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Wang J, Du J, Wang Y, Song Y, Wu J, Wang T, Yu Z, Song B. CILP2 promotes hypertrophic scar through Snail acetylation by interaction with ACLY. Biochim Biophys Acta Mol Basis Dis 2024; 1870:167202. [PMID: 38670440 DOI: 10.1016/j.bbadis.2024.167202] [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: 02/10/2024] [Revised: 04/16/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND & AIMS Hypertrophic scar (HS) is a skin fibroproliferative disorder occurring after burns, surgeries or traumatic injuries, and it has caused a tremendous economic and medical burden. Its molecular mechanism is associated with the abnormal proliferation and transition of fibroblasts and excessive deposition of extracellular matrix. Cartilage intermediate layer protein 2 (CILP2), highly homologous to cartilage intermediate layer protein 1 (CILP1), is mainly secreted predominantly from chondrocytes in the middle/deeper layers of articular cartilage. Recent reports indicate that CILP2 is involved in the development of fibrotic diseases. We investigated the role of CILP2 in the progression of HS. METHODS AND RESULTS It was found in this study that CILP2 expression was significantly higher in HS than in normal skin, especially in myofibroblasts. In a clinical cohort, we discovered that CILP2 was more abundant in the serum of patients with HS, especially in the early stage of HS. In vitro studies indicated that knockdown of CILP2 suppressed proliferation, migration, myofibroblast activation and collagen synthesis of hypertrophic scar fibroblasts (HSFs). Further, we revealed that CILP2 interacts with ATP citrate lyase (ACLY), in which CILP2 stabilizes the expression of ACLY by reducing the ubiquitination of ACLY, therefore prompting Snail acetylation and avoiding reduced expression of Snail. In vivo studies indicated that knockdown of CILP2 or ACLY inhibitor, SB-204990, significantly alleviated HS formation. CONCLUSION CILP2 exerts a vital role in hypertrophic scar formation and might be a detectable biomarker reflecting the progression of hypertrophic scar and a therapeutic target for hypertrophic scar.
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Affiliation(s)
- Jianzhang Wang
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Juan Du
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Yuanyong Wang
- Department of Thoracic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Yajuan Song
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Junzheng Wu
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Tong Wang
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Zhou Yu
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
| | - Baoqiang Song
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
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Xu C, Zhang H, Yang C, Wang Y, Wang K, Wang R, Zhang W, Li C, Tian C, Han C, Li M, Liu X, Wang Y, Li Y, Zhang J, Li Y, Luo L, Shang Y, Zhang L, Chen Y, Shen K, Hu D. miR-125b-5p delivered by adipose-derived stem cell exosomes alleviates hypertrophic scarring by suppressing Smad2. Burns Trauma 2024; 12:tkad064. [PMID: 38765787 PMCID: PMC11102599 DOI: 10.1093/burnst/tkad064] [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] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 12/08/2023] [Accepted: 12/14/2023] [Indexed: 05/22/2024]
Abstract
Background Hypertrophic scarring is the most serious and unmet challenge following burn and trauma injury and often leads to pain, itching and even loss of function. However, the demand for ideal scar prevention and treatment is difficult to satisfy. We aimed to discover the effects and mechanisms of adipose-derived stem cell (ADSC) exosomes in hypertrophic scarring. Methods ADSC exosomes were isolated from the culture supernatant of ADSCs and identified by nanoparticle tracking analysis, transmission electron microscopy and western blotting. The effect of ADSC exosomes on wound healing and scar formation was detected by the wound model of BALB/c mice. We isolated myofibroblasts from hypertrophic scar tissue and detected the cell viability, proliferation and migration of myofibroblasts. In addition, collagen formation and fibrosis-related molecules were also detected. To further disclose the mechanism of ADSC exosomes on fibrosis in myofibroblasts, we detected the expression of Smad2 in hypertrophic scar tissue and normal skin and the regulatory mechanism of ADSC exosomes on Smad2. Injection of bleomycin was performed in male BALB/c mice to establish an in vivo fibrosis model while ADSC exosomes were administered to observe their protective effect. The tissue injury of mice was observed via hematoxylin and eosin and Masson staining and related testing. Results In this study, we found that ADSC exosomes could not only speed up wound healing and improve healing quality but also prevent scar formation. ADSC exosomes inhibited expression of fibrosis-related molecules such as α-smooth muscle actin, collagen I (COL1) and COL3 and inhibited the transdifferentiation of myofibroblasts. In addition, we verified that Smad2 is highly expressed in both hypertrophic scar tissue and hypertrophic fibroblasts, while ADSC exosomes downregulated the expression of Smad2 in hypertrophic fibroblasts. Further regulatory mechanism analysis revealed that microRNA-125b-5p (miR-125b-5p) is highly expressed in ADSC exosomes and binds to the 3' untranslated region of Smad2, thus inhibiting its expression. In vivo experiments also revealed that ADSC exosomes could alleviate bleomycin-induced skin fibrosis and downregulate the expression of Smad2. Conclusions We found that ADSC exosomes could alleviate hypertrophic scars via the suppression of Smad2 by the specific delivery of miR-125b-5p.
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Affiliation(s)
- Chaolei Xu
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, China
| | - Hao Zhang
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, China
| | - Chen Yang
- Department of Plastic Surgery, Burns and Cosmetology, The First Affiliated Hospital of Xi’an Medical University, Xi’an 710032, China
| | - Ying Wang
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, China
| | - Kejia Wang
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, China
| | - Rui Wang
- Department of Aerospace Medical Training, School of Aerospace Medicine, Fourth Military Medical University, Xi’an 710032, China
| | - Wei Zhang
- Department of Plastic Surgery, Burns and Cosmetology, The First Affiliated Hospital of Xi’an Medical University, Xi’an 710032, China
| | - Chao Li
- Department of Plastic Surgery, Burns and Cosmetology, The First Affiliated Hospital of Xi’an Medical University, Xi’an 710032, China
| | - Chenyang Tian
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, China
| | - Chao Han
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, China
| | - Mengyang Li
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, China
| | - Xu Liu
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, China
| | - Yunwei Wang
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, China
| | - Yan Li
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, China
| | - Jian Zhang
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, China
| | - Yu Li
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, China
| | - Liang Luo
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, China
| | - Yage Shang
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, China
| | - Lixia Zhang
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, China
| | - Yuxi Chen
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, China
| | - Kuo Shen
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, China
| | - Dahai Hu
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, China
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Yan Q, Shen S, Liu L, Weng J, Zheng G, Dong X, Yang J, Yang Q, Xie J. Fabrication of controlled porous and ultrafast dissolution porous microneedles by organic-solvent-free ice templating method. Int J Pharm 2024:124220. [PMID: 38734274 DOI: 10.1016/j.ijpharm.2024.124220] [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: 03/25/2024] [Revised: 05/02/2024] [Accepted: 05/08/2024] [Indexed: 05/13/2024]
Abstract
Porous Microneedles (PMNs) have been widely used in drug delivery and medical diagnosis owing to their abundant interconnected pores. However, the mechanical strength, the use of organic solvent, and drug loading capacity have long been challenging. Herein, a novel strategy of PMNs fabrication based on the Ice Templating Method is proposed that is suitable for insoluble, soluble, and nanosystem drug loading. The preparation process simplifies the traditional microneedle preparation process with a shorter preparation time. It endows the highly tunable porous morphology, enhanced mechanical strength, and rapid dissolution performance. Micro-CT three-dimensional reconstruction was used to better quantify the internal structures of PMNs, and we further established the equivalent pore network model to statistically analyze the internal pore structure parameters of PMNs. In particular, the mechanical strength is mainly negatively correlated with the surface porosity, while the dissolution velocity is mainly positively correlated with the permeability coefficient by the correlation heatmap. The poorly water-soluble Asiatic acid was encapsulated in PMNs in nanostructured lipid carriers, showing prominent hypertrophic scar healing trends. This work offers a quick and easy way of preparation that may be used to expand PMNs function and be introduced in industrial manufacturing development.
