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Turunen JA, Tuisku IS, Repo P, Mörtenhumer S, Kawan S, Järvinen RS, Korsbäck A, Immonen AT, Kivelä TT. Epithelial recurrent erosion dystrophy (ERED) from the splice site altering COL17A1 variant c.3156C>T in families of Finnish-Swedish ancestry. Acta Ophthalmol 2024; 102:296-305. [PMID: 37289141 DOI: 10.1111/aos.15716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/05/2023] [Accepted: 05/17/2023] [Indexed: 06/09/2023]
Abstract
PURPOSE To describe four Finnish families with epithelial recurrent erosion dystrophy (ERED) caused by the pathogenic variant c.3156C>T in collagen type XVII alpha 1 chain gene (COL17A1). METHODS Eleven affected and two unaffected individuals underwent clinical ophthalmological examination, anterior segment photography, and corneal topography. Two of them underwent phototherapeutic keratectomy (PTK). Genetic analysis included both next-generation and Sanger sequencing. Specimens from the manual keratectomy of one patient were available for ophthalmic pathologic examination, including immunohistochemistry. RESULTS The common splice-site altering synonymous variant c.3156C > T, p.(Gly1052=) in COL17A1 was confirmed in 15 individuals with ERED from the four families. Subepithelial corneal scarring grades varied and increased with age, leading to decreased best-corrected visual acuity. PTK improved vision in 58- and 67-year-old individuals without reactivating the disease. The keratectomy specimens showed an uneven epithelium and a spectrum of basement membrane abnormalities, including breaks, fragmentation, multiplication and entrapment within the subepithelial scar, reflecting recurrent erosions. The stromal cells consisted of varying proportions of bland and activated fibroblasts and myofibroblasts, reflecting different ages of scars. The family with the largest number of known affected generations originated from Southern Sweden. CONCLUSION The phenotype in the Finnish ERED families is consistent with earlier reports of the c.3156C > T variant, although the severity has varied between reports. The phenotype may be modulated by other genes. This study suggests a likely founder effect of the variant in both Finnish and Swedish populations due to their shared population histories. If vision is compromised, PTK can be considered especially in older patients.
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Affiliation(s)
- Joni A Turunen
- Ophthalmic Genetics Service, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Eye Genetics Group, Folkhälsan Research Center, Helsinki, Finland
| | - Ilpo S Tuisku
- Cornea and Anterior Segment Surgery Service, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Pauliina Repo
- Ophthalmic Genetics Service, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Eye Genetics Group, Folkhälsan Research Center, Helsinki, Finland
| | - Sanna Mörtenhumer
- Cornea and Anterior Segment Surgery Service, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Sabita Kawan
- Eye Genetics Group, Folkhälsan Research Center, Helsinki, Finland
| | | | - Anna Korsbäck
- Cornea and Anterior Segment Surgery Service, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Annamari T Immonen
- Eye Genetics Group, Folkhälsan Research Center, Helsinki, Finland
- Cornea and Anterior Segment Surgery Service, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tero T Kivelä
- Ophthalmic Pathology Laboratory, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Pathology, HUSLAB, Helsinki, Finland
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Hameedi SG, Saulsbery A, Olutoye OO. The Pathophysiology and Management of Pathologic Scarring-a Contemporary Review. Adv Wound Care (New Rochelle) 2024. [PMID: 38545753 DOI: 10.1089/wound.2023.0185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Abstract
Significance: Pathologic scarring occurs secondary to imbalances in the cellular mechanisms of wound healing and affects millions of people annually. This review article aims to provide a concise overview of the pathophysiology and management of pathologic scarring for clinicians and scientists alike. Recent Advances: Contemporary research in the field has identified aberrations in transforming growth factor-β/small mothers against decapentaplegic (TGF-β/SMAD) signaling pathways as key drivers of pathologic scar formation; indeed, this pathway is targeted by many treatment modalities and translational investigations currently underway. Although intralesional injection of corticosteroids has been the gold standard in the treatment of pathologic scarring, studies show greater treatment efficacy with the use of combination injections such as triamcinolone/5-fluorouracil and triamcinolone/botulinum toxin. Adjunctive therapies including ablative fractional carbon dioxide/erbium-doped yttrium aluminum garnet and non-ablative pulsed-dye lasers, microneedling, and carboxytherapy have shown encouraging results in small cohort studies. Translational investigations involving the use of nanogels, RNA interference, and small molecules targeting TGF-β/SMAD pathways are also currently underway and hold promise for the future. Critical Issues: The heterogeneous nature of hypertrophic scars and keloids poses significant challenges in formulating standardized treatment and assessment protocols, thereby limiting the conclusions that can be drawn. Future Directions: Rigorous clinical trials into the individual and synergistic effects of these therapies would be ideal before any definitive conclusions or evidence-based treatment recommendations can be made. Owing to the heterogeneity of the pathology and patient population, well-conducted cohort studies may be the next best option.
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Affiliation(s)
- Sophia G Hameedi
- Center for Regenerative Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Angela Saulsbery
- Center for Regenerative Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Oluyinka O Olutoye
- Center for Regenerative Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Surgery, The Ohio State University, Columbus, Ohio, USA
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Díaz-Hurtado D, Etxart-Lasa MP, Izaga-González O, Lodoso-Gibaja L, Larramendi-Fernández MTRD, Riaño-Fernández I. Effect of a topical silicone gel and a polyurethane dressing on the evolution of scars. Enferm Clin (Engl Ed) 2024:S2445-1479(24)00036-5. [PMID: 38642837 DOI: 10.1016/j.enfcle.2024.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/11/2024] [Accepted: 02/12/2024] [Indexed: 04/22/2024]
Abstract
OBJECTIVE To assess the effectiveness and safety of a topical silicone gel (BE + Gel reductor y reparador de cicatrices) and a polyurethane dressing (BE + Apósito reductor y reparador de cicatrices) on the evolution of scars of patients who were previously recruited in the emergency care unit while seeking wound care. METHOD A single center, stratified observational, open label study was performed in the emergency care unit of Donostia Universitary Hospital (recruitment) and in the Biodonostia Health Research Institute (intervention). Scars located in unexposed body areas with the dressing, and scars located in exposed areas with either the gel or the dressing. Investigators assessed interventions at day 1 and on weeks 4, 8 and 12. Vancouver Scar Scale (VSS) and a photographical assessment were used to determine the scars evolution, and the subjective perception of the scar was evaluated by means of a questionnaire administered to the patients. RESULTS Patients whose scars were treated with the silicone gel had an average initial VSS score of 5.4 ± 2.08. This value was reduced to 0.86 ± 1.17 after 90 days of treatment. Patients treated with the polyurethane dressing had an average initial VSS score of 5.8 ± 2.29. After 90 days of treatment, this average score was reduced to 0.33 ± 0.66. Positive evolution of scars was also supported by photographs and by a patient questionnaire. CONCLUSIONS Both treatments appear to be safe and effective, objectively, and subjectively, in the context of scar evolution.
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Affiliation(s)
- David Díaz-Hurtado
- Unidad de Urgencias, Hospital Universitario de Donostia, Osakidetza, San Sebastián, Spain; Instituto de Investigación Sanitaria Biodonostia, Plataforma de Investigación Clínica, San Sebastián, Spain.
| | - María Pilar Etxart-Lasa
- Instituto de Investigación Sanitaria Biodonostia, Plataforma de Investigación Clínica, San Sebastián, Spain
| | - Oihane Izaga-González
- Unidad de Urgencias, Hospital Universitario de Donostia, Osakidetza, San Sebastián, Spain
| | - Leire Lodoso-Gibaja
- Unidad de Urgencias, Hospital Universitario de Donostia, Osakidetza, San Sebastián, Spain
| | | | - Ioana Riaño-Fernández
- Instituto de Investigación Sanitaria Biodonostia, Plataforma de Investigación Clínica, San Sebastián, Spain
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Cho H, Dohi T, Wakai H, Quong WL, Linh NDT, Usami S, Ogawa R. In the face and neck, keloid scar distribution is related to skin thickness and stiffness changes associated with movement. Wound Repair Regen 2024. [PMID: 38602106 DOI: 10.1111/wrr.13180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 02/25/2024] [Accepted: 04/01/2024] [Indexed: 04/12/2024]
Abstract
Keloid scars tend to occur in high-tension sites due to mechanical stimuli that are involved in their development. To date, a detailed analysis of keloid distribution focused specifically on facial and neck areas has not been reported, and limited literature exists as to the related mechanical factors. To rectify this deficiency of knowledge, we first quantified the facial and neck keloid distribution observed clinically in 113 patients. Subsequently, we performed a rigorous investigation into the mechanical factors and their associated changes at these anatomic sites in healthy volunteers without a history of pathologic scarring. The association between keloid-predilection sites and sebaceous gland-dense and acne-prone sites was also examined. To assess skin stretch, thickness and stiffness, VECTRA, ultrasound and indentometer were utilised. Baseline skin stiffness and thickness were measured, as well as the magnitude of change in these values associated with facial expression and postural changes. Within the face and neck, keloids were most common near the mandibular angle (41.3%) and lateral submental (20.0%) regions. These areas of increased keloid incidence were not associated with areas more dense in sebaceous glands, nor linked consistently with acne-susceptible regions. Binomial logistic regression revealed that changes in skin stiffness and thickness related to postural changes significantly predicted keloid distribution. Skin stiffness and thickness changes related to prolonged mechanical forces (postural changes) are most pronounced at sites of high keloid predilection. This finding further elucidates the means by which skin stretch and tension are related to keloid development. As a more detailed analysis of mechanical forces on facial and neck skin, this study evaluates the nuances of multiple skin-mechanical properties, and their changes in a three-dimensional framework. Such factors may be critical to better understanding keloid progression and development in the face and neck.
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Affiliation(s)
- Hoyu Cho
- Department of Plastic, Reconstructive and Regenerative Surgery, Nippon Medical School, Tokyo, Japan
| | - Teruyuki Dohi
- Department of Plastic, Reconstructive and Regenerative Surgery, Nippon Medical School, Tokyo, Japan
| | - Hanae Wakai
- Department of Plastic, Reconstructive and Regenerative Surgery, Nippon Medical School, Tokyo, Japan
| | - Whitney Laurel Quong
- Department of Plastic, Reconstructive and Regenerative Surgery, Nippon Medical School, Tokyo, Japan
- Department of Plastic, Reconstructive, and Aesthetic Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Nguyen Doan Tien Linh
- Department of Plastic, Reconstructive and Regenerative Surgery, Nippon Medical School, Tokyo, Japan
| | - Satoshi Usami
- Department of Plastic, Reconstructive and Regenerative Surgery, Nippon Medical School, Tokyo, Japan
- Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Rei Ogawa
- Department of Plastic, Reconstructive and Regenerative Surgery, Nippon Medical School, Tokyo, Japan
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Jiang Z, Chen Z, Xu Y, Li H, Li Y, Peng L, Shan H, Liu X, Wu H, Wu L, Jian D, Su J, Chen X, Chen Z, Zhao S. Low-Frequency Ultrasound Sensitive Piezo1 Channels Regulate Keloid-Related Characteristics of Fibroblasts. Adv Sci (Weinh) 2024; 11:e2305489. [PMID: 38311578 PMCID: PMC11005750 DOI: 10.1002/advs.202305489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 01/16/2024] [Indexed: 02/06/2024]
Abstract
Keloids are benign fibroproliferative tumors that severely diminish the quality of life due to discomfort, dysfunction, and disfigurement. Recently, ultrasound technology as a noninvasive adjuvant therapy is developed to optimize treatment protocols. However, the biophysical mechanisms have not yet been fully elucidated. Here, it is proposed that piezo-type mechanosensitive ion channel component 1 (Piezo1) plays an important role in low-frequency sonophoresis (LFS) induced mechanical transduction pathways that trigger downstream cellular signaling processes. It is demonstrated that patient-derived primary keloid fibroblasts (PKF), NIH 3T3, and HFF-1 cell migration are inhibited, and PKF apoptosis is significantly increased by LFS stimulation. And the effects of LFS is diminished by the application of GsMTx-4, the selective inhibitor of Piezo1, and the knockdown of Piezo1. More importantly, the effects of LFS can be imitated by Yoda1, an agonist of Piezo1 channels. Establishing a patient-derived xenograft keloid implantation mouse model further verified these results, as LFS significantly decreased the volume and weight of the keloids. Moreover, blocking the Piezo1 channel impaired the effectiveness of LFS treatment. These results suggest that LFS inhibits the malignant characteristics of keloids by activating the Piezo1 channel, thus providing a theoretical basis for improving the clinical treatment of keloids.
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Lohasammakul S, Jyot A, Chaiyasate K. An approach to achieve tension-free closure and mitigate recurrence in the management of recurrent cervical keloids. J Surg Case Rep 2024; 2024:rjae222. [PMID: 38605696 PMCID: PMC11007642 DOI: 10.1093/jscr/rjae222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 03/17/2024] [Accepted: 03/19/2024] [Indexed: 04/13/2024] Open
Abstract
Keloid is a burdensome condition that negatively affects patient's quality of life. It is influenced by a spectrum of risk factors, including tension. We propose an approach to address the tension-free closure and optimize surgical outcomes in neck keloid. A retrospective review of neck keloid patients who underwent surgical treatment between 2014 and 2022 was performed. Five patients underwent surgical interventions. Two patients had sufficient and three had insufficient tissue redundancy. The former underwent keloid excision with tension-free closure. The latter underwent keloid excision with full thickness skin graft for tension-free closure. One patient required re-excision with free flap coverage. All patients received postoperative low dose radiation. All patients were satisfied with the results and there were no signs of keloid recurrence during the follow-up period. Tension during closure following keloid excision is a modifiable risk factor. An appropriate algorithm providing tension-free closure can minimize the recurrence.
