
- College of Marine Life Science
- Ocean University of China
- Qingdao 266003
- China
| | - Chao Feng
- College of Marine Life Science
- Ocean University of China
- Qingdao 266003
- China
| | - Xiaojie Cheng
- College of Marine Life Science
- Ocean University of China
- Qingdao 266003
- China
| | - Ya Liu
- College of Marine Life Science
- Ocean University of China
- Qingdao 266003
- China
| | - Xiguang Chen
- College of Marine Life Science
- Ocean University of China
- Qingdao 266003
- China
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Sidgwick GP, McGeorge D, Bayat A. A comprehensive evidence-based review on the role of topicals and dressings in the management of skin scarring. Arch Dermatol Res 2015; 307:461-77. [PMID: 26044054 PMCID: PMC4506744 DOI: 10.1007/s00403-015-1572-0] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 04/11/2015] [Accepted: 04/29/2015] [Indexed: 12/22/2022]
Abstract
Wound healing after dermal injury is an imperfect process, inevitably leading to scar formation as the skin re-establishes its integrity. The resulting scars have different characteristics to normal skin, ranging from fine-line asymptomatic scars to problematic scarring including hypertrophic and keloid scars. Scars appear as a different colour to the surrounding skin and can be flat, stretched, depressed or raised, manifesting a range of symptoms including inflammation, erythema, dryness and pruritus, which can result in significant psychosocial impact on patients and their quality of life. In this paper, a comprehensive literature review coupled with an analysis of levels of evidence (LOE) for each published treatment type was conducted. Topical treatments identified include imiquimod, mitomycin C and plant extracts such as onion extract, green tea, Aloe vera, vitamin E and D, applied to healing wounds, mature scar tissue or fibrotic scars following revision surgery, or in combination with other more established treatments such as steroid injections and silicone. In total, 39 articles were included, involving 1703 patients. There was limited clinical evidence to support their efficacy; the majority of articles (n = 23) were ranked as category 4 LOE, being of limited quality with individual flaws, including low patient numbers, poor randomisation, blinding, and short follow-up periods. As trials were performed in different settings, they were difficult to compare. In conclusion, there is an unmet clinical need for effective solutions to skin scarring, more robust long-term randomised trials and a consensus on a standardised treatment regime to address all aspects of scarring.
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Affiliation(s)
- G. P. Sidgwick
- />Plastic and Reconstructive Surgery Research, Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, Manchester Institute of Biotechnology, University of Manchester, 131 Princess Street, Manchester, M1 7DN UK
| | - D. McGeorge
- />Grosvenor Nuffield Hospital, Wrexham Road, Chester, CH4 7QP England, UK
| | - A. Bayat
- />Plastic and Reconstructive Surgery Research, Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, Manchester Institute of Biotechnology, University of Manchester, 131 Princess Street, Manchester, M1 7DN UK
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MiR-10a and miR-181c regulate collagen type I generation in hypertrophic scars by targeting PAI-1 and uPA. FEBS Lett 2014; 589:380-9. [DOI: 10.1016/j.febslet.2014.12.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Revised: 12/17/2014] [Accepted: 12/17/2014] [Indexed: 11/19/2022]
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Wang Y, Long J, Wang X, Sun Y. Association of the plasminogen activator inhibitor-1 (PAI-1) Gene -675 4G/5G and -844 A/G promoter polymorphism with risk of keloid in a Chinese Han population. Med Sci Monit 2014; 20:2069-73. [PMID: 25350781 PMCID: PMC4220586 DOI: 10.12659/msm.892397] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background A keloid is pathological scar caused by aberrant response to skin injuries, characterized by excessive accumulation of histological extracellular matrix, and occurs in genetically susceptible individuals. Plasminogen activator inhibitor-1 (PAI-1) has been implicated in the pathogenesis of keloid. We investigated the association between PAI-1 polymorphisms and plasma PAI-1 level with keloid risk. Material/Methods A total of 242 Chinese keloid patients and 207 controls were enrolled in this study. Polymerase chain reaction-restriction technique was used to determine PAI-1 promoter polymorphism (-675 4G/5G and -844 A/G) distribution. Plasma PAI-1 levels were detected using enzyme-linked immunosorbent assay (ELISA). Results There was a statistically significant difference in the distribution of PAI-1 -675 4G/5G polymorphism between keloid patients and healthy controls. 4G/4G carriers were more likely to develop keloid. In contrast, the -844 A/G polymorphism distribution did not vary significantly between keloid patients and controls. The keloid patients group had a significantly higher plasma PAI-1 level than the control group. In the -675 4G/4G carrier population, the plasma PAI-1 levels were significant higher in keloid patients compared with controls. Conclusions Our study provides evidence that PAI-1 promoter polymorphism -675 4G/5G and plasma PAI-1 level are associated with keloid risk. PAI-1 -675 4G/5G polymorphism may be an important hereditary factor responsible for keloid development in the Chinese Han population.