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Affiliation(s)
- Qinying Yan
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou 310014, PR China; Research Institute of Pharmaceutical Particle Technology, Zhejiang University of Technology, Hangzhou 310014, PR China
| | - Shulin Shen
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou 310014, PR China; Research Institute of Pharmaceutical Particle Technology, Zhejiang University of Technology, Hangzhou 310014, PR China
| | - Linxiao Liu
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou 310014, PR China; Research Institute of Pharmaceutical Particle Technology, Zhejiang University of Technology, Hangzhou 310014, PR China
| | - Jiaqi Weng
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou 310014, PR China; Institute of Laser Advanced Manufacturing, Zhejiang University of Technology, Hangzhou, Zhejiang 310023, PR China; College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou, Zhejiang 310023, PR China
| | - Gensuo Zheng
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou 310014, PR China; Research Institute of Pharmaceutical Particle Technology, Zhejiang University of Technology, Hangzhou 310014, PR China
| | - Xu Dong
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou 310014, PR China; Research Institute of Pharmaceutical Particle Technology, Zhejiang University of Technology, Hangzhou 310014, PR China
| | - Jing Yang
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou 310014, PR China; Research Institute of Pharmaceutical Particle Technology, Zhejiang University of Technology, Hangzhou 310014, PR China
| | - Qingliang Yang
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou 310014, PR China; Research Institute of Pharmaceutical Particle Technology, Zhejiang University of Technology, Hangzhou 310014, PR China
| | - Jing Xie
- Third Clinical College of Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou 325000, PR China.
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Li Y, Xiao Y, Han Y, Zhu H, Han J, Wang H. Blocking the MIR155HG/miR-155 axis reduces CTGF-induced inflammatory cytokine production and α-SMA expression via upregulating AZGP1 in hypertrophic scar fibroblasts. Cell Signal 2024; 120:111202. [PMID: 38729323 DOI: 10.1016/j.cellsig.2024.111202] [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: 03/13/2024] [Revised: 04/21/2024] [Accepted: 05/01/2024] [Indexed: 05/12/2024]
Abstract
Hypertrophic scarring (HS) is a pathological condition characterized by excessive fibrosis and inflammation, resulting in excessive extracellular matrix formation in the skin. MIR155HG, a long non-coding RNA, is abnormally upregulated in fibrotic tissues; however, its underlying mechanism is poorly understood. Using single-cell sequencing data, we analyzed connective tissue growth factor (CTGF) expression in various cell types in HS and normal skin tissues and MIR155HG expression in clinical samples. To investigate the mechanism of fibrosis, an in vitro model using CTGF-treated hypertrophic scar fibroblasts (HSFBs) was established and qRT-PCR, western blotting and ELISA assays were performed to investigate the expression of interleukin (IL)-1β, IL-6, and mesenchymal markers α-smooth muscle actin (α-SMA). CTGF stimulates MIR155HG level through phosphorylated STAT3 binding to the MIR155HG promoter. We analyzed the methylation of MIR155HG, assessed the levels of miR-155-5p/-3p in CTGF-treated HSFBs and identified differentially expressed genes among HS and NS samples using the Gene Expression Omnibus RNA sequencing data. The binding between miR-155-5p/-3p and AZGP1 was confirmed using a dual-luciferase assay and inflammatory cytokine production and α-SMA expression were investigated in rescue experiments. The findings revealed that CTGF elevated inflammatory cytokine production, α-SMA and MIR155HG expression in HSFBs. MIR155HG is upregulated in HS tissues due to low DNA methylation. Mechanistically, miR-155-5p/-3p was directly bound to MIR155HG 3'UTR. MIR155HG silencing inhibited cytokine production and α-SMA expression by repressing the generation of miR-155-5p/-3p in CTGF-treated HSFBs. Bioinformatics analysis and luciferase reporter assays revealed that miR-155-5p/-3p targets AZGP1. In addition, transfection with plasmids carrying AZGP1 cDNA significantly inhibited the signaling activity of miR-155-5p/-3 p-overexpressing HSFBs. Our findings highlight the importance of the MIR155HG/miR-155/AZGP1 axis in regulating cytokine production and α-SMA in HS.
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Affiliation(s)
- Yize Li
- Department of Clinical Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Yujie Xiao
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Yongfeng Han
- Department of Ultrasound, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Huayu Zhu
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, China.
| | - Juntao Han
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, China.
| | - Hongtao Wang
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, China.
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Qiu K, Tian Y, Guo C, Liu O, Shi Y, Liu D, Luo T. Global proteomic analysis reveals lysine succinylation is involved in the pathogenesis of hypertrophic scar. J Proteomics 2024; 298:105155. [PMID: 38460743 DOI: 10.1016/j.jprot.2024.105155] [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: 10/20/2023] [Revised: 02/28/2024] [Accepted: 03/05/2024] [Indexed: 03/11/2024]
Abstract
Lysine succinylation (Ksucc) is a recently identified posttranslational modification that is involved in many diseases. This study examined the role of Ksucc in the pathogenesis of hypertrophic scar (HS). The presence of Ksucc in human skin was measured by immunoblotting. Ksucc occurs in many skin proteins ranging from 25 to 250 kDa, and higher levels of Ksucc are found in HS skin than in normal skin. An immunoaffinity approach coupled with LC-MS/MS was used to characterize the first succinylome of human skin, and 159 Ksucc sites in 79 proteins were identified. Among these, there were 38 increased succinylated sites in 29 proteins but no decreased succinylated sites in HS compared with normal skin. A parallel reaction monitoring assay was performed to validate the results of the succinylome and showed that the levels of Ksucc in decorin and collagens, which are involved in the pathogenesis of HS, were increased in HS than in normal skin. In addition, increasing the level of Ksucc enhanced cell proliferation and upregulated the expression of fibrosis markers (α-SMA, COL1, and COL3) in human skin fibroblasts. Our results provide global insights into the functional role of Ksucc in hypertrophic scarring.
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Affiliation(s)
- Keqing Qiu
- Department of Dermatology, The 2nd Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi 330006, China
| | - Yan Tian
- Institute of Biomedical Innovation and School of Basic Medical Sciences, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi 330031, China
| | - Chunyan Guo
- Department of Dermatology, The 2nd Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi 330006, China
| | - Ougen Liu
- Department of Dermatology, The 2nd Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi 330006, China
| | - Yan Shi
- Department of Plastic, Medical Center of Burn Plastic and Wound Repair, The 1st Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi 330006, China
| | - Dewu Liu
- Department of Plastic, Medical Center of Burn Plastic and Wound Repair, The 1st Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi 330006, China.
| | - Tao Luo
- Institute of Biomedical Innovation and School of Basic Medical Sciences, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi 330031, China.