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Affiliation(s)
- Suphalerk Lohasammakul
- Department of Anatomy, Faculty of Medicine Siriraj Hospital, 2 Thanon Wang Lang, Bangkok Noi, Bangkok 10700, Thailand
- Department of Plastic and Reconstructive Surgery, Corewell Health East William Beaumont University Hospital, 3555 W 13 Mile Road Suite N120, Royal Oak, MI 48073, United States
| | - Apram Jyot
- Department of Plastic and Reconstructive Surgery, Corewell Health East William Beaumont University Hospital, 3555 W 13 Mile Road Suite N120, Royal Oak, MI 48073, United States
| | - Kongkrit Chaiyasate
- Department of Plastic and Reconstructive Surgery, Corewell Health East William Beaumont University Hospital, 3555 W 13 Mile Road Suite N120, Royal Oak, MI 48073, United States
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Tan Q, Xu J, Xu W, Lu H. Surgery and superficial x-ray radiotherapy for keloids of the preauricular and contralateral ear lobe: Case report. Clin Case Rep 2024; 12:e8657. [PMID: 38560287 PMCID: PMC10980782 DOI: 10.1002/ccr3.8657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 02/24/2024] [Accepted: 03/01/2024] [Indexed: 04/04/2024] Open
Abstract
The combined approach of surgical resection along with superficial x-ray radiotherapy emerges as a superior treatment option for individuals with keloids, which hold huge potential for enhancing aesthetic outcomes and preventing keloid recurrence.
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Affiliation(s)
- Qin Tan
- Department of DermatologyChongqing Traditional Chinese Medicine HospitalChongqingChina
| | - JinHui Xu
- Department of DermatologyChongqing Traditional Chinese Medicine HospitalChongqingChina
| | - Wei Xu
- Department of DermatologyChongqing Traditional Chinese Medicine HospitalChongqingChina
| | - Hao Lu
- Department of DermatologyChongqing Traditional Chinese Medicine HospitalChongqingChina
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Yeo E, Shim J, Oh SJ, Choi Y, Noh H, Kim H, Park JH, Lee KT, Kim SH, Lee D, Lee JH. Revisiting roles of mast cells and neural cells in keloid: exploring their connection to disease activity. Front Immunol 2024; 15:1339336. [PMID: 38524141 PMCID: PMC10957560 DOI: 10.3389/fimmu.2024.1339336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 02/19/2024] [Indexed: 03/26/2024] Open
Abstract
Background Mast cells (MCs) and neural cells (NCs) are important in a keloid microenvironment. They might contribute to fibrosis and pain sensation within the keloid. However, their involvement in pathological excessive scarring has not been adequately explored. Objectives To elucidate roles of MCs and NCs in keloid pathogenesis and their correlation with disease activity. Methods Keloid samples from chest and back regions were analyzed. Single-cell RNA sequencing (scRNA-seq) was conducted for six active keloids (AK) samples, four inactive keloids (IK) samples, and three mature scar (MS) samples from patients with keloids. Results The scRNA-seq analysis demonstrated notable enrichment of MCs, lymphocytes, and macrophages in AKs, which exhibited continuous growth at the excision site when compared to IK and MS samples (P = 0.042). Expression levels of marker genes associated with activated and degranulated MCs, including FCER1G, BTK, and GATA2, were specifically elevated in keloid lesions. Notably, MCs within AK lesions exhibited elevated expression of genes such as NTRK1, S1PR1, and S1PR2 associated with neuropeptide receptors. Neural progenitor cell and non-myelinating Schwann cell (nmSC) genes were highly expressed in keloids, whereas myelinating Schwann cell (mSC) genes were specific to MS samples. Conclusions scRNA-seq analyses of AK, IK, and MS samples unveiled substantial microenvironmental heterogeneity. Such heterogeneity might be linked to disease activity. These findings suggest the potential contribution of MCs and NCs to keloid pathogenesis. Histopathological and molecular features observed in AK and IK samples provide valuable insights into the mechanisms underlying pain and pruritus in keloid lesions.
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Affiliation(s)
- Eunhye Yeo
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Medical Device Management and Research, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Joonho Shim
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Se Jin Oh
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - YoungHwan Choi
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Medical Device Management and Research, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Hyungrye Noh
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Heeyeon Kim
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ji-Hye Park
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyeong-Tae Lee
- Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seok-Hyung Kim
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dongyoun Lee
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jong Hee Lee
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Medical Device Management and Research, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
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Wang J, Patel P, Jagdeo J. An analysis of keloid patient questions on Reddit. Wound Repair Regen 2024; 32:164-170. [PMID: 38372454 DOI: 10.1111/wrr.13160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/15/2023] [Accepted: 01/28/2024] [Indexed: 02/20/2024]
Abstract
Reddit is one of the world's leading social media platforms, fostering active community discussions on a variety of topics including keloids. The prevalence and reach of conversations on Reddit underscore the need to investigate and understand patient perspectives and gaps in knowledge. Herein, we present an in-depth analysis of questions and concerns of Reddit users on keloids, offering valuable insights into patient experiences, knowledge gaps and treatment preferences. The study presents a distinct approach by harnessing the power of social media data to understand patient perspectives, which may not be readily apparent in clinical settings. All posts on the 'Hot' page of the subreddit r/Keloids were analyzed. Questions were categorized and subcategorized to reveal common themes. A total of 644 questions from 513 posts between 26 March 2017 and 28 August 2023 were identified and analyzed. Reddit users most frequently asked questions regarding keloid management (57.5%). Other common categories included uncertainty regarding diagnosis or symptoms (15.1%), living with keloids (7.5%) and causes or triggers (6.2%). This analysis highlights critical areas of patient knowledge gaps and potential misconceptions regarding keloids. For dermatologists, understanding these patient questions is crucial. Such insights allow for patient-centric education and treatments, ensuring more effective and comprehensive care.
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Affiliation(s)
- Jennifer Wang
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, New York, USA
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York, USA
| | - Paras Patel
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York, USA
- Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA
| | - Jared Jagdeo
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, New York, USA
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York, USA
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Chang CT, Kim J, Carney H, Gao J. Semi-firm lesions on the flanks and extensor surfaces. JAAD Case Rep 2024; 45:128-130. [PMID: 38559584 PMCID: PMC10980862 DOI: 10.1016/j.jdcr.2024.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Affiliation(s)
- Crystal T. Chang
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | - Joyce Kim
- Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
| | - Heather Carney
- Department of Dermatopathology, Mid Atlantic Permanente Medical Group, Rockville, Maryland
| | - Jingyun Gao
- Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
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Isoldi FC, Garcia A, Vieites L, Ferreira LM. Keloids in male genitalia-Systematic review and illustrative case report. Wound Repair Regen 2024; 32:171-181. [PMID: 38351501 DOI: 10.1111/wrr.13157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 01/03/2024] [Accepted: 01/16/2024] [Indexed: 03/12/2024]
Abstract
Keloid is the maximum expression of pathological fibroproliferative skin wound healing, whose pathophysiology is not yet fully understood. Its occurrence in the perineum and genitalia is uncommon. A systematic review was carried out regarding the occurrence and treatment of keloids on the penis. An illustrative case was also reported. The review used the PRISMA checklist and was registered in PROSPERO. The entire literature period up to April 2023 was searched in the EMBASE/Elsevier, Cochrane, Scopus, Medline, BVS, SciELO, and Lilacs databases. The inclusion criteria embraced primary studies, clinical trials, prospective or retrospective cohorts, case series, case-control studies and case reports. Three hundred and sixty-one studies were found and 12 of them were included, consisting of 9 case reports and 3 case series. The most common triggering factor for keloid formation was circumcision, in 11 of the cases, of which more than half occurred in prepubescent children. Several therapies, associated or isolated, were used to treat the cases. Only one of the reported patients had scar recurrence after surgical treatment. Studies with better scientific evidence are needed to understand the involvement of keloids in male genitalia. However, keloid formation in this topography is rare, making it difficult to carry out more elaborate studies.
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Affiliation(s)
- Felipe Contoli Isoldi
- Postgraduate Program in Translational Surgery at Universidade Federal de São Paulo - Escola Paulista de Medicina (Unifesp/EPM), São Paulo, Brazil
| | - Ariane Garcia
- Postgraduate Program in Translational Surgery at Universidade Federal de São Paulo - Escola Paulista de Medicina (Unifesp/EPM), São Paulo, Brazil
| | - Luiza Vieites
- Postgraduate Program in Translational Surgery at Universidade Federal de São Paulo - Escola Paulista de Medicina (Unifesp/EPM), São Paulo, Brazil
| | - Lydia Masako Ferreira
- Postgraduate Program in Translational Surgery at Universidade Federal de São Paulo - Escola Paulista de Medicina (Unifesp/EPM), São Paulo, Brazil
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Komulainen T, Daymond P, Hietanen KE, Kaartinen IS, Järvinen TAH. Myofibroblasts reside in the middle dermis of the keloids but do not predict the response to injection therapies: a double-blinded, randomized, controlled trial. Front Med (Lausanne) 2024; 11:1293028. [PMID: 38495113 PMCID: PMC10943694 DOI: 10.3389/fmed.2024.1293028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/29/2024] [Indexed: 03/19/2024] Open
Abstract
Introduction Keloids form as a pathological response to skin wound healing, and their etiopathology is poorly understood. Myofibroblasts, which are cells transformed from normal fibroblasts, are believed to contribute to pathological scar formation in wounds. Methods We carried out a double-blinded randomized controlled trial (RCT) comparing the efficacy of intralesional 5-fluorouracil (5-FU) and triamcinolone (TAC) injections in treating keloids. A total of 43 patients with 50 keloids were treated with either intralesional TAC or 5-FU injections, and their clinical response was evaluated. Biopsies were collected before, during, and after injection therapy from the active border of a keloid. To understand the role of myofibroblasts in keloids, we conducted an immunohistochemical analysis to identify myofibroblasts [α-smooth muscle actin (αSMA)] from the biopsies. We first defined the three histologically distinct regions-superficial, middle, and deep dermis-in each keloid. Results We then demonstrated that myofibroblasts almost exclusively exist in the middle dermis of the keloids as 80% of the cells in the middle dermis were αSMA positive. However, both the percentage of myofibroblasts as well as the area covered by them was substantially lower in the superficial and deep dermis than in the middle dermis of the keloids. Myofibroblasts do not predict the clinical response to intralesional injection therapies. There is no difference in the myofibroblast numbers in keloids or in the induced change in myofibroblasts between the responders and non-responders after treatment. Discussion This study demonstrates that myofibroblasts reside almost exclusively in the middle dermis layer of the keloids, but their numbers do not predict the clinical response to intralesional injection therapies in the RCT.
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Affiliation(s)
- Tuomas Komulainen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Musculoskeletal Surgery and Diseases, Tampere University Hospital, Tampere, Finland
| | - Patrik Daymond
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Kristiina E. Hietanen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Plastic Surgery, Hospital Nova, Wellbeing Services County of Central Finland, Jyväskylä, Finland
| | - Ilkka S. Kaartinen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Musculoskeletal Surgery and Diseases, Tampere University Hospital, Tampere, Finland
| | - Tero A. H. Järvinen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Musculoskeletal Surgery and Diseases, Tampere University Hospital, Tampere, Finland
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Zhou B, Zhou N, Liu Y, Dong E, Peng L, Wang Y, Yang L, Suo H, Tao J. Identification and validation of CCR5 linking keloid with atopic dermatitis through comprehensive bioinformatics analysis and machine learning. Front Immunol 2024; 15:1309992. [PMID: 38476235 PMCID: PMC10927814 DOI: 10.3389/fimmu.2024.1309992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 02/02/2024] [Indexed: 03/14/2024] Open
Abstract
There is sufficient evidence indicating that keloid is strongly associated with atopic dermatitis (AD) across ethnic groups. However, the molecular mechanism underlying the association is not fully understood. The aim of this study is to discover the underlying mechanism of the association between keloid and AD by integrating comprehensive bioinformatics techniques and machine learning methods. The gene expression profiles of keloid and AD were downloaded from the Gene Expression Omnibus (GEO) database. A total of 449 differentially expressed genes (DEGs) were found to be shared in keloid and AD using the training datasets of GEO (GSE158395 and GSE121212). The hub genes were identified using the protein-protein interaction network and Cytoscape software. 20 of the most significant hub genes were selected, which were mainly involved in the regulation of the inflammatory and immune response. Through two machine learning algorithms of LASSO and SVM-RFE, CCR5 was identified as the most important key gene. Subsequently, upregulated CCR5 gene expression was confirmed in validation GEO datasets (GSE188952 and GSE32924) and clinical samples of keloid and AD. Immune infiltration analysis showed that T helper (Th) 1, 2 and 17 cells were significantly enriched in the microenvironment of both keloid and AD. Positive correlations were found between CCR5 and Th1, Th2 and Th17 cells. Finally, two TFs of CCR5, NR3C2 and YY1, were identified, both of which were downregulated in keloid and AD tissues. Our study firstly reveals that keloid and AD shared common inflammatory and immune pathways. Moreover, CCR5 plays a key role in the pathogenesis association between keloid and AD. The common pathways and key genes may shed light on further mechanism research and targeted therapy, and may provide therapeutic interventions of keloid with AD.
