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Fernández-Guarino M, Hernández-Bule ML, Bacci S. Cellular and Molecular Processes in Wound Healing. Biomedicines 2023; 11:2526. [PMID: 37760967 PMCID: PMC10525842 DOI: 10.3390/biomedicines11092526] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 09/10/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
This review summarizes the recent knowledge of the cellular and molecular processes that occur during wound healing. However, these biological mechanisms have yet to be defined in detail; this is demonstrated by the fact that alterations of events to pathological states, such as keloids, consisting of the excessive formation of scars, have consequences yet to be defined in detail. Attention is also dedicated to new therapies proposed for these kinds of pathologies. Awareness of these scientific problems is important for experts of various disciplines who are confronted with these kinds of presentations daily.
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Affiliation(s)
- Montserrat Fernández-Guarino
- Dermatology Service, Hospital Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (Irycis), 28034 Madrid, Spain;
| | - Maria Luisa Hernández-Bule
- Bioelectromagnetic Lab, Hospital Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (Irycis), 28034 Madrid, Spain;
| | - Stefano Bacci
- Research Unit of Histology and Embriology, Department of Biology, University of Florence, Viale Pieraccini 6, 50134 Firenze, Italy
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Cohen L, Brodsky MA, Zubair R, Kohli I, Hamzavi IH, Sadeghpour M. Cutaneous interaction with visible light: What do we know? J Am Acad Dermatol 2023; 89:560-568. [PMID: 32289393 DOI: 10.1016/j.jaad.2020.03.115] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 03/25/2020] [Accepted: 03/31/2020] [Indexed: 10/24/2022]
Abstract
Visible light has been used therapeutically in dermatology for years for a variety of cosmetic and medical indications, including skin rejuvenation and the treatment of inflammatory and neoplastic conditions, among others. Until recently, visible light was thought to be relatively inert compared to its spectral neighbors, ultraviolet and infrared radiation. However, recent literature has described the ability of visible light to cause erythema in light skin and pigmentary changes in individuals with darker skin types. Concern surrounding its potentially damaging cutaneous effects has been raised in both the medical community and social media outlets. In this article, we provide an evidenced-based review describing what is currently known about visible light, focusing on its role in dermatologic diseases including disorders of hyperpigmentation such as melasma and postinflammatory hyperpigmentation.
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Affiliation(s)
- Leah Cohen
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Raheel Zubair
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - Indermeet Kohli
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
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Ivanova Z, Aleksiev T, Dobrev H, Atanasov N. Use of a novel indentometer to evaluate skin stiffness in healthy and diseased human skin. Skin Res Technol 2023; 29:e13384. [PMID: 37522487 PMCID: PMC10339004 DOI: 10.1111/srt.13384] [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: 01/02/2023] [Accepted: 05/25/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Mechanical behavior of the skin can be evaluated by different non-invasive methods. In this study, we applied a new measurement device based on indentometry to determine the skin mechanical properties in healthy individuals and in patients with systemic sclerosis (SSc). MATERIAL AND METHODS Three studies were performed. Study 1 included 100 healthy individuals (46 male and 54 female) divided into four age groups with mean ages of 21.5, 28.9, 51.2, and 69.3 years, respectively. Test sites were located on the center of the forehead and the middle of both volar forearms. Study 2 included 16 healthy individuals (two males and 14 females). Test sites were on both volar forearms. Measurements were made before and after the application of Vaseline and emulsion with 12% urea. Study 3 included 20 patients (one male and 19 females) with SSc and 60 age-matched healthy individuals (23 males and 37 females). Test sites were on the center of the forehead and the middle of both volar forearms. Skin stiffness was measured with skin Indentometer IDM 800 (Courage + Khazaka, Cologne, Germany) equipped with two probes with pin diameters of 3 and 5 mm, respectively. The stiffer the skin, the less deep the displacement by the indenter. The smaller the diameter, the deeper the pin will go into the skin when using the same force. In addition, the Corneometer CM 820 (Courage + Khazaka) was used to determine epidermal water content in study 2. RESULTS Indentometric (IDM) values of healthy subjects measured with both probes were lower on the forehead compared to volar forearms. There was no significant difference between both forearms. In all age groups, the IDM values on the male forearms were lower than on the female forearms whereas there was no significant difference on the forehead. In both sex and on all test locations a significant positive correlation between age and IDM values measured with both probes was observed. There was a significant positive correlation between IDM values measured with both probes. The application of moisturizers induced significant changes in epidermal water content whereas the IDM values remained unchanged. At both the forehead and volar forearms, the IDM values in patients with SSc were significantly lower compared to the healthy control skin. CONCLUSION The non-invasive indentometric method used can successfully distinguish the changes in normal skin mechanical properties related to age, sex, and anatomical location, as well as in patients with SSc. The method is not appropriate to study the changes related to epidermal hydration.