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Chen J, Mo Y, Chen Y, Ma Z, Shen S, Sang H, Tan Q, Mo R. Application and effect of tension-reducing suture in surgical treatment of hypertrophic scar. BMC Surg 2024; 24:119. [PMID: 38654240 PMCID: PMC11036683 DOI: 10.1186/s12893-024-02390-7] [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: 12/31/2023] [Accepted: 03/16/2024] [Indexed: 04/25/2024] Open
Abstract
PURPOSE To investigate the application and effectiveness of tension-reducing suture in the repair of hypertrophic scars. METHODS A retrospective analysis of clinical data was conducted on 82 patients with hypertrophic scars treated at the Department of Burns and Plastic Surgery of Nanjing Drum Tower Hospital from September 2021 to December 2022. Patients were operated with combination of heart-shaped tension-reducing suturing technique and looped, broad, and deep buried (LBD) suturing technique or conventional suture method. Outcomes of surgical treatment were assessed before and 6 months after surgery using the Patient and Observer Scar Assessment Scale (POSAS) and the Vancouver Scar Scale (VSS). RESULTS Improvements were achieved on scar quality compared to that preoperatively, with a reduction in scar width (1.7 ± 0.6 cm vs. 0.7 ± 0.2 cm, P < 0.001). Assessment using the POSAS and VSS scales showed significant improvements in each single parameter and total score compared to preoperative values (P < 0.05). The Combination method group achieved better score in total score of VSS scale, in color, stiffness, thickness and overall opinion of PSAS scale, and in vascularity, thickness, pliability and overall opinion of OSAS scale. CONCLUSION The amalgamation of the heart-shaped tension-reducing suturing technique and the LBD suturing technique has shown promising outcomes, garnering notably high levels of patient satisfaction in the context of hypertrophic scar repair. Patients have exhibited favorable postoperative recoveries, underscoring the clinical merit and the prospective broader applicability of this approach in the realm of hypertrophic scar management.
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Affiliation(s)
- Jingjing Chen
- Department of Burns & Plastic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, NO. 321, Zhongshan Road, Nanjing, China
| | - Yan Mo
- Department of Dermatology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, NO. 321, Zhongshan Road, Nanjing, China
- Department of Dermatology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Yadan Chen
- Department of Burns & Plastic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, NO. 321, Zhongshan Road, Nanjing, China
- Department of Burns & Plastic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, NO. 321, Zhongshan Road, Nanjing, Jiangsu, China
| | - Zhouji Ma
- Department of Burns & Plastic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, NO. 321, Zhongshan Road, Nanjing, China
- Department of Burns & Plastic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, NO. 321, Zhongshan Road, Nanjing, Jiangsu, China
| | - Siyun Shen
- Department of Burns & Plastic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, NO. 321, Zhongshan Road, Nanjing, China
| | - Hong Sang
- Department of Dermatology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
| | - Qian Tan
- Department of Burns & Plastic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, NO. 321, Zhongshan Road, Nanjing, China.
- Department of Burns & Plastic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, NO. 321, Zhongshan Road, Nanjing, Jiangsu, China.
| | - Ran Mo
- Department of Burns & Plastic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, NO. 321, Zhongshan Road, Nanjing, China.
- Department of Burns & Plastic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, NO. 321, Zhongshan Road, Nanjing, Jiangsu, China.
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Shi N, Wang Y, Xia Z, Zhang J, Jia S, Jiao Y, Wang C, Wang X, Zhao J, Zhang J, Jiang D. The regulatory role of the apelin/APJ axis in scarring: Identification of upstream and downstream mechanisms. Biochim Biophys Acta Mol Basis Dis 2024; 1870:167125. [PMID: 38508477 DOI: 10.1016/j.bbadis.2024.167125] [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: 12/23/2023] [Revised: 02/27/2024] [Accepted: 03/14/2024] [Indexed: 03/22/2024]
Abstract
Scarring, a prevalent issue in clinical settings, is characterized by the excessive generation of extracellular matrix within the skin tissue. Among the numerous regulatory factors implicated in fibrosis across various organs, the apelin/APJ axis has emerged as a potential regulator of fibrosis. Given the shared attribute of heightened extracellular matrix production between organ fibrosis and scarring, we hypothesize that the apelin/APJ axis also plays a regulatory role in scar development. In this study, we examined the expression of apelin and APJ in scar tissue, normal skin, and fibroblasts derived from these tissues. We investigated the impact of the hypoxic microenvironment in scars on apelin/APJ expression to identify the transcription factors influencing apelin/APJ expression. Through overexpressing or knocking down apelin/APJ expression, we observed their effects on fibroblast secretion of extracellular matrix proteins. We further validated these effects in animal experiments while exploring the underlying mechanisms. Our findings demonstrated that the apelin/APJ axis is expressed in fibroblasts from keloid, hypertrophic scar, and normal skin. The regulation of apelin/APJ expression by the hypoxic environment in scars plays a significant role in hypertrophic scar and keloid development. This regulation promotes extracellular matrix secretion through upregulation of TGF-β1 expression via the PI3K/Akt/CREB1 pathway.
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Affiliation(s)
- Nian Shi
- Department of Burns and Plastic Surgery, The Second Hospital, Shandong University, Jinan, Shandong 250033, China; School of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Yi Wang
- Department of Burns and Plastic Surgery, The Second Hospital, Shandong University, Jinan, Shandong 250033, China; School of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Zhenyu Xia
- Department of Burns and Plastic Surgery, The Second Hospital, Shandong University, Jinan, Shandong 250033, China; School of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Jingjuan Zhang
- Department of Burns and Plastic Surgery, The Second Hospital, Shandong University, Jinan, Shandong 250033, China; School of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Shanshan Jia
- Department of Burns and Plastic Surgery, The Second Hospital, Shandong University, Jinan, Shandong 250033, China; School of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Ya Jiao
- Department of Burns and Plastic Surgery, The Second Hospital, Shandong University, Jinan, Shandong 250033, China; School of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Chao Wang
- Department of Burns and Plastic Surgery, The Second Hospital, Shandong University, Jinan, Shandong 250033, China; School of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Xiaoyang Wang
- Department of Burns and Plastic Surgery, The Second Hospital, Shandong University, Jinan, Shandong 250033, China; School of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Jie Zhao
- Department of Burns and Plastic Surgery, The Second Hospital, Shandong University, Jinan, Shandong 250033, China; School of Medicine, Shandong University, Jinan, Shandong 250012, China.
| | - Jixun Zhang
- Department of Burns and Plastic Surgery, The Second Hospital, Shandong University, Jinan, Shandong 250033, China; School of Medicine, Shandong University, Jinan, Shandong 250012, China.
| | - Duyin Jiang
- Department of Burns and Plastic Surgery, The Second Hospital, Shandong University, Jinan, Shandong 250033, China; School of Medicine, Shandong University, Jinan, Shandong 250012, China.
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8
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Cai LZ, Caceres M, Dangol MK, Nakarmi K, Rai SM, Chang J, Gibran NS, Pham TN. Accuracy of remote burn scar evaluation via live video-conferencing technology. Burns 2024; 50:781-788. [PMID: 27931764 DOI: 10.1016/j.burns.2016.11.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [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: 08/18/2016] [Revised: 11/02/2016] [Accepted: 11/07/2016] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Telemedicine in outpatient burn care, particularly in burn scar management, may provide cost-effective care and comes highly rated by patients. However, an effective scar scale using both video and photographic elements has not been validated. The purpose of this study is to test the reliability of the Patient and Observer Scar Assessment Scale (POSAS) using live video-conferencing. METHODS A prospective study was conducted with individuals with healed burn scars in Kathmandu, Nepal. Three independent observers assessed 85 burn scars from 17 subjects, using the Observer portion to evaluate vascularity, pigmentation, thickness, relief, pliability, surface area, and overall opinion. The on-site observer was physically present with the subjects and used a live videoconferencing application to show the scars to two remote observers in the United States. Subjects used the Patient portion to evaluate the scar that they believed appeared the worst appearance and had the greatest impact on function. RESULTS The single-rater reliability of the Observer scale was acceptable (ICC>0.70) in overall opinion, thickness, pliability, and surface area. The average-rater reliability for three observers was acceptable (ICC>0.70) for all parameters except for vascularity. When comparing Patients' and Observers' overall opinion scores, patients consistently reported worse opinion. CONCLUSIONS Evaluation of burn scars using the Patient and Observer Scar Assessment Scale can be accurately performed via live videoconferencing and presents an opportunity to expand access to burn care to rural communities, particularly in low- and middle-income countries, where patients face significant access barriers to appropriate follow-up care.