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Affiliation(s)
- Bin Zhou
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei, China
- Hubei Engineering Research Center for Skin Repair and Theranostics, Wuhan, Hubei, China
| | - Nuoya Zhou
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei, China
- Hubei Engineering Research Center for Skin Repair and Theranostics, Wuhan, Hubei, China
| | - Yan Liu
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei, China
- Hubei Engineering Research Center for Skin Repair and Theranostics, Wuhan, Hubei, China
| | - Enzhu Dong
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei, China
- Hubei Engineering Research Center for Skin Repair and Theranostics, Wuhan, Hubei, China
| | - Lianqi Peng
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei, China
- Hubei Engineering Research Center for Skin Repair and Theranostics, Wuhan, Hubei, China
| | - Yifei Wang
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei, China
- Hubei Engineering Research Center for Skin Repair and Theranostics, Wuhan, Hubei, China
| | - Liu Yang
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei, China
- Hubei Engineering Research Center for Skin Repair and Theranostics, Wuhan, Hubei, China
| | - Huinan Suo
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei, China
- Hubei Engineering Research Center for Skin Repair and Theranostics, Wuhan, Hubei, China
| | - Juan Tao
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei, China
- Hubei Engineering Research Center for Skin Repair and Theranostics, Wuhan, Hubei, China
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Li C, Xie R, Zhang S, Yun J, Zhong A, Cen Y, Chen J. Metabolism, fibrosis, and apoptosis: The effect of lipids and their derivatives on keloid formation. Int Wound J 2024; 21:e14733. [PMID: 38339798 PMCID: PMC10858330 DOI: 10.1111/iwj.14733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
Keloids, pathological scars resulting from skin trauma, have traditionally posed significant clinical management challenges due to their persistence and high recurrence rates. Our research elucidates the pivotal roles of lipids and their derivatives in keloid development, driven by underlying mechanisms of abnormal cell proliferation, apoptosis, and extracellular matrix deposition. Key findings suggest that abnormalities in arachidonic acid (AA) synthesis and non-essential fatty acid synthesis are integral to keloid formation. Further, a complex interplay exists between lipid derivatives, notably butyric acid (BA), prostaglandin E2 (PGE2), prostaglandin D2 (PGD2), and the regulation of hyperfibrosis. Additionally, combinations of docosahexaenoic acid (DHA) with BA and 15-deoxy-Δ12,14-Prostaglandin J2 have exhibited pronounced cytotoxic effects. Among sphingolipids, ceramide (Cer) displayed limited pro-apoptotic effects in keloid fibroblasts (KFBs), whereas sphingosine 1-phosphate (S1P) was found to promote keloid hyperfibrosis, with its analogue, FTY720, demonstrating contrasting benefits. Both Vitamin D and hexadecylphosphorylcholine (HePC) showed potential antifibrotic and antiproliferative properties, suggesting their utility in keloid management. While keloids remain a prevalent concern in clinical practice, this study underscores the promising potential of targeting specific lipid molecules for the advancement of keloid therapeutic strategies.
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Affiliation(s)
- Chen‐yu Li
- Department of Burn and Plastic SurgeryWest China Hospital of Sichuan UniversityChengduChina
| | - Ru‐xin Xie
- Department of Burn and Plastic SurgeryWest China Hospital of Sichuan UniversityChengduChina
| | - Shi‐wei Zhang
- Department of Burn and Plastic SurgeryWest China Hospital of Sichuan UniversityChengduChina
| | - Jiao Yun
- Department of Burn and Plastic SurgeryWest China Hospital of Sichuan UniversityChengduChina
| | - Ai Zhong
- Department of Burn and Plastic SurgeryWest China Hospital of Sichuan UniversityChengduChina
| | - Ying Cen
- Department of Burn and Plastic SurgeryWest China Hospital of Sichuan UniversityChengduChina
| | - Jun‐jie Chen
- Department of Burn and Plastic SurgeryWest China Hospital of Sichuan UniversityChengduChina
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15
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Guo Z, Yu Q, Huang W, Huang F, Chen X, Wei C. Discovering and Validating Cuproptosis-Associated Marker Genes for Accurate Keloid Diagnosis Through Multiple Machine Learning Models. Clin Cosmet Investig Dermatol 2024; 17:287-300. [PMID: 38314148 PMCID: PMC10838519 DOI: 10.2147/ccid.s440231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 01/22/2024] [Indexed: 02/06/2024]
Abstract
Background Keloid is a common condition characterized by abnormal scarring of the skin, affecting a significant number of individuals worldwide. Objective The occurrence of keloids may be related to the reduction of cell death. Recently, a new cell death mode that relies on copper ions has been discovered. This study aimed to identify novel cuproptosis-related genes that are associated with keloid diagnosis. Methods We utilized several gene expression datasets, including GSE44270 and GSE145725 as the training group, and GSE7890, GSE92566, and GSE121618 as the testing group. We integrated machine learning models (SVM, RF, GLM, and XGB) to identify 10 cuproptosis-related genes (CRGs) for keloid diagnosis in the training group. The diagnostic capability of the identified CRGs was validated using independent datasets, RT-qPCR, Western blotting, and IHC analysis. Results Our study successfully categorized keloid samples into two clusters based on the expression of cuproptosis-related genes. Utilizing WGCNA analysis, we identified 110 candidate genes associated with cuproptosis. Subsequent functional enrichment analysis results revealed that these genes may play a regulatory role in cell growth within keloid tissue through the MAPK pathway. By integrating machine learning models, we identified CRGs that can be used for diagnosing keloid. The diagnostic efficacy of CRGs was confirmed using independent datasets, RT-qPCR, Western blotting, and IHC analysis. GSVA analysis indicated that high expression of CRGs influenced the gene set related to ECM receptor interaction. Conclusion This study identified 10 cuproptosis-related genes that provide insights into the molecular mechanisms underlying keloid development and may have implications for the development of targeted therapies.
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Affiliation(s)
- Zicheng Guo
- Department of Orthopaedics, Huizhou First Hospital, Huizhou, People's Republic of China
- Department of Orthopaedics, Southern Medical University, Guangzhou, People's Republic of China
| | - Qingli Yu
- Department of Orthopaedics, Huizhou First Hospital, Huizhou, People's Republic of China
| | - Wencheng Huang
- Department of Orthopaedics, Huizhou First Hospital, Huizhou, People's Republic of China
| | - Fengyu Huang
- Department of Orthopaedics, Huizhou First Hospital, Huizhou, People's Republic of China
| | - Xiurong Chen
- Department of Orthopaedics, Huizhou First Hospital, Huizhou, People's Republic of China
| | - Chuzhong Wei
- Department of Orthopaedics, Huizhou First Hospital, Huizhou, People's Republic of China
- Department of Orthopaedics, Southern Medical University, Guangzhou, People's Republic of China
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16
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Hu L, Bao Z. Inhibitory effect of a novel Curcumin derivative DMC-HA on keloid fibroblasts. Aging (Albany NY) 2024; 16:2398-2409. [PMID: 38284901 PMCID: PMC10911336 DOI: 10.18632/aging.205487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/27/2023] [Indexed: 01/30/2024]
Abstract
Keloids pose a significant dermatological challenge, marked by abnormal fibroblast proliferation and excessive collagen deposition in response to skin injury or trauma. In the present study, we introduce DMC-HA, a derivative of Curcumin, as a promising candidate for keloid treatment. DMC-HA is poised to provide superior therapeutic benefits compared to Curcumin due to its structural modifications. Examining the comparative effects of DMC-HA and Curcumin on keloid fibroblasts can offer insights into their potential as therapeutic agents and the underlying mechanisms in keloid pathogenesis. In our study, CCK-8 experiments revealed that, at equivalent concentrations, DMC-HA demonstrated greater efficacy in inhibiting the proliferation of keloid fibroblasts compared to Curcumin. Flow cytometry analysis indicated that DMC-HA induced fibroblast apoptosis more significantly than Curcumin at the same concentration. Further data demonstrated that DMC-HA notably increased the production of reactive oxygen species (ROS), upregulated the expression levels of Bax, cleaved PARP, and cleaved Caspase-3. Interestingly, the impact of DMC-HA was reversed upon the application of the antioxidant NAC. Additionally, DMC-HA could suppress IL-6-induced increased expression of p-STAT3. Collectively, our findings suggest that DMC-HA is more effective than Curcumin in inhibiting the proliferation of keloid fibroblasts. The underlying mechanism of its action appears to be associated with the augmentation of ROS induction and the concurrent inhibition of STAT3 activation.
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Affiliation(s)
- Liang Hu
- Department of Burns and Plastic Surgery, Kunshan Hospital Affiliated to Jiangsu University, Kunshan 215300, Jiangsu, China
| | - Zhicheng Bao
- Department of Rehabilitation Medicine, Kunshan Hospital Affiliated to Jiangsu University, Kunshan 215300, Jiangsu, China
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17
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Zhong Y, Zhang Y, Lu B, Deng Z, Zhang Z, Wang Q, Zhang J. Hydrogel Loaded with Components for Therapeutic Applications in Hypertrophic Scars and Keloids. Int J Nanomedicine 2024; 19:883-899. [PMID: 38293605 PMCID: PMC10824614 DOI: 10.2147/ijn.s448667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/12/2024] [Indexed: 02/01/2024] Open
Abstract
Hypertrophic scars and keloids are common fibroproliferative diseases following injury. Patients with pathologic scars suffer from impaired quality of life and psychological health due to appearance disfiguration, itch, pain, and movement disorders. Recently, the advancement of hydrogels in biomedical fields has brought a variety of novel materials, methods and therapeutic targets for treating hypertrophic scars and keloids, which exhibit broad prospects. This review has summarized current research on hydrogels and loaded components used in preventing and treating hypertrophic scars and keloids. These hydrogels attenuate keloid and hypertrophic scar formation and progression by loading organic chemicals, drugs, or bioactive molecules (such as growth factors, genes, proteins/peptides, and stem cells/exosomes). Among them, smart hydrogels (a very promising method for loading many types of bioactive components) are currently favoured by researchers. In addition, combining hydrogels and current therapy (such as laser or radiation therapy, etc.) could improve the treatment of hypertrophic scars and keloids. Then, the difficulties and limitations of the current research and possible suggestions for improvement are listed. Moreover, we also propose novel strategies for facilitating the construction of target multifunctional hydrogels in the future.
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Affiliation(s)
- Yixiu Zhong
- Department of Dermatology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, People’s Republic of China
| | - Youfan Zhang
- Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
| | - Beibei Lu
- Department of Dermatology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, People’s Republic of China
| | - Zhenjun Deng
- Department of Dermatology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, People’s Republic of China
| | - Zhiwen Zhang
- Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
| | - Qi Wang
- Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
| | - Jianglin Zhang
- Department of Dermatology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, People’s Republic of China
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18
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Franco E, Kreichman R, Metanes I, Segal M, Nae B, Bryzgalin L, Zouboulis C, Har-Shai Y. Intralesional Cryosurgery of a Bulky Postburned Auricular Keloid and EAR-Q Patient-reported Outcome Measure Assessment. J Burn Care Res 2024; 45:246-249. [PMID: 37795836 DOI: 10.1093/jbcr/irad144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Indexed: 10/06/2023]
Abstract
Postburned auricular keloids are a challenging problem for the patient and physician. We describe a successful combined treatment of a bulky postburn auricular keloid employing intralesional cryosurgery followed by multiple W-plasty. An EAR-Q pre- and postoperative patient-reported outcome assessments have revealed a significant improvement in all ear parameters of appearance, adverse effects, and quality of life. This combined treatment might be added to the armamentarium of possible treatment modalities for this perplexing problem.