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Affiliation(s)
- Zlatina Ivanova
- Department of Dermatology and Venereology, Medical FacultyMedical UniversityPlovdivBulgaria
| | - Teodor Aleksiev
- Department of Dermatology and Venereology, Medical FacultyMedical UniversityPlovdivBulgaria
| | - Hristo Dobrev
- Department of Dermatology and Venereology, Medical FacultyMedical UniversityPlovdivBulgaria
| | - Nikolay Atanasov
- Department of Health Management and Health Economics, Faculty of Public HealthMedical UniversityPlovdivBulgaria
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Kim YH, Kim HK, Choi JW, Kim YC. Photobiomodulation therapy with an 830-nm light-emitting diode for the prevention of thyroidectomy scars: a randomized, double-blind, sham device-controlled clinical trial. Lasers Med Sci 2022; 37:3583-3590. [PMID: 36045183 DOI: 10.1007/s10103-022-03637-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 08/22/2022] [Indexed: 10/14/2022]
Abstract
This randomized, double-blind, and sham device-controlled trial aimed to evaluate the efficacy and safety of home-based photobiomodulation therapy using an 830-nm light-emitting diode (LED)-based device for the prevention of and pain relief from thyroidectomy scars. Participants were randomized to receive photobiomodulation therapy using an LED device or a sham device without an LED from 1 week postoperatively for 4 weeks. Scars were assessed using satisfaction scores, the numeric rating scale (NRS) score for pain, Global Assessment Scale (GAS), and Vancouver Scar Scale (VSS) scores. The scars were also assessed using a three-dimensional (3D) skin imaging device to detect color, height, pigmentation, and vascularity. Assessments were performed at the 1-, 3-, and 6-month follow-ups. Forty-three patients completed this trial with 21 patients in the treatment group and 22 patients in the control group. The treatment group showed significantly higher patient satisfaction and GAS scores and lower NRS and VSS scores than the control group at 6 months. Improvements in color variation, height, pigmentation, and vascularity at 6 months were greater in the treatment group than in the control group, although the differences were not significant. In conclusion, early application of 830-nm LED-based photobiomodulation treatment significantly prevents hypertrophic scar formation and reduces postoperative pain without noticeable adverse effects.
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Affiliation(s)
- Yul Hee Kim
- Department of Dermatology, School of Medicine, Ajou University, 164, World cup-ro, Yeongtong-gu, Suwon-si, Gyeonggi-do, Republic of Korea.,Department of Medical Sciences, Graduate School of Ajou University, Suwon, Korea
| | - Hyeung Kyoo Kim
- Department of Surgery, School of Medicine, Ajou University, Suwon, Korea
| | - Jee Woong Choi
- Department of Dermatology, School of Medicine, Ajou University, 164, World cup-ro, Yeongtong-gu, Suwon-si, Gyeonggi-do, Republic of Korea
| | - You Chan Kim
- Department of Dermatology, School of Medicine, Ajou University, 164, World cup-ro, Yeongtong-gu, Suwon-si, Gyeonggi-do, Republic of Korea.