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Affiliation(s)
- Lawrence Z Cai
- Stanford School of Medicine, Stanford University, United States.
| | - Maria Caceres
- University of Washington Regional Burn Center, United States
| | - Mohan Krishna Dangol
- Department of Physical Therapy, Kirtipur Hospital, Nepal; ReSurge International, California, United States
| | - Kiran Nakarmi
- Division of Plastic Surgery, Kirtipur Hospital, Nepal; ReSurge International, California, United States
| | - Shankar Man Rai
- Division of Plastic Surgery, Kirtipur Hospital, Nepal; ReSurge International, California, United States
| | - James Chang
- Department of Surgery, Division of Plastic Surgery, Stanford University, United States; ReSurge International, California, United States
| | - Nicole S Gibran
- University of Washington Regional Burn Center, United States
| | - Tam N Pham
- University of Washington Regional Burn Center, United States
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9
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Li X, Wang X, Shen T, Xiong J, Ma Q, Guo G, Zhu F. Advances in photodynamic therapy of pathologic scar. Photodiagnosis Photodyn Ther 2024; 46:104040. [PMID: 38462122 DOI: 10.1016/j.pdpdt.2024.104040] [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: 12/13/2023] [Revised: 03/02/2024] [Accepted: 03/04/2024] [Indexed: 03/12/2024]
Abstract
Pathologic scars include keloids and hypertrophic scars due to abnormal wound healing. Both cause symptoms of itching and pain; they also affect one's appearance and may even constrain movement. Such scars place a heavy burden on the individual's physical and mental health; moreover, treatment with surgery alone is highly likely to leave more scarring. Therefore, there is an urgent need for a treatment that is both minimally invasive and convenient. Photodynamic therapy (PDT) is an emerging safe and noninvasive technology wherein photosensitizers and specific light sources are used to treat malignant tumors and skin diseases. Research on PDT from both the laboratory and clinic has been reported. These findings on the treatment of pathologic scars using photosensitizers, light sources, and other mechanisms are reviewed in the present article.
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Affiliation(s)
- Xing Li
- Medical Center of Burn Plastic and Wound Repair, The First Affiliated Hospital of Nanchang University, Jiangxi Medical College, Nanchang University, Nanchang 330006, China
| | - Xin Wang
- Medical Center of Burn Plastic and Wound Repair, The First Affiliated Hospital of Nanchang University, Jiangxi Medical College, Nanchang University, Nanchang 330006, China
| | - Tuo Shen
- Department of Critical Care Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China
| | - Jianxiang Xiong
- Department of Vascular Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Qimin Ma
- Department of Critical Care Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China
| | - Guanghua Guo
- Medical Center of Burn Plastic and Wound Repair, The First Affiliated Hospital of Nanchang University, Jiangxi Medical College, Nanchang University, Nanchang 330006, China.
| | - Feng Zhu
- Department of Critical Care Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China.
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Park JG, Lim DC, Park JH, Park S, Mok J, Kang KW, Park J. Benzbromarone Induces Targeted Degradation of HSP47 Protein and Improves Hypertrophic Scar Formation. J Invest Dermatol 2024; 144:633-644. [PMID: 37838329 DOI: 10.1016/j.jid.2023.09.279] [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: 06/10/2023] [Revised: 08/29/2023] [Accepted: 09/28/2023] [Indexed: 10/16/2023]
Abstract
Fibrotic diseases are characterized by the abnormal accumulation of collagen in the extracellular matrix, leading to the functional impairment of various organs. In the skin, excessive collagen deposition manifests as hypertrophic scars and keloids, placing a substantial burden on patients and the healthcare system worldwide. HSP47 is essential for proper collagen assembly and contributes to fibrosis. However, identifying clinically applicable HSP47 inhibitors has been a major pharmaceutical challenge. In this study, we identified benzbromarone (BBR) as an HSP47 inhibitor for hypertrophic scarring treatment. BBR inhibited collagen production and secretion in fibroblasts from patients with keloid by binding to HSP47 and inhibiting the interaction between HSP47 and collagen. Interestingly, BBR not only inhibits HSP47 but also acts as a molecular glue degrader that promotes its proteasome-dependent degradation. Through these molecular mechanisms, BBR effectively reduced hypertrophic scarring in mini pigs and rats with burns and/or excisional skin damage. Thus, these findings suggest that BBR can be used to clinically treat hypertrophic scars and, more generally, fibrotic diseases.
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Affiliation(s)
- Jung Gyu Park
- Innovo Therapeutics, Daejeon, Korea; College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Korea
| | | | - Jeong Hwan Park
- Graduate School of International Agricultural Technology, PyeongChang, Korea; Institute of Green Bio Science & Technology, Seoul National University, Pyeongchang, Korea
| | - Seoah Park
- Graduate School of International Agricultural Technology, PyeongChang, Korea; Institute of Green Bio Science & Technology, Seoul National University, Pyeongchang, Korea
| | - Jongsoo Mok
- Graduate School of International Agricultural Technology, PyeongChang, Korea; Institute of Green Bio Science & Technology, Seoul National University, Pyeongchang, Korea
| | - Keon Wook Kang
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Korea.
| | - Joonghoon Park
- Graduate School of International Agricultural Technology, PyeongChang, Korea; Institute of Green Bio Science & Technology, Seoul National University, Pyeongchang, Korea.
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11
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Yu B, Cao Y, Li S, Bai R, Zhou G, Fu Q, Liang L, Gu W, Zhang L, Chen M. Identification and validation of CRLF1 and NRG1 as immune-related signatures in hypertrophic scar. Genomics 2024; 116:110797. [PMID: 38262564 DOI: 10.1016/j.ygeno.2024.110797] [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: 10/14/2023] [Revised: 12/27/2023] [Accepted: 01/20/2024] [Indexed: 01/25/2024]
Abstract
BACKGROUND Hypertrophic scar (HTS) is a prevalent chronic inflammatory skin disorder characterized by abnormal proliferation and extracellular matrix deposition and the precise mechanisms underlying HTS remain elusive. This study aimed to identify and validate potential immune-related genes associated with hypertrophic scar formation. METHODS Skin samples from normal (n = 12) and hypertrophic scar tissues (n = 12) were subjected to RNA-seq analysis. Differentially expressed genes (DEGs) and significant modular genes in Weighted gene Co-expression Network Analysis (WGCNA) were identified. Subsequently, functional enrichment analysis was performed on the intersecting genes. Additionally, eight immune-related genes were matched from the ImmPort database. Validation of NRG1 and CRLF1 was carried out using an external cohort (GSE136906). Furthermore, the association between these two genes and immune cells was assessed by Spearman correlation analysis. Finally, RNA was extracted from normal and hypertrophic scar samples, and RT-qPCR, Immunohistochemistry staining and Western Blot were employed to validate the expression of characteristic genes. RESULTS A total of 940 DEGs were identified between HTS and normal samples, and 288 key module genes were uncovered via WGCNA. Enrichment analysis in key module revealed involvement in many immune-related pathways, such as Th17 cell differentiation, antigen processing and presentation and B cell receptor signaling pathway. The eight immune-related genes (IFI30, NR2F2, NRG1, ESM1, NFATC2, CRLF1, COLEC12 and IL6) were identified by matching from the ImmPort database. Notably, we observed that activated mast cell positively correlated with CRLF1 expression, while CD8 T cells exhibited a positive correlation with NRG1. The expression of NRG1 and CRLF1 was further validated in clinical samples. CONCLUSION In this study, two key immune-related genes (CRLF1 and NRG1) were identified as characteristic genes associated with HTS. These findings provide valuable insights into the immune-related mechanisms underlying hypertrophic scar formation.