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Affiliation(s)
- Eyal Franco
- Department of Plastic Surgery, Carmel Medical Center, Haifa, Israel
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Rita Kreichman
- Department of Plastic Surgery, Carmel Medical Center, Haifa, Israel
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Issa Metanes
- Department of Plastic Surgery, Carmel Medical Center, Haifa, Israel
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Miriam Segal
- Department of Plastic Surgery, Carmel Medical Center, Haifa, Israel
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Bluma Nae
- Department of Plastic Surgery, Carmel Medical Center, Haifa, Israel
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Leonid Bryzgalin
- Department of Plastic Surgery, Carmel Medical Center, Haifa, Israel
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Christos Zouboulis
- Department of Dermatology, Venereology and Allergology/Immunological, Dessau Medical Center, Brandenburg Medical School, Dessau, Germany
| | - Yaron Har-Shai
- Department of Plastic Surgery, Carmel Medical Center, Haifa, Israel
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Yuan T, Meijia L, Rong C, Jian Y, Lijun H. Identification of novel biomarkers of ferroptosis involved in keloid based on bioinformatics analysis. Int Wound J 2024; 21:e14606. [PMID: 38272797 PMCID: PMC10805535 DOI: 10.1111/iwj.14606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 12/10/2023] [Accepted: 12/11/2023] [Indexed: 01/27/2024] Open
Abstract
Keloid is a fibroproliferative disease of unknown aetiology, which has a significant impact the quality of life of patients. Ferroptosis plays an important role in the occurrence and development of fibrosis, but there is still a lack of research related to keloids. The objective of this work was to identify the hub genes related to ferroptosis in keloid to better understand the keloid process. The microarray data (GSE7890 GSE145725, and GSE44270) (23 keloid and 22 normal fibroblast) were analysed via the gene expression comprehensive database (GEO). Only GSE7890 met the FerrDB database. Cell cycle and pathway analysis were performed with gene ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis was performed to differentially expressed genes (DEG). The differential genes were confirmed in other GEO datasets (GSE145725 and GSE44270), and multi-fibrosis-gene correlation analysed. To validate these hub genes, quantitative real-time PCR (qRT-PCR) was conducted. A total of 581 DEGs were screened, with 417 genes down-regulated and 164 genes up-regulated, with 11 ferroptosis genes significantly up-regulated in both keloid and normal tissue, and 6 genes are consistent with our findings and are associated with multiple fibrosis genes. The qRT-PCR results and tissues of normal skin and keloid agreed with our predictions. Our findings provide new evidence for the ferroptosis-related molecular pathways and biomarker of keloid.
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Affiliation(s)
- Tian Yuan
- Department of Plastic SurgeryThe First Affiliated Hospital of Harbin Medical UniversityHarbinChina
| | - Li Meijia
- Department of Plastic SurgeryThe First Affiliated Hospital of Harbin Medical UniversityHarbinChina
| | - Cheng Rong
- Department of Plastic SurgeryThe First Affiliated Hospital of Harbin Medical UniversityHarbinChina
| | - Yuan Jian
- Department of Plastic SurgeryThe First Affiliated Hospital of Harbin Medical UniversityHarbinChina
| | - Hao Lijun
- Department of Plastic SurgeryThe First Affiliated Hospital of Harbin Medical UniversityHarbinChina
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21
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Bekkers VZ, Khan F, Aarts P, Zdunczyk K, Prens EP, Wolkerstorfer A, Rissmann R, van Doorn MBA. Needle-free electronically-controlled jet injector treatment with bleomycin and lidocaine is effective and well-tolerated in patients with recalcitrant keloids. Lasers Surg Med 2024; 56:45-53. [PMID: 37933762 DOI: 10.1002/lsm.23737] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/20/2023] [Accepted: 10/24/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVES The treatment of recalcitrant keloids is challenging. Although intralesional bleomycin using conventional needle injectors (CNI) is effective, it has important drawbacks, such as the need for repetitive and painful injections. Therefore, we aimed to evaluate the effectiveness, tolerability and patient satisfaction of intralesional bleomycin with lidocaine administered with a needle-free electronically-controlled pneumatic jet-injector (EPI) in recalcitrant keloids. METHODS This retrospective study included patients with recalcitrant keloids who had received three intralesional EPI-assisted treatments with bleomycin and lidocaine. Effectiveness was assessed using the Patient and Observer Scar Assessment Scale (POSAS) at baseline and four to six weeks after the third treatment. Additionally, treatment related pain scores numeric rating scale, adverse effects, patient satisfaction and Global Aesthetic Improvement Scale (GAIS) were assessed. RESULTS Fifteen patients with a total of >148 recalcitrant keloids were included. The median total POSAS physician- and patient-scores were respectively 40 and 41 at baseline, and reduced with respectively 7 and 6-points at follow-up ( p < 0.001; p < 0.001). The median pain scores during EPI-assisted injections were significantly lower compared to CNI-assistant injections, (2.5 vs. 7.0, respectively ( p < 0.001)). Adverse effects were mild. Overall, patients were "satisfied" or "very satisfied" with the treatments (14/15, 93.3%). The GAIS was "very improved" in one patient, "improved" in nine patients and "unaltered" in four patients. CONCLUSIONS EPI-assisted treatment with bleomycin and lidocaine is an effective, well tolerated, patient-friendly alternative for CNI in patients with recalcitrant keloid scars. Randomized controlled trials are warranted to confirm our findings and improve the clinical management of recalcitrant keloids.
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Affiliation(s)
- Vazula Zulfra Bekkers
- Department of Dermatology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Fatima Khan
- Department of Dermatology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Pim Aarts
- Department of Dermatology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Katarzyna Zdunczyk
- Centre for Human Drug Research, Leiden, The Netherlands
- Division of BioTherapeutics, Leiden Academic Center for Human Drug Research, Leiden, The Netherlands
| | - Errol Prospero Prens
- Department of Dermatology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Albert Wolkerstorfer
- Department of Dermatology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Robert Rissmann
- Centre for Human Drug Research, Leiden, The Netherlands
- Division of BioTherapeutics, Leiden Academic Center for Human Drug Research, Leiden, The Netherlands
- Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Martijn Bastiaan Adriaan van Doorn
- Department of Dermatology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
- Centre for Human Drug Research, Leiden, The Netherlands
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22
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Nowowiejska J, Arias-Rodriguez C, Argenziano G, Ronchi A, Piccolo V. Cutaneous Bronchogenic Cyst Presenting as a Keloid on the Back - A Case Report. Dermatol Pract Concept 2024; 14:dpc.1401a54. [PMID: 38364429 PMCID: PMC10868951 DOI: 10.5826/dpc.1401a54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2023] [Indexed: 02/18/2024] Open
Affiliation(s)
- Julia Nowowiejska
- Department of Dermatology and Venereology, Medical University of Bialystok, Poland
| | | | | | - Andrea Ronchi
- Pathology Unit, University of Campania, Naples, Italy
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23
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Wang Q, Huang X, Zeng S, Zhou R, Wang D. Weighted gene co-expression network analysis and machine learning identified the lipid metabolism-related gene LGMN as a novel biomarker for keloid. Exp Dermatol 2024; 33:e14974. [PMID: 37930112 DOI: 10.1111/exd.14974] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/05/2023] [Accepted: 10/27/2023] [Indexed: 11/07/2023]
Abstract
The aetiology of keloid formation remains unclear, and existing treatment modalities have not definitively established a successful approach. Therefore, it is necessary to identify reliable and novel keloid biomarkers as potential targets for therapeutic interventions. In this study, we performed differential expression analysis and functional enrichment analysis on the keloid related datasets, and found that multiple metabolism-related pathways were associated with keloid formation. Subsequently, the differentially expressed genes (DEGs) were intersected with the results of weighted gene co-expression network analysis (WGCNA) and the lipid metabolism-related genes (LMGs). Then, three learning machine algorithms (SVM-RFE, LASSO and Random Forest) together identified legumain (LGMN) as the most critical LMGs. LGMN was overexpressed in keloid and had a high diagnostic performance. The protein-protein interaction (PPI) network related to LGMN was constructed by GeneMANIA database. Functional analysis of indicated PPI network was involved in multiple immune response-related biological processes. Furthermore, immune infiltration analysis was conducted using the CIBERSORT method. M2-type macrophages were highly infiltrated in keloid tissues and were found to be significantly and positively correlated with LGMN expression. Gene set variation analysis (GSVA) indicated that LGMN may be related to promoting fibroblast proliferation and inhibiting their apoptosis. Moreover, eight potential drug candidates for keloid treatment were predicted by the DSigDB database. Western blot, qRT-PCR and immunohistochemistry staining results confirmed that LGMN was highly expressed in keloid. Collectively, our findings may identify a new biomarker and therapeutic target for keloid and contribute to the understanding of the potential pathogenesis of keloid.
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Affiliation(s)
- Qirui Wang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xingtai Huang
- Shanghai Key Laboratory of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
| | - Siyi Zeng
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Renpeng Zhou
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Danru Wang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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24
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Liu Y, Xiong X, Cao N, Zhao Y. Diagnosis and Treatment of Keloid: Method Summary and Effect Evaluation. Clin Cosmet Investig Dermatol 2023; 16:3775-3783. [PMID: 38170138 PMCID: PMC10759814 DOI: 10.2147/ccid.s446018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024]
Abstract
Keloid is a prevalent skin disorder characterized by the abnormal growth of keloid tissue, which usually occurs following wound healing or surgical incisions. It typically progresses through several stages: the inflammatory stage, the proliferative stage, collagen remodeling, and ultimately the formation of keloid. This review aims to summarize the diagnostic and therapeutic methods for keloid, and evaluate their effectiveness. The diagnosis of keloid is usually based on medical history and clinical manifestations such as pain, itching, erythema, and induration. Other commonly used diagnostic methods include tissue biopsy and ultrasound examination. Various treatment options for keloid exist, including physical therapy, medication, surgical treatment, and radiation therapy. Physical therapy includes pressure therapy, laser therapy, such as silicone sheets, elastic bandages, and laser irradiation. Medication treatment mainly involves the application of topical medications or intralesional injections, such as topical corticosteroids, 5-fluorouracil, and others. Radiation therapy can be administered using applicators and superficial radiation therapy, among other methods. The treatment outcomes of keloid vary from person to person and recurrence is common. Therefore, a comprehensive treatment approach may be the most effective strategy. Individualized treatment plans should consider factors such as the patient's age, gender, medical history, and the severity of the condition. In conclusion, the diagnosis and treatment of keloid require consideration of multiple factors and the implementation of individualized treatment plans. Future research should focus on identifying the molecular mechanisms underlying the occurrence and progression of keloid in order to develop more effective treatment methods.
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Affiliation(s)
- Yu Liu
- Nuclear Medicine Department, Jilin University Second Hospital, Changchun, Jilin Province, People’s Republic of China
| | - Xiaoliang Xiong
- Nuclear Medicine Department, Jilin University Second Hospital, Changchun, Jilin Province, People’s Republic of China
| | - Nan Cao
- Nuclear Medicine Department, Jilin University Second Hospital, Changchun, Jilin Province, People’s Republic of China
| | - Yinlong Zhao
- Nuclear Medicine Department, Jilin University Second Hospital, Changchun, Jilin Province, People’s Republic of China
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25
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Alfurayh N, Alqahtani R, AlFada M. Keloid Scar Resistance to Intralesional Steroid Injections: Should We Look for Foreign Bodies? A Case Report. Clin Cosmet Investig Dermatol 2023; 16:3693-3697. [PMID: 38146404 PMCID: PMC10749577 DOI: 10.2147/ccid.s443813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 12/13/2023] [Indexed: 12/27/2023]
Abstract
Keloid is a challenging pathological condition characterized by abnormal scarring that extends beyond the boundaries of the original wound. Despite the available treatment options, keloid scars remain difficult to manage. This case report discusses a 10-year-old boy with a keloid scar on his neck following branchial anomaly repair surgery. The patient underwent multiple treatments, including triamcinolone injections, cryotherapy, and a pulsed dye laser session, with limited improvement. Subsequently, an X-ray and ultrasound were performed revealing the presence of metallic clips over the surgical site. To our knowledge, the effect of the presence of foreign bodies within the keloid scar on its response to treatment is not well understood yet. The findings of this case encourage performing imaging studies on post-surgical keloid scars resistant to treatment to rule out the presence of any foreign material. However, more trials to investigate the effect of the presence of foreign bodies on the treatment of keloid scar are required before it can be set as a mandatory investigation.
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Affiliation(s)
- Nuha Alfurayh
- Department of Dermatology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Reem Alqahtani
- College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Mohammed AlFada
- Department of Dermatology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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26
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Xu S, Zhu Y, Wang P, Qi S, Shu B. Derazantinib Inhibits the Bioactivity of Keloid Fibroblasts via FGFR Signaling. Biomedicines 2023; 11:3220. [PMID: 38137441 PMCID: PMC10741236 DOI: 10.3390/biomedicines11123220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 11/28/2023] [Accepted: 12/02/2023] [Indexed: 12/24/2023] Open
Abstract
Keloids are common benign cutaneous pathological fibrous proliferation diseases, which are difficult to cure and easily recur. Studies have shown that fibroblast growth factor receptor-1 (FGFR1) was enhanced in pathological fibrous proliferation diseases, such as cirrhosis and idiopathic pulmonary fibrosis (IPF), suggesting the FGFR1 pathway has potential for keloid treatment. Derazantinib is a selective FGFR inhibitor with antiproliferative activity in in vitro and in vivo models. The present study determined the effects of derazantinib on human keloid fibroblasts (KFs). Cell viability assay, migration assay, invasion assay, immunofluorescence staining, quantitative polymerase chain reaction, Western blot analysis, HE staining, Masson staining, and immunohistochemical analysis were used to analyze the KFs and keloid xenografts. In this study, we found that derazantinib inhibited the proliferation, migration, invasion, and collagen production of KFs in vitro. The transcription and expression of plasminogen activator inhibitor-1 (PAI-1), which is closely related to collagen deposition and tissue fibrosis, was significantly inhibited. Also, derazantinib inhibited the expression of FGFR1 and PAI-1 and reduced the weight of the implanted keloid from the xenograft mice model. These findings suggest that derazantinib may be a potent therapy for keloids via FGFR signaling.
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Affiliation(s)
- Shuqia Xu
- Department of Plastic Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China;
| | - Yongkang Zhu
- Department of Burn Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China; (Y.Z.); (P.W.)