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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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Urda A, Radu T, Socaci C, Floare-Avram V, Cosma D, Rosu MC, Coros M, Pruneanu S, Pogacean F. Evaluation of N-doped graphene role in the visible-light driven photodegradation of sulfamethoxazole by a TiO2-silver-graphene composite. J Photochem Photobiol A Chem 2022. [DOI: 10.1016/j.jphotochem.2021.113701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Suciu M, Porav S, Radu T, Rosu MC, Lazar MD, Macavei S, Socaci C. Photodynamic effect of light emitting diodes on E. coli and human skin cells induced by a graphene-based ternary composite. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2021; 223:112298. [PMID: 34474299 DOI: 10.1016/j.jphotobiol.2021.112298] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 08/17/2021] [Accepted: 08/18/2021] [Indexed: 01/10/2023]
Abstract
In this paper, the photodynamic effect of a ternary nanocomposite (TiO2-Ag/graphene) on Escherichia coli bacteria and two human cell lines: A375 (melanoma) and HaCaT (keratinocyte) after exposure to different wavelength domains (blue, green or red-Light Emitting Diode, LED) was analyzed. The results obtained through bioassays were correlated with the morphological, structural and spectral data obtained through FT-IR, XPS and UV-Vis spectroscopy, powder X-Ray diffractometry (XRD) and STEM/EDX techniques, leading to conclusions that showed different photodynamic activation mechanisms and effects on bacteria and human cells, depending on the wavelength. The nanocomposite proved a therapeutic potential for blue light-activated antibacterial treatment and revealed a keratinocyte cytotoxic effect under blue and green LEDs. The red light-nanocomposite duo gave a metabolic boost to normal keratinocytes and induced stasis to melanoma cells. The light and nanocomposite combination could be a potential therapy for bacterial keratosis or for skin tumors.
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Affiliation(s)
- Maria Suciu
- National Institute for Research and Development of Isotopic and Molecular Technologies, Donat 67-103 Str., RO-400293 Cluj-Napoca, Romania; Biology and Geology Faculty, Babes-Bolyai University, 5-7 Clinicilor Str, Cluj-Napoca, Romania
| | - Sebastian Porav
- National Institute for Research and Development of Isotopic and Molecular Technologies, Donat 67-103 Str., RO-400293 Cluj-Napoca, Romania
| | - Teodora Radu
- National Institute for Research and Development of Isotopic and Molecular Technologies, Donat 67-103 Str., RO-400293 Cluj-Napoca, Romania
| | - Marcela C Rosu
- National Institute for Research and Development of Isotopic and Molecular Technologies, Donat 67-103 Str., RO-400293 Cluj-Napoca, Romania
| | - Mihaela D Lazar
- National Institute for Research and Development of Isotopic and Molecular Technologies, Donat 67-103 Str., RO-400293 Cluj-Napoca, Romania
| | - Sergiu Macavei
- National Institute for Research and Development of Isotopic and Molecular Technologies, Donat 67-103 Str., RO-400293 Cluj-Napoca, Romania
| | - Crina Socaci
- National Institute for Research and Development of Isotopic and Molecular Technologies, Donat 67-103 Str., RO-400293 Cluj-Napoca, Romania.
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Kurtti A, Nguyen JK, Weedon J, Mamalis A, Lai Y, Masub N, Geisler A, Siegel DM, Jagdeo JR. Light emitting diode-red light for reduction of post-surgical scarring: Results from a dose-ranging, split-face, randomized controlled trial. JOURNAL OF BIOPHOTONICS 2021; 14:e202100073. [PMID: 33788987 PMCID: PMC8919713 DOI: 10.1002/jbio.202100073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/19/2021] [Accepted: 03/29/2021] [Indexed: 06/12/2023]
Abstract
Scarring has significant esthetic and functional consequences for patients. A need exists for anti-scarring therapeutics. Light emitting diode-red light (LED-RL) has been shown to modulate skin fibrosis. The aim of this study is to evaluate the safety and efficacy of LED-RL to reduce post-operative scarring. Cutaneous Understanding of Red-light Efficacy on Scarring was a randomized, mock-controlled, single-blind, dose-ranging, split-face phase II clinical trial. Starting 1 week post-surgery, patients received LED-RL irradiation and temperature-controlled mock therapy to incision sites at fluences of 160, 320 or 480 J/cm2 , triweekly for 3 weeks. Efficacy was assessed at 1, 3 and 6-12 months. The primary endpoint was difference in scar pliability between LED-RL-treated and control sites. Secondary outcomes included Patient and Observer Scar Assessment Scale, collagen and water concentration, and adverse events. There were no significant differences in scar pliability between treated and control scars. At certain fluences, treated scars showed greater improvements in observer rating and scar pliability, reflected by greater reductions in induration, from baseline to 6 months compared to control scars. Treatment-site adverse events included blistering (n = 2) and swelling (n = 1), which were mild and resolved without sequelae. LED-RL phototherapy is safe in the early postoperative period and may reduce scarring.