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Affiliation(s)
- Boya Yu
- Department of Plastic and Reconstructive Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing 100048, China; Chinese PLA Medical School, Beijing 100853, China
| | - Yalei Cao
- Department of Urology, Peking University Third Hospital, Beijing 100191, China
| | - Shiyi Li
- Department of Plastic and Reconstructive Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing 100048, China; Chinese PLA Medical School, Beijing 100853, China
| | - Ruiqi Bai
- Department of Plastic and Reconstructive Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing 100048, China; Chinese PLA Medical School, Beijing 100853, China
| | - Guiwen Zhou
- Department of Plastic and Reconstructive Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing 100048, China
| | - Qiang Fu
- Department of Plastic and Reconstructive Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing 100048, China
| | - Liming Liang
- Department of Plastic and Reconstructive Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing 100048, China
| | - Weijie Gu
- Department of Dermatology, Air Force Medical Center, Air Force Medical University, Beijing 100142, China.
| | - Lixia Zhang
- Department of Plastic and Reconstructive Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing 100048, China; Chinese PLA Medical School, Beijing 100853, China.
| | - Minliang Chen
- Department of Plastic and Reconstructive Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing 100048, China.
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Li S, Wang Y, Chen Y, Zhang H, Shen K, Guan H. PTEN hinders the formation of scars by regulating the levels of proteins in the extracellular matrix and promoting the apoptosis of dermal fibroblasts through Bcl-xL. Arch Biochem Biophys 2024; 753:109912. [PMID: 38325773 DOI: 10.1016/j.abb.2024.109912] [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: 08/16/2023] [Revised: 01/19/2024] [Accepted: 01/24/2024] [Indexed: 02/09/2024]
Abstract
Hypertrophic scar (HS) is a dermatological condition characterized by an excessive accumulation of proteins in the extracellular matrix (ECM) and an elevated cell count. The development of HS is thought to be linked to the disruption of dermal fibroblast proliferation and apoptosis. The processes of cell proliferation and apoptosis are notably influenced by PTEN. However, the precise mechanisms by which PTEN regulates hypertrophic scar fibroblasts (HSFs) and its overall role in scar formation are still not fully understood. The objective of this study was to investigate the influence of PTEN on hypertrophic scars(HS) and its function in the regulation of scar formation, with the aim of identifying a pivotal molecular target for scar treatment. Our results demonstrate that the overexpression of PTEN (AdPTEN) significantly suppressed the expression of type I collagen (Col I), type III collagen (Col III), and alpha smooth muscle actin (α-SMA) in HSFs. Furthermore, it was observed that the introduction of AdPTEN resulted in the suppression of Bcl-xL expression, which consequently led to an increase in the apoptosis of HSFs. Similarly, in the inhibition of collagens expression and subsequent increase in HSF apoptosis were also observed upon silencing Bcl-xL (sibcl-xL). Additionally, the in vitro model demonstrated that both AdPTEN and sibcl-xL were effective in reducing the contraction of FPCL. The findings of our study provide validation for the role of PTEN in inhibiting the development of hypertrophic scars (HS) by modulating the expression of extracellular matrix (ECM) proteins and promoting apoptosis in hypertrophic scar fibroblasts (HSFs) via Bcl-xL. These results indicate that PTEN and Bcl-xL may hold promise as potential molecular targets for therapeutic interventions aimed at managing hypertrophic scars.
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Affiliation(s)
- Shaohui Li
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, 127 West Chang-le Road, Xi'an, 710032, China
| | - Yunwei Wang
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, 127 West Chang-le Road, Xi'an, 710032, China
| | - Yang Chen
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, 127 West Chang-le Road, Xi'an, 710032, China
| | - Hao Zhang
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, 127 West Chang-le Road, Xi'an, 710032, China
| | - Kuo Shen
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, 127 West Chang-le Road, Xi'an, 710032, China
| | - Hao Guan
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, 127 West Chang-le Road, Xi'an, 710032, China.
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13
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Yang Z, Yang Z, Zuo Z. Early intervention of carbon dioxide fractional laser in hypertrophic scar through TGFβ-1/ Smad3 signaling pathway. Lasers Med Sci 2024; 39:78. [PMID: 38388742 DOI: 10.1007/s10103-024-04026-x] [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: 12/28/2022] [Accepted: 02/13/2024] [Indexed: 02/24/2024]
Abstract
Hypertrophic scars are usually the result of surgical trauma or burn,and more common in individuals with a darker skin color. They appear as red and raised lesions around the wound that continually expand over a period of weeks or months, causing itching, pain, burning sensation and discomfort. Severe scarring affects interpersonal and social relationships, and decreases the quality of life of the patients.The aim of this study was to evaluate the effect of carbon dioxide fractional laser as an early intervention against hypertrophic scars using a rabbit ear scar model, and explore the role of the TGFβ-1/ Smad3 signaling pathway in scar hyperplasia. Four wounds were made into each ear of rabbits, and divided into the untreated control and three laser-treatment groups. The experimental groups received laser intervention once, twice and thrice respectively. laser treatment significantly inhibited the formation of hypertrophic scars, and maximum benefits were seen in the wounds that received three laser treatments. Immunohistochemical staining showed that the in situ expression of TGFβ-1 and Smad3 in the scars decreased by varying degrees after laser intervention, and was most obvious after three laser interventions. Furthermore, the expression levels were the lowest at the end of 6 months after modeling. Therefore, we can assume that early intervention with carbon dioxide fractional laser can prevent formation of hypertrophic scars by regulating the TGF-β1/Smad3 pathway.
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Affiliation(s)
- Zizheng Yang
- Department of Plastic and Cosmetic Burns, Anhui No.2 Provincial People's Hospital, Anhui Medical University, Hefei, China
| | - Zhiguo Yang
- Department of Plastic and Reconstructive Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Zongbao Zuo
- Department of Plastic and Cosmetic Burns, Anhui No.2 Provincial People's Hospital, Anhui Medical University, Hefei, China.