- Department of Burn and Plastic Surgery, Shenzhen Institute of Translational Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen 518025, China
| | - Peng Wang
- Department of Burn Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China; (Y.Z.); (P.W.)
| | - Shaohai Qi
- Department of Burn Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China; (Y.Z.); (P.W.)
| | - Bin Shu
- Department of Burn Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China; (Y.Z.); (P.W.)
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27
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Palić J, Saey V, van der Lugt J, Baumgärtner W, Hülskötter K. Cytologic, histopathologic, and immunohistochemical features of keloidal fibroma in a dog. Vet Clin Pathol 2023; 52:676-680. [PMID: 37661191 DOI: 10.1111/vcp.13282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 05/12/2023] [Accepted: 06/04/2023] [Indexed: 09/05/2023]
Abstract
A five-year-old male English Bulldog was presented with a firm, well-circumscribed, 1 cm in diameter cutaneous mass on the left flank. Fine-needle aspiration (FNA) biopsy samples were collected for cytologic analysis. Cytology revealed a highly cellular sample consisting of spindle cells, numerous bundles of thick, glassy eosinophilic material (hyalinized collagen), and inflammatory cells. Spindle cells showed moderate anisocytosis and anisokaryosis, had oval nuclei with coarsely stippled chromatin, 1-3 prominent round nucleoli, and moderate amounts of wispy cytoplasm. Cells were occasionally associated with an eosinophilic extracellular matrix. Binucleated and trinucleated spindle cells were often noted. Low numbers of macrophages, small lymphocytes, and individual well-granulated mast cells were also present. The lesion was excised and submitted for histopathologic examination, revealing a well-delineated, nonencapsulated mass composed of hyalinized collagen fibers separated by spindle-shaped mesenchymal cells in the deep dermis and subcutis. Mild anisocytosis and anisokaryosis and less than one mitosis per 10 × high power fields were present. Excision of the mass was complete. The findings were consistent with a keloidal fibroma, a rare benign variant of fibroma. Neoplastic cells showed positive immunoreactivity for vimentin, and a small-to-moderate number of tumor cells showed positive immunoreactivity for α-smooth muscle actin. This is the first cytologic description of a keloidal fibroma correlated with histopathologic findings and immunolabeling. In cases where keloidal neoplasia is suspected, and since moderate cellular atypia can be present on cytologic examination even in cases of keloidal fibroma, histopathologic examination is necessary to differentiate between keloidal fibroma and keloidal fibrosarcoma.
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Affiliation(s)
- Jelena Palić
- Vet Med Labor GmbH Division of IDEXX Laboratories, Kornwestheim, Germany
| | - Veronique Saey
- Vet Med Labor GmbH Division of IDEXX Laboratories, Kornwestheim, Germany
| | - Jaco van der Lugt
- Vet Med Labor GmbH Division of IDEXX Laboratories, Kornwestheim, Germany
| | - Wolfgang Baumgärtner
- Department of Pathology, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Kirsten Hülskötter
- Department of Pathology, University of Veterinary Medicine Hannover, Hannover, Germany
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28
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Al Zahrani RA, Alotaibi WN, Almanasef ZM, Malawi I, Mohammed LA, Algahamdi RA, Almohanna AA, AlKhaytan AN, Albishi RJ, Alsofyani YA, Aljindan FK. Comprehensive Analysis of Current Treatment Approaches for Keloids in Pediatrics: A Systematic Review. Cureus 2023; 15:e50290. [PMID: 38205454 PMCID: PMC10776453 DOI: 10.7759/cureus.50290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2023] [Indexed: 01/12/2024] Open
Abstract
Keloids, benign fibrous growths resulting from atypical skin responses to injuries, present a complex challenge in dermatology. These lesions, characterized by excessive collagen production, often lead to physical discomfort and psychological distress. While various treatment methods exist, the lack of a universally effective modality underscores the need for a systematic evaluation of current approaches. This systematic review aims to comprehensively analyze the current available treatment modalities used for the management of keloids in the pediatric population in terms of their effectiveness, safety, and quality of life outcomes. The review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was conducted on PubMed and Google Scholar databases to identify relevant studies published in English. The review specifically focused on randomized controlled trials involving patients under 18 diagnosed with keloids, assessing different treatment modalities, and reporting validated measures of treatment efficacy, safety outcomes, and quality of life. The risk of bias was assessed using Cochrane's Risk of Bias Tool for randomized studies to ensure the methodological quality of the included trials. Four studies met the inclusion criteria, collectively involving 196 pediatric patients. Treatment interventions included glucocorticosteroid and fusidic acid cream with silicone gel patches, botulinum toxin type A injections, and Scarban silicone gel sheets. Patient-reported outcomes exhibited varying degrees of improvement in scar size, vascularity, and pliability. Complications, such as rash and wound infection, were reported in some cases. Based on our review of the selected studies and due to the incompletely understood pathogenesis of keloids, there is an ongoing lack of universally effective treatment modality for the management of keloids resulting in their persistently high recurrence rate.
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Affiliation(s)
| | - Wejdan N Alotaibi
- Pediatrics, Armed Forces Hospital Southern Region, Khamis Mashait, SAU
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29
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Zhang J, Bao Q, Song N, Li C, Ma J. The upregulation of circFoxp1 influences keloid by promoting cell proliferation. Aging (Albany NY) 2023; 15:12998-13009. [PMID: 37993257 DOI: 10.18632/aging.205215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/02/2023] [Indexed: 11/24/2023]
Abstract
As a result of abnormal wound healing in susceptible individuals, keloids are characterized by hyperproliferation of fibroblasts and excessive deposition of the extracellular matrix (ECM). Current surgical and therapeutic modalities provide limited satisfactory results. Circular ribonucleic acids (circRNAs) play a crucial role in the pathogenesis of various fibrotic diseases, but the potential biological function and expression profile of circRNAs in keloid formation remain unknown. In this study, we explored the function of circFoxp1 on keloid formation. Methods: Quantitative reverse transcription-polymerase chain reaction (qRT-PCR) results revealed that circFoxp1 expression was higher in the keloid tissues. Furthermore, RNA-fluorescence in situ hybridization (RNA-FISH) and RNAscope illustrated that circFoxp1 was present in the cytoplasm. Subsequent cellular experiments demonstrated that circFoxp1 overexpression enhanced proliferation, migration, and ECM deposition. In addition, apoptosis was inhibited. Cell proliferation, inflammatory response, and oxidative phosphorylation of fibroblasts were also observed by RNA sequencing and were closely related to scar formation. The therapeutic potential of circFoxp1 was investigated by establishing keloid implantation models. In vivo, circFoxp1 can promote fibroblast proliferation and ECM deposition. RNA pull-down and western blot assays verified the interaction of circFoxp1 with RACK1. The present study reveals that circFoxp1 contributes to the pathological hyperplasia of keloid, which may improve inflammation and cell proliferation. Our data indicate that circFoxp1 may serve as a novel, promising therapeutic target, presenting a new avenue for understanding the underlying pathogenesis of keloid.
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Affiliation(s)
- Jing Zhang
- Department of Facial Plastic and Reconstructive Surgery, ENT Institute, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Qianyi Bao
- School of Medicine, Southeast University, Nanjing, Jiangsu, China
- Key Laboratory for The Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Bio-X Institutes, Shanghai Jiao Tong University, Shanghai, China
| | - Nan Song
- Department of Facial Plastic and Reconstructive Surgery, ENT Institute, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Chunming Li
- Weigao Fenwei Health Technology Development (Shanghai) Co., Ltd., Shanghai, China
| | - Jing Ma
- Department of Facial Plastic and Reconstructive Surgery, ENT Institute, Eye and ENT Hospital, Fudan University, Shanghai, China
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30
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Liu H, Chi X, Yang N, Shan M, Xiao Y, Zhang M, Hao Y, Hou S, Liu Y, Wang Y. Joint effect of RRP9 and DDX21 on development of colorectal cancer and keloid. Aging (Albany NY) 2023; 15:14703-14719. [PMID: 37988222 PMCID: PMC10781455 DOI: 10.18632/aging.205240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/12/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Colorectal cancer (CRC) is a common malignancy in the gastrointestinal tract. Keloid refers to abnormal scar tissue that forms on the skin or mucous membrane. The relationship between RRP9 and DDX21 and the two diseases is unclear. METHODS Download the colorectal cancer dataset GSE134834, GSE206800, GSE209892 and keloid dataset GSE44270 from the GEO database. Differentially expressed genes (DEGs) were screened and weighted gene co-expression network analysis (WGCNA) was performed. The construction and analysis of protein-protein interaction (PPI) network, functional enrichment analysis, gene set enrichment analysis (GSEA). Gene expression heat map was drawn. The comparative toxicogenomics database (CTD) analysis was performed to find diseases most related to core genes. TargetScan screened miRNAs that regulated central DEGs. We conducted experimental validation using Western blotting and Polymerase Chain Reaction (PCR). RESULTS In the colorectal cancer dataset and the scar tissue dataset, we identified 1380 DEGs and 1000 DEGs, respectively. The enrichment pattern for scar tissue was similar to that of colorectal cancer. We identified two core genes, RRP9 and DDX21. CTD analysis indicated that RRP9 and DDX21 are associated with proliferation, scar tissue, colorectal tumors, scleroderma, and inflammation. We found that the core genes (RRP9 and DDX21) were highly expressed in colorectal cancer and scar tissue samples, while their expression was lower in normal samples. This was further validated through Western blotting (WB) and Polymerase Chain Reaction (PCR). CONCLUSIONS The higher the expression of RRP9 and DDX21 in colorectal cancer and keloid, the worse the prognosis.
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Affiliation(s)
- Hao Liu
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Xiaoqian Chi
- Department of General Surgery, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Ning Yang
- Department of General Surgery, The First Affiliated Hospital, Hebei Medical University, Shijiazhuang, China
| | - Mengjie Shan
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Yiding Xiao
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Mingzi Zhang
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Yan Hao
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Shiyang Hou
- Department of General Surgery, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Yabin Liu
- Department of General Surgery, The Fourth Affiliated Hospital, Hebei Medical University, Shijiazhuang, China
| | - Youbin Wang
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China
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31
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Tam I, Sun L, Patel A, Woo L, Weaver J, Shah SD. Penile keloid formation post-circumcision: A case series and review of literature. Pediatr Dermatol 2023. [PMID: 37983948 DOI: 10.1111/pde.15473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 10/29/2023] [Indexed: 11/22/2023]
Abstract
The formation of penile keloid after circumcision is an uncommon complication. Herein, we report two pediatric cases of large circumferential keloids that developed post-circumcision and were successfully treated by surgical excision and intralesional triamcinolone injections. In addition, we provide a comprehensive review of the reported cases of penile keloids that developed after circumcision in the literature to highlight the various presentations, treatment options, and outcomes for this condition.
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Affiliation(s)
- Idy Tam
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Lillian Sun
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Anish Patel
- Department of Urology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Lynn Woo
- Department of Pediatric Urology, Rainbow Babies & Children's Hospital, Cleveland, Ohio, USA
| | - John Weaver
- Department of Pediatric Urology, Rainbow Babies & Children's Hospital, Cleveland, Ohio, USA
| | - Sonal D Shah
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
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32
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Fu S, Duan L, Zhong Y, Zeng Y. Comparison of surgical excision followed by adjuvant radiotherapy and laser combined with steroids for the treatment of keloids: A systematic review and meta-analysis. Int Wound J 2023; 21:e14449. [PMID: 37967571 PMCID: PMC10895202 DOI: 10.1111/iwj.14449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 10/10/2023] [Indexed: 11/17/2023] Open
Abstract
This meta-analysis aims to evaluate and compare the effect of surgical excision followed by adjuvant radiotherapy and laser combined with steroids on keloids. Relevant studies reporting the recurrence rate or incidence of adverse events (AEs) were retrieved from the PubMed, Web of Science, Embase and Cochrane Library databases through August 2023. The quality of noncomparative single-arm clinical trials was evaluated using the methodological index for nonrandomised studies (MINORS) Methodological items. This meta-analysis was conducted utilizing Stata 12.0 statistical software. 26 studies involving 989 patients were included in the analysis. The recurrence rate in the laser combined with steroids therapy group (12.2%, 95% confidence interval [CI]: 5.9%-18.5%) was lower than that of the surgical excision combined with radiotherapy group (13.5%, 95% CI: 6.6%-22.2%). For the incidence of AEs, relatively low incidence of atrophy (0.0%, 95% CI: 0.0%-1.2%), telangiectasia (3.2%, 95% CI: 0.4%-7.6%), erythema (2.3%, 95% CI: 0.0%-10.6%), infection (0.2%, 95% CI: 0.0%-1.6%) and high hyperpigmentation rate (8.3%, 95% CI: 4.2%-13.4%) were obtained in the surgical excision combined with radiotherapy group. Compared with surgical resection followed by radiotherapy, the combination of laser and steroids for keloids showed a lower hyperpigmentation rate (6.5%), as well as a higher incidence of atrophy (22.7%), telangiectasia (6.4%), erythema (3.3%) and infection (3.3%). Only a hypopigmentation rate of 2.9% was obtained in patients treated with surgical excision plus radiotherapy. Current evidence revealed that surgical excision followed by adjuvant radiotherapy and laser combined with steroids therapy were effective and safe treatments for keloids, with relatively low recurrence rate and complication rate. Comparative studies are needed to further compare the effects of these two combination therapies on keloids.