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Affiliation(s)
- Alana Kurtti
- Rutgers Robert Wood Johnson Medical School, Piscataway, NJ
- Dermatology Service, VA New York Harbor Healthcare System, Brooklyn, NY
| | - Julie K. Nguyen
- Dermatology Service, VA New York Harbor Healthcare System, Brooklyn, NY
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY
| | - Jeremy Weedon
- Office of the SVP for Research, SUNY Downstate Health Sciences University, Brooklyn, NY
| | - Andrew Mamalis
- Department of Dermatology, The Permanente Medical Group, Modesto, CA
| | - Yi Lai
- Dermatology Service, VA New York Harbor Healthcare System, Brooklyn, NY
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY
| | - Natasha Masub
- Dermatology Service, VA New York Harbor Healthcare System, Brooklyn, NY
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY
| | - Amaris Geisler
- Dermatology Service, VA New York Harbor Healthcare System, Brooklyn, NY
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY
| | - Daniel M. Siegel
- Dermatology Service, VA New York Harbor Healthcare System, Brooklyn, NY
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY
| | - Jared R. Jagdeo
- Dermatology Service, VA New York Harbor Healthcare System, Brooklyn, NY
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY
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Masub N, Austin E, Huang A, Jagdeo J. High-fluence light emitting diode-red light inhibits cell cycle progression in human dermal fibroblasts. JOURNAL OF BIOPHOTONICS 2021; 14:e202000359. [PMID: 33038043 PMCID: PMC8935855 DOI: 10.1002/jbio.202000359] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/02/2020] [Accepted: 10/04/2020] [Indexed: 05/11/2023]
Abstract
Skin fibrosis is a debilitating feature of several systemic and dermatologic diseases. While current treatment options carry significant risk of side effects and recurrence, high-fluence light emitting diode-generated red light (LED-RL) is an alternative therapeutic that is safe, non-invasive, and accessible. We previously demonstrated LED-RL decreases fibroblast proliferation, a key pathogenic component of fibrosis. However, the cellular mechanism by which high fluence LED-RL modulates fibroblast proliferation is unclear. Herein, we explored the effects of high fluence LED-RL on human dermal fibroblast cell cycle progression. We demonstrate that LED-RL at 640 J/cm2 induced significant arrest of cells in G0 /G1 compared to temperature-matched control. This was accompanied by a corresponding increase in expression of checkpoint regulator p53 in irradiated cells. These data demonstrate high fluence LED-RL may exert its anti-proliferative effect on fibroblasts by inducing G0 /G1 arrest. Further, this study provides insight into the molecular mechanism underlying LED-RL as an anti-fibrotic therapeutic.
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Affiliation(s)
- Natasha Masub
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, NY
| | - Evan Austin
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, NY
| | - Alisen Huang
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, NY
| | - Jared Jagdeo
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, NY
- Dermatology Service, VA New York Harbor Healthcare System – Brooklyn Campus, Brooklyn, NY
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Gerkowicz A, Bartosińska J, Wolska-Gawron K, Michalska-Jakubus M, Kwaśny M, Krasowska D. Application of superluminescent diodes (sLED) in the treatment of scarring alopecia – A pilot study. Photodiagnosis Photodyn Ther 2019; 28:195-200. [DOI: 10.1016/j.pdpdt.2019.09.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 09/08/2019] [Accepted: 09/19/2019] [Indexed: 12/19/2022]
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