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Affiliation(s)
- Yongjie Wang
- Department of Plastic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Jianhong Long
- Department of Plastic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Xiaoyan Wang
- Department of Burns, Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Yang Sun
- Department of Plastic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
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Sun LM, Wang KH, Lee YCG. Keloid incidence in Asian people and its comorbidity with other fibrosis-related diseases: a nationwide population-based study. Arch Dermatol Res 2014; 306:803-8. [PMID: 25081927 DOI: 10.1007/s00403-014-1491-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 07/15/2014] [Accepted: 07/18/2014] [Indexed: 01/09/2023]
Abstract
Keloids is a fibroproliferative disease. The incidence of keloids among Asians has not been thoroughly studied. The objective of this study is to determine the incidence of keloids in Taiwan, which mainly consists of ethnic Chinese. Furthermore, we want to determine the comorbidity rate of other fibrosis-related diseases among keloid patients. This study was based on the National Health Insurance Research Database, which contains the data of 1 million randomly selected patients. Multivariate logistic regression analyses were employed to estimate the relative odds of keloids as a function of fibrosis-related diseases. The annual keloid incidence rate in Taiwan was 0.15 % for the general population. With a 1.33 ratio, women outnumbered men. Women with uterine leiomyoma have a 2.25-fold greater risk of keloids, compared with women without leiomyoma. We concluded that keloid incidence in Taiwan is approximately 0.15 %. Women with leiomyoma have a greater risk of keloids, this implicates that both diseases share a common etiopathological pathway.
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Affiliation(s)
- Lei-Ming Sun
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, No. 250, Wuxin St., Taipei, 11031, Taiwan
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Gao Y, Cheng X, Wang Z, Wang J, Gao T, Li P, Kong M, Chen X. Transdermal delivery of 10,11-methylenedioxycamptothecin by hyaluronic acid based nanoemulsion for inhibition of keloid fibroblast. Carbohydr Polym 2014; 112:376-86. [PMID: 25129757 DOI: 10.1016/j.carbpol.2014.05.026] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 05/03/2014] [Accepted: 05/05/2014] [Indexed: 11/27/2022]
Abstract
This study designs an alternative transdermal delivery system for 10,11-methylenedioxycamptothecin(MD-CPT) to inhibit keloid. Hyaluronic acid nanoemulsions (HANs) with nano size, negative charge and good stability were prepared as transdermal carriers. The MD-CPT loaded HANs performed desirable skin permeable capacity across human keloid skin and the drug was transferred directly to keloid lesion area. MD-CPT was delivered percutaneously higher than the control group. FITC-HANs could be successfully internalized by keloid fibroblast (KF) and deliver MD-CPT toward nucleus, inhibited the proliferation of KF, while there was no serious toxicity to normal skin fibroblasts. The growth-inhibitory effect was further clarified upon cell cycle regulation, which arrested cells at G1/S and prevented them entry into mitosis. KF gene expression demonstrated plasminogen activator inhibitor-1 (PAI-1) was significantly down-regulated and Smad7 up-regulated, which was beneficial to inhibit keloid. The study demonstrated that as transdermal delivery of MD-CPT by HANs has potential for inhibition of keloid fibroblast.
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Affiliation(s)
- Yuanyuan Gao
- College of Marine Life Science, Ocean University of China, Yushan Road, Qingdao 266003, Shandong, China
| | - Xiaojie Cheng
- College of Marine Life Science, Ocean University of China, Yushan Road, Qingdao 266003, Shandong, China
| | - Zhiguo Wang
- Department of Plastic Surgery, The Affiliated Hospital of Medical College Qingdao University, Qingdao 266013, Shandong, China
| | - Juan Wang
- College of Marine Life Science, Ocean University of China, Yushan Road, Qingdao 266003, Shandong, China
| | - Tingting Gao
- College of Marine Life Science, Ocean University of China, Yushan Road, Qingdao 266003, Shandong, China
| | - Peng Li
- Department of Plastic Surgery, The Affiliated Hospital of Medical College Qingdao University, Qingdao 266013, Shandong, China
| | - Ming Kong
- College of Marine Life Science, Ocean University of China, Yushan Road, Qingdao 266003, Shandong, China.
| | - Xiguang Chen
- College of Marine Life Science, Ocean University of China, Yushan Road, Qingdao 266003, Shandong, China.
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