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Kivi MK, Jafarzadeh A, Hosseini-Baharanchi FS, Salehi S, Goodarzi A. The efficacy, satisfaction, and safety of carbon dioxide (CO2) fractional laser in combination with pulsed dye laser (PDL) versus each one alone in the treatment of hypertrophic burn scars: a single-blinded randomized controlled trial. Lasers Med Sci 2024; 39:69. [PMID: 38376542 DOI: 10.1007/s10103-024-03976-6] [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: 07/08/2023] [Accepted: 01/02/2024] [Indexed: 02/21/2024]
Abstract
The tendency to use less-invasive laser-based methods with far more obvious effectiveness has been taken into consideration today for improvement of burning scars. The present study thus aimed to assess the efficacy of two laser-based techniques including pulsed dye laser (PDL) and ablative fractional CO2 laser (AFCL) and its combination on improving different aspects of burning scars regardless of the types of scar as hypertrophic or keloid scars. This randomized single-blinded clinical trial was performed on patients suffering hypertrophic or keloid burning scars. The patients were randomly assigned into three groups scheduling for treatment with PDL alone, AFCL alone, or its combination. All patients were visited before and 40 days after the last treatment session, and their scars were assessed. In all groups, significant improvement was revealed in the Vancouver scar scale (VSS) score, the color of scar, vascular bed in the scar, the and height of scar and its pliability; however, the improvement in each item was more highlighted in the group receiving a combination therapy with PDL and AFCL techniques. In this regard, the highest improvement was found in vascular bed and pliability in the combination therapy group as compared to other groups. Although the superiority of the combined group was not statistically significant, due to the high percentage of improvement in total VSS and most of its indicators, it can be clinically significant. The efficacy of the treatment protocols was different considering subgroups of mature and immature scars (less than 1 year), so that more improvement in pliability of scar, vascularity, and color of scar was found in the group scheduling for PDL + AFCL as compared to those who were treated with PDL alone in immature scar group but not in mature scar group. Combined treatment can be much more effective in improving the appearance and pathological characteristics of scars than each individual treatment. This effectiveness can be seen mainly in immature scars.
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Affiliation(s)
- Maedeh Karimi Kivi
- Medical Students Association, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Alireza Jafarzadeh
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Fatemeh Sadat Hosseini-Baharanchi
- Minimally Invasive Surgery Research Center & Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Sadaf Salehi
- Medical Students Association, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Azadeh Goodarzi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran.
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Liang Q, Pan F, Qiu H, Zhou X, Cai J, Luo R, Xiong Z, Yang H, Zhang L. CLC-3 regulates TGF-β/smad signaling pathway to inhibit the process of fibrosis in hypertrophic scar. Heliyon 2024; 10:e24984. [PMID: 38333829 PMCID: PMC10850413 DOI: 10.1016/j.heliyon.2024.e24984] [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: 08/15/2023] [Revised: 01/17/2024] [Accepted: 01/17/2024] [Indexed: 02/10/2024] Open
Abstract
Objective To study the role and mechanism of chloride channel-3 (ClC-3) in the formation of hypertrophic scar by constructing ClC-3 interference vectors and examining their effects on human hypertrophic scar fibroblasts (HSFB). Methods Human HSFB and human normal skin fibroblasts (NSFB) were used in this study, and ClC-3 interference vectors were constructed to transfect cells. ClC-3 inhibitors NPPB and Tamoxifen were used to treat cells. Cell migration and the expression of TGF-β/Smad, CollagenⅠ,CollagenⅢ were examined to explore the role of ClC-3 in the formation of hypertrophic scar. Results Compared with the normal skin tissue, the positive expression of ClC-3 and TGF-β in the scar tissue was significantly increased. The relative expression of ClC-3 and TGF-β1 in HSFB cells was higher than that in NSFB cells. Interfering with the expression of CLC-3 can inhibit the migration of HSFB cells and the expression of TGF- β/Smad, CollagenⅠ/Ⅲ. The experiment of HSFB cells treated by CLC-3 inhibitors can also obtain similar results. Conclusion Inhibiting CLC-3 can reduce the formation of hypertrophic scars.
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Affiliation(s)
- Qian Liang
- Department of Medical Cosmetology, The Second Affiliated Hospital of Guangxi Medical University, No. 166 Daxue East Road, Xixiangtang District, Nanning City, Guangxi Province, China
| | - Fuqiang Pan
- Department of Medical Cosmetology, The Second Affiliated Hospital of Guangxi Medical University, No. 166 Daxue East Road, Xixiangtang District, Nanning City, Guangxi Province, China
| | - Houhuang Qiu
- Department of Medical Cosmetology, The Second Affiliated Hospital of Guangxi Medical University, No. 166 Daxue East Road, Xixiangtang District, Nanning City, Guangxi Province, China
| | - Xiang Zhou
- Department of Medical Cosmetology, The Second Affiliated Hospital of Guangxi Medical University, No. 166 Daxue East Road, Xixiangtang District, Nanning City, Guangxi Province, China
| | - Jieyun Cai
- Department of Medical Cosmetology, The Second Affiliated Hospital of Guangxi Medical University, No. 166 Daxue East Road, Xixiangtang District, Nanning City, Guangxi Province, China
| | - Ruijin Luo
- Department of Medical Cosmetology, The Second Affiliated Hospital of Guangxi Medical University, No. 166 Daxue East Road, Xixiangtang District, Nanning City, Guangxi Province, China
| | - Zenghui Xiong
- Department of Medical Cosmetology, The Second Affiliated Hospital of Guangxi Medical University, No. 166 Daxue East Road, Xixiangtang District, Nanning City, Guangxi Province, China
| | - Huawei Yang
- Department of Breast Surgery, Affiliated Cancer Hospital of Guangxi Medical University, No. 71 Hedi Road, Nanning City, Guangxi Province, China
| | - Liming Zhang
- Department of Medical Cosmetology, The Second Affiliated Hospital of Guangxi Medical University, No. 166 Daxue East Road, Xixiangtang District, Nanning City, Guangxi Province, China
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Meng F, Wu Q, Zheng C, Fu Q, Zhou G, Ding H, Xu X, Chen M. The Comparison of Efficacy and Safety Between General and Topical Anesthesia on Micro-Plasma Radiofrequency Treatment for Hypertrophic Scar: A Retrospective Cohort Study. Aesthetic Plast Surg 2024; 48:451-460. [PMID: 37884619 DOI: 10.1007/s00266-023-03706-3] [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: 07/19/2023] [Accepted: 09/30/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND While micro-plasma radiofrequency (MPR) treatment has a significant impact on hypertrophic scars, patients often require anesthesia to alleviate substantial discomfort. Currently, patients with similar degrees of scarring may choose surface anesthesia or general anesthesia based on their personal preferences. Nevertheless, the effectiveness and safety of different anesthesia modalities remain uncertain. OBJECTIVE To assess the effectiveness and safety of both general and surface anesthesia in MPR treatment for hypertrophic scars. METHODS We conducted a retrospective cohort study involving 101 patients diagnosed with hypertrophic scars who underwent MPR with different anesthesia methods. The primary measures of efficacy included the Vancouver Scar Scale (VSS) scores assessed before the first treatment and six months after the final treatment. Pain relief was evaluated using Visual Analog Scale (VAS) scores. Safety was assessed by comparing the incidence of adverse reactions between the two groups. RESULTS Patients in the general anesthesia group showed a significant difference in scar pigmentation 6 months after the treatment and lower pain level than those in the surface anesthesia group in the treatment of MPR. The difference in safety was not statistically significant. After adjusting for confounding factors and propensity score matching, the outcome of VSS and VAS scores was stable. CONCLUSION General anesthesia, as opposed to surface anesthesia, appears to enhance both the effectiveness and safety of MPR while reducing postoperative pain in the treatment of hypertrophic scars. For patients with heightened pain sensitivity, general anesthesia may be the preferred treatment option. LEVEL OF EVIDENCE II This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .
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Affiliation(s)
- Fanting Meng
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Forth Medical Center of Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 10048, China
| | - Qian Wu
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Forth Medical Center of Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 10048, China
| | - Can Zheng
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Forth Medical Center of Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 10048, China
| | - Qiang Fu
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Forth Medical Center of Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 10048, China
| | - Guiwen Zhou
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Forth Medical Center of Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 10048, China
| | - Hongfan Ding
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Forth Medical Center of Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 10048, China
| | - Xiao Xu
- Department of Ophthalmology, The Third Medical Center of Chinese PLA General Hospital, No. 69 Yongding Road, Haidian District, Beijing, 100039, China.
| | - Minliang Chen
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Forth Medical Center of Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 10048, China.