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Affiliation(s)
- Siqi Fu
- Department of DermatologySecond Xiangya Hospital, Central South UniversityChangshaChina
| | - Liu Duan
- Department of DermatologyThe Third Hospital of ChangshaChangshaChina
| | - Yan Zhong
- Department of Preventive MedicineSchool of Medicine, Hunan Normal UniversityChangshaChina
| | - Yu Zeng
- Hunan Provincial University Key Laboratory of the Fundamental and Clinical Research on Neurodegenerative DiseasesChangsha Medical UniversityChangshaChina
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33
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Zhang MZ, Liu YF, Ding L, Li ZJ, Li YZ, Si LB, Yu NZ, Wang XJ, Long X. 2-Methoxyestradiol inhibits the proliferation level in keloid fibroblasts through p38 in the MAPK/Erk signaling pathway. J Cosmet Dermatol 2023; 22:3135-3142. [PMID: 37190848 DOI: 10.1111/jocd.15810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/06/2023] [Accepted: 04/28/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND The MAPK/Erk signaling pathway is a classic pathway in cell proliferation. Our former study showed that keloid tissue revealed a higher proliferation level than physiological scars and normal skin. As a natural metabolite of estradiol, 2-methoxyestradiol (2ME2) showed an inhibition proliferation effect on tumor cells. AIM In this study, the treatment effect of 2ME2 and its potential mechanisms are explored. METHODS Six keloid patients and six non-keloid patients were randomly selected from the Department of Plastic Surgery at our hospital during June 2021 to December 2021. Six groups were established: normal skin fibroblasts (N); keloid fibroblasts (K); keloid fibroblasts treated with 2ME2 (K + 2ME2); keloid fibroblasts treated with dimethyl sulfoxide (DMSO) (K + DMSO); keloid fibroblasts treated with doramapimod (K + IN); keloid fibroblasts treated with doramapimod (p38 inhibitor) and 2ME2 (K + IN+2ME2). The fibroblast activity and key factor expression of the MAPK/Erk signaling pathway were measured. RESULTS In the results, 2ME2 significantly inhibited keloid fibroblast activity and key factor expression (except STAT1). CONCLUSION The proliferation levels were reduced by both the p38 inhibitor and 2ME2, indicating 2ME2 may achieve an antiproliferation effect by targeting p38 in keloid fibroblasts.
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Affiliation(s)
- Ming-Zi Zhang
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Yi-Fang Liu
- International Education College, Beijing Vocational College of Agriculture, Beijing, China
| | - Li Ding
- Department of Planned Immunity, Changjianglu Community Health Center of the West Coast New Area, Qingdao, China
| | - Zhi-Jin Li
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Yun-Zhu Li
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Lou-Bin Si
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Nan-Ze Yu
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Xiao-Jun Wang
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Xiao Long
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China
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Hong L, Junjie C, Pengyu Z, Ping L, Wei C. The mechanism of oxidative stress in keloid fibroblasts and the experimental study of early application of angiotensin-converting enzyme inhibitor. Indian J Dermatol Venereol Leprol 2023; 89:842-849. [PMID: 37067128 DOI: 10.25259/ijdvl_323_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 10/12/2022] [Indexed: 03/31/2023]
Abstract
Objective To investigate the protective effects of an angiotensin-converting enzyme inhibitor after inducing oxidative stress on keloid fibroblasts. Methods Primary keloid fibroblasts were isolated and cultured by enzyme digestion combined with the tissue adhesion method in vitro, and the third to fifth generations of cells were selected for the experiment. For 24 hours, keloid fibroblasts were treated with different concentrations of hydrogen peroxide. Different concentrations of angiotensin-converting enzyme inhibitor were added to the keloid fibroblast culture medium, and then the cells were treated with hydrogen peroxide for 24 hours. Results With the increase of hydrogen peroxide concentration, the growth of keloid fibroblasts was inhibited and the levels of malondialdehyde, superoxide dismutase, and reactive oxygen species increased gradually, accompanied by an increase in the expression of nicotinamide adenine dinucleotide phosphate oxidase and collagen I mRNA. The expression of nicotinamide adenine dinucleotide phosphate oxidase-mRNA in keloid fibroblasts and the formation of reactive oxygen species in keloid fibroblasts were induced by different concentrations of angiotensin II, and the most significant effect was at 10-5 mmol/mL. The effects of diphenyleneiodonium chloride (NOX inhibitor), N-acetylcysteine (reactive oxygen species inhibitor) and nicotinamide adenine dinucleotide phosphate oxidase (NADPH oxidase) RNA treatment on angiotensin II-induced nicotinamide adenine dinucleotide phosphate oxidase and collagen I increased significantly. Hydrogen peroxide and angiotensin II alone or combined can induce NADPH oxidase and reactive oxygen species expression in keloid fibroblasts. When the angiotensin-converting enzyme inhibitor was added, the expression of NADPH oxidase and reactive oxygen species in keloid induced by hydrogen peroxide and angiotensin II could be inhibited. Conclusion Oxidative stress can lead to increased expression of reactive oxygen species, NADPH oxidase and collagen I in keloid fibroblasts, suggesting oxidative stress mediates the migration of human keloid fibroblasts and extracellular matrix synthesis.
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Affiliation(s)
- Li Hong
- Department of Medical Cosmetology, Chengdu Second People's Hospital, Chengdu, China
| | - Chen Junjie
- Department of Aesthetic and Plastic Burn Surgery, West China Hospital of Sichuan University, Huaxi, China
| | - Zhao Pengyu
- Department of Medical Cosmetology, Chengdu Second People's Hospital, Chengdu, China
| | - Liu Ping
- Department of Medical Cosmetology, Chengdu Second People's Hospital, Chengdu, China
| | - Chen Wei
- Department of Medical Cosmetology, Chengdu Second People's Hospital, Chengdu, China
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Cho MY, Lee SG, Kim JE, Lee YS, Chang HS, Roh MR. Analysis of Risk Factors to Predict Occurrence and Prognosis of Postsurgical Hypertrophic Scar Development: A Review of 4238 Cases. Yonsei Med J 2023; 64:687-691. [PMID: 37880850 PMCID: PMC10613765 DOI: 10.3349/ymj.2023.0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/05/2023] [Accepted: 07/28/2023] [Indexed: 10/27/2023] Open
Abstract
PURPOSE This study aimed to identify the risk factors associated with the occurrence and prognosis of hypertrophic scarring following thyroidectomy. MATERIALS AND METHODS A total of 4238 patients who underwent thyroidectomy were included in this study. A multivariable logistic regression model was developed to identify the risk factors for hypertrophic scar development and its prognosis. RESULTS Our analysis revealed that hypertrophic scar development was associated with younger age [odds ratio (OR)=0.949, p<0.0001], male sex (OR=0.562, p<0.0001), higher body mass index (OR=1.137, p<0.0001), prominent sternocleidomastoid muscles (OR=2.522, p<0.0001), scarring located within 1 cm of the sternal notch (OR=4.345, p<0.0001), and a history of keloid development (OR=2.789, p=0.0031). Additionally, scar location within 1 cm of the sternal notch (beta=4.326, p=0.0429) and a history of keloid development (beta=23.082, p<0.0001) were found to be associated with the prognosis of hypertrophic scarring. CONCLUSION The findings of this study provide valuable insights into the risk factors associated with hypertrophic scarring following thyroidectomy. Clinicians can use this information to predict the occurrence of hypertrophic scarring and its prognosis, and take preventative measures accordingly.
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Affiliation(s)
- Mi Yeon Cho
- Department of Dermatology, Yongin Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Yongin, Korea
| | - Sang Gyun Lee
- Department of Dermatology, Gangnam Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jee Eun Kim
- Department of Dermatology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Yong Sang Lee
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hang-Seok Chang
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Mi Ryung Roh
- Department of Dermatology, Gangnam Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.
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Tang Y, Li X. Role and mechanism of Circ-PDE7B in the formation of keloid. Int Wound J 2023; 20:3738-3749. [PMID: 37291755 PMCID: PMC10588313 DOI: 10.1111/iwj.14269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/22/2023] [Indexed: 06/10/2023] Open
Abstract
The excessive proliferation of keloid fibroblasts is one of the important reasons leading to the formation of keloids. Circular RNA (circRNA) is an important regulator that regulates the biological functions of cells. However, the role and mechanism of circ-PDE7B in keloid formation have not been studied yet. QRT-PCR was used to detect the circ-PDE7B, miR-331-3p and cyclin-dependent kinase 6 (CDK6) expression. The biological functions of keloid fibroblasts were determined by MTT assay, flow cytometry, transwell assay and wound healing assay. Western blot analysis was used to measure the protein levels of extracellular matrix (ECM) markers and CDK6. The interaction between miR-331-3p and circ-PDE7B or CDK6 was confirmed by dual-luciferase reporter assay and RIP assay. Circ-PDE7B was found to be upregulated in keloid tissues and fibroblasts. Downregulation of circ-PDE7B could suppress the proliferation, invasion, migration, ECM accumulation and accelerate the apoptosis of keloid fibroblasts. Circ-PDE7B could serve as a sponge of miR-331-3p, and the regulation of silenced circ-PDE7B on the biological functions of keloid fibroblasts could be abolished by miR-331-3p inhibitor. Additionally, CDK6 was a target of miR-331-3p, and its overexpression could reverse the negative regulation of miR-331-3p on the biological functions of keloid fibroblasts. Circ-PDE7B sponged miR-331-3p to positively regulate CDK6 expression. Taken together, circ-PDE7B promoted the proliferation, invasion, migration and ECM accumulation of keloid fibroblasts by regulating the miR-331-3p/CDK6 axis, suggesting that circ-PDE7B might be a potential target for keloid treatment.
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Affiliation(s)
- Yueling Tang
- Department of Plastic SurgeryThe First Affiliated Hospital of Anhui Medical University, Xi'an Central HospitalXi'anChina
| | - Xiaojing Li
- Department of Plastic SurgeryThe First Affiliated Hospital of Anhui Medical UniversityHefeiAnhuiChina
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Wang Y, Liu R, Wu Z, Xu X, He L. Development and validation of a risk assessment scale for pathological scarring. Int Wound J 2023; 20:3628-3638. [PMID: 37211352 PMCID: PMC10588301 DOI: 10.1111/iwj.14241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 05/05/2023] [Accepted: 05/09/2023] [Indexed: 05/23/2023] Open
Abstract
To develop a risk assessment scale for pathological scarring and validate its psychometric properties. This was a methodological study. Researchers developed the scale based on a literature review, qualitative study and Delphi expert consultation. Subsequently, 409 patients participated in the study to test the psychometric properties of the scale. We evaluated construct validity, content validity, internal consistency reliability, and interrater reliability. The researchers developed a scale consisting of three dimensions and 12 items. Factor analysis extracted a total of four common factors that accounted for 62.22% of the total variance. The results revealed that the item-content validity index (I-CVI) ranged from 0.67 to 1, while the scale-content validity index (S-CVI) was 0.82. Internal consistency reliability: Cronbach's α of the items ranged from 0.67 to 0.76, while Cronbach's α of the whole scale was 0.74. Interrater reliability: the Kappa number was 0.73. The final scale showed adequate construct validity, content validity, and reliability. It is appropriate for use in research and clinical practice settings to identify patients with a risk of pathological scarring. Further study is needed to confirm the scale's validity and reliability in other settings and populations.
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Affiliation(s)
- Yanqiong Wang
- Department of Burn and Plastic Surgery, West China Hospital / West China School of NursingSichuan UniversityChengduChina
| | - Ruiqi Liu
- Department of Burn and Plastic Surgery, West China Hospital / West China School of NursingSichuan UniversityChengduChina
| | - Zhihui Wu
- Department of Burn and Plastic Surgery, West China Hospital / West China School of NursingSichuan UniversityChengduChina
| | - Xuewen Xu
- Department of Burn and Plastic Surgery, West China Hospital / West China School of NursingSichuan UniversityChengduChina
| | - Lingxiao He
- Department of Trauma Center, West China HospitalSichuan UniversityChengduChina
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Liu Y, Cao Y, Su X, Li S, Dou M, Qu C, Hu J, Wang L. A modified nonsurgical treatment of keloids: Cocktail therapy. J Cosmet Dermatol 2023; 22:3095-3099. [PMID: 37438961 DOI: 10.1111/jocd.15917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/13/2023] [Accepted: 06/25/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND The high recurrence rate after nonsurgical treatment of keloid is a major challenge for clinicians. Although there are many existing treatment options, how to optimize and upgrade the existing options and make a reasonable combination of utilization is our concern. The aim of this study is to provide a comprehensive non-surgical treatment for keloid-cocktail therapy. METHODS According to the different changes of keloid with treatment, the treatment was divided into four stages, and different treatment schemes were adopted for each stage. The incidence of side effects of keloid at each stage and the effective rate and cure rate 16 months after the end of treatment were analyzed. RESULTS All patients completed this study on time, and were followed up 16 months after the end of treatment, the treatment effective rate was 100%, and the cure rate was up to 92.8%. CONCLUSION Cocktail therapy can achieve a higher cure rate of keloid, and is worthy of clinical promotion.