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Dinot V, Deffinis C, Goetz C, Olive M. Manufacture and use of transparent facial orthotic masks for treating facial burn scars: A systematic review. Burns 2024; 50:13-22. [PMID: 37821284 DOI: 10.1016/j.burns.2023.06.009] [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: 03/08/2023] [Accepted: 06/12/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Custom-made transparent facial orthoses (TFOs) (face masks) are used to improve facial burn scars. We conducted a systematic literature review on TFO manufacture and use. METHODS Pubmed and Cochrane databases were searched without restrictions for relevant articles. TFO manufacture details and use according to international recommendations (20-32 mmHg pressure, TFO worn 20-23 h/day for ≥2 months) were extracted. RESULTS Of 279 retrieved articles, 11 published over the last 41 years (four in the last 5 years) discussed TFO manufacture/use. There were five technical notes, five case reports, and a patient-cohort study (total patients in the studies=21). TFO-manufacture methods could be categorized as classical, digital, or mixed classical-digital. Relative clinical efficacies and cost advantages were unclear. The plastics used, harness materials, harness-point number, and silicone-interface use differed from study to study. Target pressure, actual pressure, expected daily wearing time, and treatment duration ranged widely and often did not meet current guidelines. Actual wearing time and treatment duration were never measured. CONCLUSIONS Although TFOs play an important global role in burn care, there is a grave paucity of research. Further research is needed to promote the standardization of TFO-related practices and thereby improve the outcomes of facial-burn patients.
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Affiliation(s)
- Vincent Dinot
- Clinical Research Support Unit, Metz-Thionville Regional Hospital, Mercy Hospital, 1 allée du château, 57085 Metz, France; Division of Rehabilitation, Metz-Thionville Regional Hospital, Felix Marechal Hospital, 1 Rue Xavier Roussel, 57000 Metz, France.
| | - Clémence Deffinis
- Division of Rehabilitation, Metz-Thionville Regional Hospital, Felix Marechal Hospital, 1 Rue Xavier Roussel, 57000 Metz, France
| | - Christophe Goetz
- Clinical Research Support Unit, Metz-Thionville Regional Hospital, Mercy Hospital, 1 allée du château, 57085 Metz, France
| | - Magali Olive
- Division of Rehabilitation, Metz-Thionville Regional Hospital, Felix Marechal Hospital, 1 Rue Xavier Roussel, 57000 Metz, France
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Qian Y, Wei W, Pan T, Lu J, Wei Y. Comparison research on the therapeutic effects of botulinum toxin type A and stromal vascular fraction gel on hypertrophic scars in the rabbit ear model. Burns 2024; 50:178-189. [PMID: 37783633 DOI: 10.1016/j.burns.2023.09.010] [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: 12/12/2022] [Revised: 08/05/2023] [Accepted: 09/12/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND AND OBJECTIVES Botulinum toxin type A (BTA) is often used for wrinkles and muscle convulsive diseases due to its blocking of the transmission of nerve impulses. Stromal vascular fraction gel (SVF-gel) prepared from adipose tissue has novel effects on skin depression and poor texture. Both BTA and SVF-gel are proved to possess anti-scar potential. This study aimed to assess and compare their therapeutic effects on hypertrophic scars. MATERIALS AND METHODS The rabbit ear scar model was established and treated with BTA and SVF-gel, alone or in combination. Gross evaluation using Manchester Scar Scale (MSS) was conducted immediately, 4 and 8 weeks after initial treatment. After tissue sample harvest, histological and Western blot analyses were performed. RESULTS All the treatments alleviated scar hyperplasia in different degrees by inhibiting fibroblast activation (Ki-67, α-SMA), tissue inflammation (CD45, IL-1β) and the transforming growth factor-β1 (TGF-β1)/Smad3 pathway. Despite an excellent anti-inflammatory effect, improvement of scar appearance and pathological characteristics in SVF-gel-contained groups was not as good as that in BTA-only group, which might be related to the retention of M2-type macrophages (CD163 +) and partial maintenance of TGF-β1 expression. CONCLUSION Our data suggest that BTA has better anti-scar efficacy than SVF-gel, and the combination of these two treatments shows no obvious combinatorial effect.
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Affiliation(s)
- Yao Qian
- Department of Plastic Surgery, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, China
| | - Wang Wei
- Department of Plastic Surgery, Changxing People's Hospital, Huzhou, China
| | - Tianyun Pan
- Department of Pathology, Huzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Huzhou, China
| | - Jianfeng Lu
- Department of Plastic Surgery, Changxing People's Hospital, Huzhou, China
| | - Ying Wei
- Department of Plastic Surgery, Changxing People's Hospital, Huzhou, China; Department of Plastic Surgery, Jiahui Medical Beauty Clinic Co.Ltd, Huzhou, China.
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19
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Carney BC, Travis TE, Keyloun JW, Moffatt LT, Johnson LS, McLawhorn MM, Shupp JW. Rete ridges are decreased in dyschromic burn hypertrophic scar: A histological study. Burns 2024; 50:66-74. [PMID: 37777456 DOI: 10.1016/j.burns.2023.09.005] [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: 07/22/2022] [Revised: 02/28/2023] [Accepted: 09/10/2023] [Indexed: 10/02/2023]
Abstract
Dyschromic hypertrophic scar (HTS) is a common sequelae of burn injury, however, its mechanism has not been elucidated. This work is a histological study of these scars with a focus on rete ridges. Rete ridges are important for normal skin physiology, and their absence or presence may hold mechanistic significance in post-burn HTS dyschromia. It was posited that hyper-, and hypo-pigmented areas of scars have different numbers of rete ridges. Subjects with dyschromic burn hypertrophic scar were prospectively enrolled (n = 44). Punch biopsies of hyper-, hypo-, and normally pigmented scar and skin were collected. Biopsies were paraffin embedded, sectioned, stained with H&E, and imaged. The number of rete ridges were investigated. Burn hypertrophic scars that healed without autografts were first investigated. The number of rete ridges was higher in normal skin compared to HTS that was either hypo- (p < 0.01) or hyper-pigmented (p < 0.001). This difference was similar despite scar pigmentation phenotype (p = 0.8687). Autografted hyper-pigmented scars had higher rete ridge ratio compared to non-autografted hyper-pigmented HTS (p < 0.0001). Burn hypertrophihc scars have fewer rete ridges than normal skin. This finding may explain the decreased epidermal adherence to underlying dermis associated with hypertrophic scars. Though, contrary to our hypothesis, no direct link between the extent of dyschromia and rete ridge quantity was observed, the differences in normal skin and hypertrophic scar may lead to further understanding of dyschromic scars.
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Affiliation(s)
- Bonnie C Carney
- Department of Biochemistry and Molecular and Cellular Biology, Georgetown University School of Medicine, Washington, DC, USA; Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, USA
| | - Taryn E Travis
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, USA; The Burn Center, Department of Surgery, MedStar Washington Hospital Center, Washington, DC, USA; Department of Surgery, Georgetown University School of Medicine, Washington, DC, USA
| | - John W Keyloun
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, USA; Department of Surgery, MedStar Washington Hospital Center and MedStar Georgetown University Hospital, Washington, DC, USA
| | - Lauren T Moffatt
- Department of Biochemistry and Molecular and Cellular Biology, Georgetown University School of Medicine, Washington, DC, USA; Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, USA; Department of Surgery, Georgetown University School of Medicine, Washington, DC, USA
| | - Laura S Johnson
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, USA; The Burn Center, Department of Surgery, MedStar Washington Hospital Center, Washington, DC, USA; Department of Surgery, Georgetown University School of Medicine, Washington, DC, USA
| | - Melissa M McLawhorn
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, USA
| | - Jeffrey W Shupp
- Department of Biochemistry and Molecular and Cellular Biology, Georgetown University School of Medicine, Washington, DC, USA; Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, USA; The Burn Center, Department of Surgery, MedStar Washington Hospital Center, Washington, DC, USA; Department of Surgery, Georgetown University School of Medicine, Washington, DC, USA.