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Affiliation(s)
- Yue Liu
- Department of Cicatrix Minimally Invasive Treatment Center, Plastic Surgery, Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuchen Cao
- Department of Cicatrix Minimally Invasive Treatment Center, Plastic Surgery, Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xueshang Su
- Department of Cicatrix Minimally Invasive Treatment Center, Plastic Surgery, Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shasha Li
- Department of Cicatrix Minimally Invasive Treatment Center, Plastic Surgery, Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Maomei Dou
- Department of Cicatrix Minimally Invasive Treatment Center, Plastic Surgery, Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chunan Qu
- Department of Cicatrix Minimally Invasive Treatment Center, Plastic Surgery, Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jintian Hu
- Department of Cicatrix Minimally Invasive Treatment Center, Plastic Surgery, Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lianzhao Wang
- Department of Cicatrix Minimally Invasive Treatment Center, Plastic Surgery, Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Xie L, Huang L, Zhang G, Su Y. Inhibition of keloid by 32P isotope radiotherapy through suppressing TGF-β/Smad signaling pathway. Aging (Albany NY) 2023; 15:11985-11993. [PMID: 37910782 PMCID: PMC10683590 DOI: 10.18632/aging.205160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 09/27/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND Keloid seriously affects the appearance, and is accompanied by some symptoms including pain, burning, itching. Radioactive nuclides such as 32P have been proved to be effective in inhibiting the formation of keloid, but the mechanism remains unclear. METHODS The keloid animal model was established through keloid tissues implantation. Hematoxylin-Eosin (HE) and Masson staining were performed to investigate histological changes and collagen deposition. The mRNA and protein expression were assessed using RT-PCR and western blotting, respectively. Cell apoptosis and cycle were evaluated through flow cytometry. RESULTS Both 32P isotope injection and skin path significantly reduced the size of keloid, and inhibited TGF-β/Smad signaling pathway. SRI-011381, the agonist of TGF-β/Smad signaling pathway, markedly reversed the influence of 32P isotope on cell proliferation, cell apoptosis, cell cycle of LNCaP cells and TGF-β/Smad signaling pathway. CONCLUSIONS 32P isotope injection and skin path greatly reduced the size of keloid, and the TGF-β/Smad signaling pathway was remarkably inhibited by 32P isotope treatment. The regulation of dermal fibroblast by 32P isotope was reversed by SRI-011381. 32P isotope might inhibit keloid through suppressing TGF-β/Smad signaling pathway. Our study provides a novel therapeutic strategy for the treatment of keloid.
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Affiliation(s)
- Long Xie
- Department of Nuclear Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Liqun Huang
- Department of Nuclear Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Guanjie Zhang
- Department of Nuclear Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Yingrui Su
- Department of Nuclear Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
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Liu C. Risk factors for recurrence after keloid surgery with electron radiotherapy. Medicine (Baltimore) 2023; 102:e35683. [PMID: 37904431 PMCID: PMC10615486 DOI: 10.1097/md.0000000000035683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 09/26/2023] [Indexed: 11/01/2023] Open
Abstract
The aim of this study was to investigate the effect of postoperative electron radiotherapy (RT) on local control for keloids and to identify risk factors for recurrence. The clinical data of 82 patients treated at our institution from January 2015 to October 2019 were collected. The data included the general condition of the patients, clinical characteristics of the keloids, treatment plan, local control, and treatment side effects. A total of 82 patients (129 keloids) were included. The study included 23 men (28%) and 59 females (72%). The median patient age was 32 years (range, 18-67 years). Twenty-six recurrences were observed, and the 1-, 3-, and 5-year local control rates were 93%, 81%, and 73%, respectively. Univariate analysis revealed that age (P = .03), hypertension (P = .04), scar shape (P < .001), primary site (P = .02), maximum lesion diameter (P < .001), pain and itching (P = .005), local tension (P = .005), and infection (P < .001) were risk factors for local recurrence. Multivariable analysis revealed that maximum lesion diameter (P < .001), infection (P < .001), interval between surgery and RT (P = .02), and previous treatment (P = .02) were independent risk factors. Complete excision of keloids combined with electron RT is safe and seemingly effective. For keloids with a high risk of recurrence, more aggressive treatment should be chosen, and further prospective studies are needed to explore the optimal treatment.
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Affiliation(s)
- Chunlei Liu
- Chifeng Municipal Hospital, Chifeng Clinical Medical School of Inner Mongolia Medical University, Chifeng, China
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Harsono AD, Dilogo IH, Prasetyono TOH, Prasetyo M, Werdhani RA, Jusman SWA, Siregar NC, Soedjana H. Clinical evaluation of intralesional umbilical cord-derived mesenchymal stem cells, conditioned medium and triamcinolone acetonide injection for keloid treatment: A pilot study. Int Wound J 2023; 21:e14460. [PMID: 37885365 PMCID: PMC10828519 DOI: 10.1111/iwj.14460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/09/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023] Open
Abstract
Topical keloid therapy is performed with triamcinolone acetonide (TA) intralesional injection. However, the recurrence rate is high with various side effects. Mesenchymal stem cells (MSCs) have high proliferative abilities and reduce the activity and proliferation of fibroblast cells in keloids. To overcome the costs and limitations, conditioned medium (CM) is used. This study aims to evaluate feasibility of intralesional injection of umbilical cord MSC (UC-MSC) and conditioned medium (UC-CM) compared to TA for keloid therapy. Twenty-four patients with keloids who met the inclusion criteria were included, randomized into three treatment groups and then got assessed for the sociodemographic data, keloid volume, histopathology (type 1:3 collagen ratio), interleukin-10 (IL-10) levels and Patient and Observer Scar Assessment Scale (POSAS) score during visits. Largest volume regression occurred in the UC-MSC group, followed by UC-CM and then the TA group (UC-MSC: 45.32% ± 2.61%; UC-CM: 43.61% ± 3.67%; TA: 28.34% ± 3.81%; p = 0.003). Similar pattern was also observed in increase in IL-10 levels, the decrease in POSAS scores and the reduction of type 1:3 collagen ratio. Hence, UC-MSC and UC-CM are promisingly more effective than TA for keloid therapy, showcasing their superiority in reducing keloid volume, symptoms and type 1:3 collagen ratio, as well as increasing the levels of IL-10.
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Affiliation(s)
- Anastasia Dessy Harsono
- Department of Plastic and Reconstructive SurgeryGatot Subroto Army HospitalJakartaIndonesia
- Doctoral Program in Medical Sciences Faculty of MedicineUniversitas IndonesiaJakartaIndonesia
| | - Ismail Hadisoebroto Dilogo
- ICTEC (Indonesian Clinical Training and Education Center), Cipto Mangunkusumo Hospital, Faculty of MedicineUniversitas IndonesiaJakartaIndonesia
- Medical Technology Cluster, Indonesian Medical Education and Research Institute, Faculty of MedicineUniversitas IndonesiaJakartaIndonesia
- Stem Cell Medical Technology Integrated Service Unit, Cipto Mangunkusumo Hospital, Faculty of MedicineUniversitas IndonesiaJakartaIndonesia
- Stem Cell and Tissue Engineering Research Center, Indonesian Medical Education and Research Institute, Faculty of MedicineUniversitas IndonesiaJakartaIndonesia
- Department of Orthopaedic and Traumatology, Cipto Mangunkusumo Hospital, Faculty of MedicineUniversitas IndonesiaJakartaIndonesia
| | - Theddeus Octavianus Hari Prasetyono
- ICTEC (Indonesian Clinical Training and Education Center), Cipto Mangunkusumo Hospital, Faculty of MedicineUniversitas IndonesiaJakartaIndonesia
- Medical Technology Cluster, Indonesian Medical Education and Research Institute, Faculty of MedicineUniversitas IndonesiaJakartaIndonesia
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Cipto Mangunkusumo Hospital, Faculty of MedicineUniversitas IndonesiaJakartaIndonesia
| | - Marcel Prasetyo
- Department of Radiology, Cipto Mangunkusumo Hospital, Faculty of MedicineUniversitas IndonesiaJakartaIndonesia
| | - Retno Asti Werdhani
- Department of Community Medicine, Cipto Mangunkusumo Hospital, Faculty of MedicineUniversitas IndonesiaJakartaIndonesia
| | - Sri Widia A. Jusman
- Department of Biochemistry and Molecular Biology, Cipto Mangunkusumo Hospital, Faculty of MedicineUniversitas IndonesiaJakartaIndonesia
| | - Nuryati Chairani Siregar
- Department of Anatomical Pathology, Cipto Mangunkusumo Hospital, Faculty of MedicineUniversitas IndonesiaJakartaIndonesia
| | - Hardisiswo Soedjana
- Department of Plastic and Reconstructive Surgery, Hasan Sadikin Hospital, Faculty of MedicineUniversitas PadjadjaranBandungIndonesia
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Zhang X, Wu X, Li D. The Communication from Immune Cells to the Fibroblasts in Keloids: Implications for Immunotherapy. Int J Mol Sci 2023; 24:15475. [PMID: 37895153 PMCID: PMC10607157 DOI: 10.3390/ijms242015475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/11/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
Keloids are a type of fibrotic disease characterized by excessive collagen production and extracellular matrix (ECM) deposition. The symptoms of pain and itching and frequent recurrence after treatment significantly impact the quality of life and mental health of patients. A deeper understanding of the pathogenesis of keloids is crucial for the development of an effective therapeutic approach. Fibroblasts play a central role in the pathogenesis of keloids by producing large amounts of collagen fibers. Recent evidence indicates that keloids exhibit high immune cell infiltration, and these cells secrete cytokines or growth factors to support keloid fibroblast proliferation. This article provides an update on the knowledge regarding the keloid microenvironment based on recent single-cell sequencing literature. Many inflammatory cells gathered in keloid lesions, such as macrophages, mast cells, and T lymphocytes, indicate that keloids may be an inflammatory skin disease. In this review, we focus on the communication from immune cells to the fibroblasts and the potential of immunotherapy for keloids. We hope that this review will trigger interest in investigating keloids as an inflammatory disease, which may open up new avenues for drug development by targeting immune mediators.
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Affiliation(s)
- Xiya Zhang
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China;
| | - Xinfeng Wu
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China;
| | - Dongqing Li
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China;
- Key Laboratory of Basic and Translational Research on Immune-Mediated Skin Diseases, Chinese Academy of Medical Sciences, Nanjing 210042, China
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing 210042, China
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Izumov IS, Shitova MS, Sabirov MS, Sheleg SA, Cherkashina OL, Kalabusheva EP, Vorotelyak EA, Morgun EI. RIPK3 Expression in Fibroblasts in an in vivo and in vitro Skin Wound Model: A Controversial Result. Acta Naturae 2023; 15:65-74. [PMID: 38234604 PMCID: PMC10790357 DOI: 10.32607/actanaturae.25452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 10/25/2023] [Indexed: 01/19/2024] Open
Abstract
One of the major problems of regenerative medicine is the development of hypertrophic scars and keloids. The protein kinase RIPK3 is involved in necroptosis; however, recent evidence indicates that it also has non-canonical functions, including its involvement in the development of renal fibrosis. The aim of our work was to study the expression of RIPK3 in mouse and human skin models of fibrotic processes. A subpopulation of RIPK3+Vim+ cells was found in both human keloid and a mouse wound, with the cell number being significantly greater in the mouse wound bed compared to healthy skin. Real-time polymerase chain reaction (RT-PCR) detected expression of the Ripk3 and fibroblast biomarkers Acta2, Fap, Col1a1, and Fn1 in the cells isolated from the wound bed, indicating that RIPK3 can be expressed by wound bed fibroblasts. An analysis of the human fibroblasts stained with anti-RIPK3 antibodies demonstrated an increase in the fluorescence intensity in the presence of lipopolysaccharide (LPS) at concentrations of 5, 10, 25, 50, and 100 ng/ml and TGF-β at concentrations of 0.1, 1, 2, and 5 ng/ml compared to the control. At the same time, the expression levels of RIPK3 and fibroblast activation markers in the presence of TGF-β and LPS did not differ significantly from the control. It is possible that RIPK3 expression in wound fibroblasts is not directly associated with fibrotic processes, and that kinase plays a different, yet unknown role in wound healing. KEYWORDS scarring, keloid, skin, fibroblasts, cell culture, RIPK3.
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Affiliation(s)
- I. S. Izumov
- Koltzov Institute of Developmental Biology of Russian Academy of Sciences, Moscow, 119334 Russian Federation
| | - M. S. Shitova
- Koltzov Institute of Developmental Biology of Russian Academy of Sciences, Moscow, 119334 Russian Federation
| | - M. S. Sabirov
- Koltzov Institute of Developmental Biology of Russian Academy of Sciences, Moscow, 119334 Russian Federation
| | - S. A. Sheleg
- Koltzov Institute of Developmental Biology of Russian Academy of Sciences, Moscow, 119334 Russian Federation
| | - O. L. Cherkashina
- Koltzov Institute of Developmental Biology of Russian Academy of Sciences, Moscow, 119334 Russian Federation
| | - E. P. Kalabusheva
- Koltzov Institute of Developmental Biology of Russian Academy of Sciences, Moscow, 119334 Russian Federation
| | - E. A. Vorotelyak
- Koltzov Institute of Developmental Biology of Russian Academy of Sciences, Moscow, 119334 Russian Federation
- M.V. Lomonosov Moscow State University, Moscow, 119234 Russian Federation
| | - E. I. Morgun
- Koltzov Institute of Developmental Biology of Russian Academy of Sciences, Moscow, 119334 Russian Federation
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44
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Jiang L, Zhuang J, Su X, Zheng Q, Hu J. Sufficient mesh polyhedral intralesional injection for treatment of keloids. J Cosmet Dermatol 2023; 22:2769-2773. [PMID: 37157932 DOI: 10.1111/jocd.15790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 04/06/2023] [Accepted: 04/17/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND The recurrence of keloids after intralesional injections is significant, and a review of the literature shows an inconsistent range of success rates. In this study, the modified medical proportion and intralesional injection method were intended to enhance the treatment effect. METHODS Twenty patients completed the study. Regional block anesthesia (lidocaine, ropivacaine) was performed. Triamcinolone acetonide (40 mg/mL), 5-fluorouracil (25 mg/mL), and ropivacaine (7.5 mg/mL) were configured in a ratio of 2:1:4 and applied on the lesion by reticular injection (horizontal fan-shaped stratified and vertical shaking pressurized injection). The minimum volume of injection per square centimeter was approximately 3.5 mL. The outcome indicators were the Vancouver Scar Scale (VSS), Visual Analogue Scale (VAS), treatment frequency. RESULTS The patients had an 82% ± 7% average reduction in VSS scores and 89% ± 13% and 93% ± 10% reductions in VAS scores of pain and pruritus, respectively, after an average of 2.5 ± 0.7 injections administered within 1 year. CONCLUSION The sufficient mesh polyhedral intralesional injection can achieve excellent results for the treatment of keloid scars.
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Affiliation(s)
- Liya Jiang
- Department of Cicatrix Minimally Invasive Treatment Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jun Zhuang
- Department of Cicatrix Minimally Invasive Treatment Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xueshang Su
- Department of Cicatrix Minimally Invasive Treatment Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qiaoyuan Zheng
- College of Clinical Medicine, Fudan University, Shanghai, China
| | - Jintian Hu
- Department of Cicatrix Minimally Invasive Treatment Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Zhang Y, Guo B, Hui Q, Li W, Chang P, Tao K. [Corrigendum] Downregulation of miR‑637 promotes proliferation and metastasis by targeting Smad3 in keloids. Mol Med Rep 2023; 28:196. [PMID: 37681449 PMCID: PMC10510025 DOI: 10.3892/mmr.2023.13083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 05/23/2018] [Indexed: 09/09/2023] Open
Abstract
Subsequently to the publication of the above paper, an interested reader drew to the authors' attention that the Transwell assay data shown in Fig. 4D on p. 1634 contained overlapping sections, such that these data, which were intended to show the results from differently performed experiments, were likely to have been derived from the same original source. After having examined their original data, the authors have realized that this figure was inadvertently assembled incorrectly. The corrected version of Fig. 4, now showing data in Fig. 4D from one of the repeated experiments, is shown on the next page. Note that this error did not significantly affect the results or the conclusions reported in this paper, and all the authors agree with the publication of this Corrigendum. The authors are grateful to the Editor of Molecular Medicine Reports for granting them the opportunity to publish this corrigendum, and apologize to the readership for any inconvenience caused. [Molecular Medicine Reports 18: 1628-1636, 2018; DOI: 10.3892/mmr.2018.9099].
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Affiliation(s)
- Ye Zhang
- Department of Reconstructive and Plastic Surgery, The General Hospital of Shenyang Military Region, Shenyang, Liaoning 110016, P.R. China
| | - Bingyu Guo
- Department of Reconstructive and Plastic Surgery, The General Hospital of Shenyang Military Region, Shenyang, Liaoning 110016, P.R. China
| | - Qiang Hui
- Department of Reconstructive and Plastic Surgery, The General Hospital of Shenyang Military Region, Shenyang, Liaoning 110016, P.R. China
| | - Wei Li
- Department of Reconstructive and Plastic Surgery, The General Hospital of Shenyang Military Region, Shenyang, Liaoning 110016, P.R. China
| | - Peng Chang
- Department of Reconstructive and Plastic Surgery, The General Hospital of Shenyang Military Region, Shenyang, Liaoning 110016, P.R. China
| | - Kai Tao
- Department of Reconstructive and Plastic Surgery, The General Hospital of Shenyang Military Region, Shenyang, Liaoning 110016, P.R. China
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Zhong Y, Zhang Y, Yu A, Zhang Z, Deng Z, Xiong K, Wang Q, Zhang J. Therapeutic role of exosomes and conditioned medium in keloid and hypertrophic scar and possible mechanisms. Front Physiol 2023; 14:1247734. [PMID: 37781228 PMCID: PMC10536244 DOI: 10.3389/fphys.2023.1247734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 08/29/2023] [Indexed: 10/03/2023] Open
Abstract
Exosomes, ranging from 40 to 160 nm in diameter, are extracellular lipid bilayer microvesicles that regulate the body's physiological and pathological processes and are secreted by cells that contain proteins, nucleic acids, amino acids and other metabolites. Previous studies suggested that mesenchymal stem cell (MSC)-derived exosomes could either suppress or support keloid and hypertrophic scar progression. Although previous research has identified the potential value of MSC-exosomes in keloid and hypertrophic scar, a comprehensive analysis of different sources of MSC-exosome in keloid and hypertrophic scar is still lacking. This review mainly discusses different insights regarding the roles of MSC-exosomes in keloid and hypertrophic scar treatment and summarizes possible underlying mechanisms.
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Affiliation(s)
- Yixiu Zhong
- Department of Dermatology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China
| | - Youfan Zhang
- Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Aijiao Yu
- Department of Dermatology, Dermatology Hospital, Southern Medical University, Guangzhou, China
- Department of Dermatology and Venereology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zhiwen Zhang
- Department of Dermatology, Dermatology Hospital, Southern Medical University, Guangzhou, China
- Department of Dermatology and Venereology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zhenjun Deng
- Department of Dermatology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China
| | - Kaifen Xiong
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qi Wang
- Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jianglin Zhang
- Department of Dermatology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China
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Torres-Delgadillo R, Corona-Rodarte E, Solis-Pompa R, Mayorga-Ríos RM, Ramírez-Sánchez J, Pérez-Aldrete B. An unusual painful scar. JAAD Case Rep 2023; 39:44-46. [PMID: 37588802 PMCID: PMC10425779 DOI: 10.1016/j.jdcr.2023.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023] Open
Affiliation(s)
| | - Eduardo Corona-Rodarte
- Department of Dermatology, Instituto Dermatológico de Jalisco “José Barba Rubio”, Jalisco, México
| | - Rodrigo Solis-Pompa
- School of Population and Public Health, University of British Columbia, British Columbia, Canada
| | | | - Joel Ramírez-Sánchez
- Department of Dermatology, Instituto Dermatológico de Jalisco “José Barba Rubio”, Jalisco, México
| | - Berenice Pérez-Aldrete
- Department of Dermatology, Instituto Dermatológico de Jalisco “José Barba Rubio”, Jalisco, México
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Yang R, Wang X, Zheng W, Chen W, Gan W, Qin X, Huang J, Chen X, Zhou S. Bioinformatics analysis and verification of m6A related genes based on the construction of keloid diagnostic model. Int Wound J 2023; 20:2700-2717. [PMID: 36896881 PMCID: PMC10410345 DOI: 10.1111/iwj.14144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/18/2023] [Accepted: 02/20/2023] [Indexed: 03/11/2023] Open
Abstract
Keloids are formed due to abnormal hyperplasia of the skin connective tissue. We explored the relationship between N6-methyladenosine (m6A)-related genes and keloids. The transcriptomic datasets (GSE44270 and GSE185309) of keloid and normal skin tissues samples were obtained from the Gene Expression Omnibus database. We constructed the m6A landscape and verified the corresponding genes using immunohistochemistry. We extracted hub genes for unsupervised clustering analysis using protein-protein interaction (PPI) network; gene ontology enrichment analysis was performed to determine the biological processes or functions affected by the differentially expressed genes (DEGs). We performed immune infiltration analysis to determine the relationship between keloids and the immune microenvironment using single-sample gene set enrichment analysis and CIBERSORT. Differential expression of several m6A genes was observed between the two groups; insulin-like growth factor 2 mRNA-binding protein 3 (IGF2BP3) was significantly upregulated in keloid patients. PPI analysis elucidated six genes with significant differences between the two keloid sample groups. Enrichment analysis revealed that the DEGs were mainly enriched in cell division, proliferation, and metabolism. Moreover, significant differences in immunity-related pathways were observed. Therefore, the results of this study will provide a reference for the elucidation of the pathogenesis and therapeutic targets of keloids.
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Affiliation(s)
- Ronghua Yang
- Department of Burn and Plastic Surgery, Guangzhou First People's HospitalSouth China University of TechnologyGuangzhouChina
| | - Xiaoxiang Wang
- The First Clinical Medical CollegeGuangdong Medical UniversityZhanjiangChina
- Department of Burn Surgery and Skin RegenerationThe First People's Hospital of FoshanFoshanChina
| | - Wenlian Zheng
- The First Clinical Medical CollegeGuangdong Medical UniversityZhanjiangChina
| | - Wentao Chen
- The First Clinical Medical CollegeGuangdong Medical UniversityZhanjiangChina
| | - Wenjun Gan
- The First Clinical Medical CollegeGuangdong Medical UniversityZhanjiangChina
| | | | - Jie Huang
- Department of Burn and Plastic Surgery, Guangzhou First People's HospitalSouth China University of TechnologyGuangzhouChina
| | - Xiaodong Chen
- Department of Burn Surgery and Skin RegenerationThe First People's Hospital of FoshanFoshanChina
| | - Sitong Zhou
- Department of DermatologyThe First People's Hospital of FoshanFoshanChina
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Hahn JM, Combs KA, Powell HM, Supp DM. A role for vitamin D and the vitamin D receptor in keloid disorder. Wound Repair Regen 2023; 31:563-575. [PMID: 37458255 DOI: 10.1111/wrr.13109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/28/2023] [Accepted: 07/06/2023] [Indexed: 07/28/2023]
Abstract
Keloids are disfiguring fibroproliferative lesions that can occur in susceptible individuals following any skin injury. They are extremely challenging to treat, with relatively low response rates to current therapies and high rates of recurrence after treatment. Although several distinct genetic loci have been associated with keloid formation in different populations, there has been no single causative gene yet identified and the molecular mechanisms guiding keloid development are incompletely understood. Further, although it is well known that keloids are more commonly observed in populations with dark skin pigmentation, the basis for increased keloid risk in skin of colour is not yet known. Because individuals with dark skin pigmentation are at higher risk for vitamin D deficiency, the role of vitamin D in keloid pathology has gained interest in the keloid research community. A limited number of studies have found lower serum vitamin D levels in patients with keloids, and reduced expression of the vitamin D receptor (VDR) in keloid lesions compared with uninjured skin. Vitamin D has documented anti-inflammatory, anti-proliferative and pro-differentiation activities, suggesting it may have a therapeutic role in suppression of keloid fibrosis. Here we review the evidence supporting a role for vitamin D and VDR in keloid pathology.
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Affiliation(s)
- Jennifer M Hahn
- Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Kelly A Combs
- Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Heather M Powell
- Departments of Materials Science and Engineering and Biomedical Engineering, The Ohio State University, Columbus, Ohio, USA
- Scientific Staff, Shriners Children's Ohio, Dayton, Ohio, USA
| | - Dorothy M Supp
- Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Scientific Staff, Shriners Children's Ohio, Dayton, Ohio, USA
- Center for Stem Cell & Organoid Medicine (CuSTOM), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
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50
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Telgenhoff D. Claudin-2 in hyperproliferative migrating keratinocytes and migration inhibition via siRNA knockdown. Anat Histol Embryol 2023; 52:723-731. [PMID: 37147871 DOI: 10.1111/ahe.12929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 04/07/2023] [Accepted: 04/17/2023] [Indexed: 05/07/2023]
Abstract
Claudin-2 is a tight junction protein found in various tissues including the epidermis of the skin. Intracellular signalling via claudin-2 may have an effect on cell proliferation and migration. While the role of claudin-2 in the epidermis has not been established, here we show an increase in claudin-2 expression in hyperproliferative archival skin samples. To further examine the role of claudin-2 in cell migration we examined its expression in cultured keratinocytes and found it was increased in wound margins in an in vitro scratch test assay. We then used a claudin-2 knockdown assay using small interfering ribonucleic acid (siRNA) with a 77% transfection efficiency and decrease in claudin-2 protein via Western blot analysis to examine cell migration, which was inhibited following claudin-2 knockdown over a 5-day period. Cells transfected with claudin-2 siRNA also showed a decreased size compared to controls and a more diffuse staining pattern. Lastly we examined claudin-2 expression in migrating keratinocytes by Western blot analysis and found a significant decrease in protein staining in scratch-test assay cultures after 4 h, followed by a significant increase in claudin-2 protein after 24 h. Taken together these results indicate a role for claudin-2 signalling in proliferation and cell migration in the epidermis of the skin.
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Affiliation(s)
- Dale Telgenhoff
- Clinical and Diagnostic Sciences, Oakland University, Rochester, Michigan, USA
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