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20
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Hong YK, Lin YC, Cheng TL, Lai CH, Chang YH, Huang YL, Hung CY, Wu CH, Hung KS, Ku YC, Ho YT, Tang MJ, Lin SW, Shi GY, McGrath JA, Wu HL, Hsu CK. TEM1/endosialin/CD248 promotes pathologic scarring and TGF-β activity through its receptor stability in dermal fibroblasts. J Biomed Sci 2024; 31:12. [PMID: 38254097 PMCID: PMC10804696 DOI: 10.1186/s12929-024-01001-0] [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: 07/06/2023] [Accepted: 01/14/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Pathologic scars, including keloids and hypertrophic scars, represent a common form of exaggerated cutaneous scarring that is difficult to prevent or treat effectively. Additionally, the pathobiology of pathologic scars remains poorly understood. We aim at investigating the impact of TEM1 (also known as endosialin or CD248), which is a glycosylated type I transmembrane protein, on development of pathologic scars. METHODS To investigate the expression of TEM1, we utilized immunofluorescence staining, Western blotting, and single-cell RNA-sequencing (scRNA-seq) techniques. We conducted in vitro cell culture experiments and an in vivo stretch-induced scar mouse model to study the involvement of TEM1 in TGF-β-mediated responses in pathologic scars. RESULTS The levels of the protein TEM1 are elevated in both hypertrophic scars and keloids in comparison to normal skin. A re-analysis of scRNA-seq datasets reveals that a major profibrotic subpopulation of keloid and hypertrophic scar fibroblasts greatly expresses TEM1, with expression increasing during fibroblast activation. TEM1 promotes activation, proliferation, and ECM production in human dermal fibroblasts by enhancing TGF-β1 signaling through binding with and stabilizing TGF-β receptors. Global deletion of Tem1 markedly reduces the amount of ECM synthesis and inflammation in a scar in a mouse model of stretch-induced pathologic scarring. The intralesional administration of ontuxizumab, a humanized IgG monoclonal antibody targeting TEM1, significantly decreased both the size and collagen density of keloids. CONCLUSIONS Our data indicate that TEM1 plays a role in pathologic scarring, with its synergistic effect on the TGF-β signaling contributing to dermal fibroblast activation. Targeting TEM1 may represent a novel therapeutic approach in reducing the morbidity of pathologic scars.
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Affiliation(s)
- Yi-Kai Hong
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- International Center for Wound Repair and Regeneration (iWRR), National Cheng Kung University, Tainan, Taiwan
- Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- The Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Chen Lin
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- International Center for Wound Repair and Regeneration (iWRR), National Cheng Kung University, Tainan, Taiwan
| | - Tsung-Lin Cheng
- Department of Physiology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Orthopaedic Research Center, College of Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
- College of Professional Studies, National Pingtung University of Science Technology, Pingtung, Taiwan
| | - Chao-Han Lai
- Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Han Chang
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Lun Huang
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chia-Yi Hung
- Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chen-Han Wu
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- International Center for Wound Repair and Regeneration (iWRR), National Cheng Kung University, Tainan, Taiwan
| | - Kuo-Shu Hung
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ya-Chu Ku
- Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- The Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yen-Ting Ho
- Department of Stem Cell Therapy Science, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Ming-Jer Tang
- International Center for Wound Repair and Regeneration (iWRR), National Cheng Kung University, Tainan, Taiwan
- The Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Physiology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shu-Wha Lin
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University Hospital, Taipei, Taiwan
| | - Guey-Yueh Shi
- Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- The Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - John A McGrath
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - Hua-Lin Wu
- International Center for Wound Repair and Regeneration (iWRR), National Cheng Kung University, Tainan, Taiwan.
- Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- The Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Chao-Kai Hsu
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- International Center for Wound Repair and Regeneration (iWRR), National Cheng Kung University, Tainan, Taiwan.
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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21
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Tomtschik J, Anand N, Bustos SS, Martinez-Jorge J, Wyles SP. Practical management of hypertrophic scarring: the mayo clinic experience. Arch Dermatol Res 2024; 316:77. [PMID: 38244097 DOI: 10.1007/s00403-023-02802-3] [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: 12/04/2023] [Revised: 12/04/2023] [Accepted: 12/14/2023] [Indexed: 01/22/2024]
Abstract
Hypertrophic scarring is a potential consequence of wound healing that causes functional and aesthetic disability. Common treatments include intralesional pharmacotherapy (e.g., triamcinolone), surgical excision, and energy-based laser devices. While numerous treatment methods have been described for hypertrophic scarring, an optimal treatment strategy has yet to be established given variability in clinical presentation. This study aims to identify patient- and provider-preferred treatment patterns. This is a single-center, retrospective study of adult patients that developed post-surgical hypertrophic scarring between 2007 and 2017. Specifically, trends in procedural management for hypertrophic scarring among this cohort were examined. A total of 442 procedures (intralesional steroid injection, surgical excision, laser-based treatment) were identified in 218 patients with a clinical diagnosis of hypertrophic scarring. Approximately 73% were female; 87% were Caucasian. The median age at first procedure was 45.6 years (SD = 17.4). The most frequent anatomical locations for procedures were the trunk (n = 242; 54.8%), followed by head/neck (n = 86; 19.5%), upper extremities (n = 67; 15.2%), and lower extremities (n = 45; 10.2%). Procedural therapies included intralesional steroid injection (n = 221; 50%), surgical excision (n = 112; 25.3%) and laser (fractional non-ablative laser vs. pulsed dye laser; n = 109; 24.5%). Treatment modality varied by stage of treatment, scar anatomical location, and scar size. This single-center series of patients with hypertrophic scarring highlights a patient-centered management approach and offers clinical guidelines for provider-patient shared decision making.
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Affiliation(s)
- Julia Tomtschik
- Department of Dermatology, Mayo Clinic, 200 First Street S.W., Rochester, MN, 55905, USA.
- University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
| | - Nimay Anand
- Department of Dermatology, Mayo Clinic, 200 First Street S.W., Rochester, MN, 55905, USA
| | - Samyd S Bustos
- Division of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, MN, USA
| | | | - Saranya P Wyles
- Department of Dermatology, Mayo Clinic, 200 First Street S.W., Rochester, MN, 55905, USA
- Center for Regenerative Medicine and Biotherapeutics, Mayo Clinic, Rochester, MN, USA
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22
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Zhao S, Liu H, Wang H, He X, Tang J, Qi S, Yang R, Xie J. Inhibition of phosphatidylinositol 3-kinase catalytic subunit alpha by miR-203a-3p reduces hypertrophic scar formation via phosphatidylinositol 3-kinase/AKT/mTOR signaling pathway. Burns Trauma 2024; 12:tkad048. [PMID: 38179473 PMCID: PMC10762504 DOI: 10.1093/burnst/tkad048] [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] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/24/2023] [Accepted: 09/12/2023] [Indexed: 01/06/2024]
Abstract
Background Hypertrophic scar (HS) is a common fibroproliferative skin disease that currently has no truly effective therapy. Given the importance of phosphatidylinositol 3-kinase catalytic subunit alpha (PIK3CA) in hypertrophic scar formation, the development of therapeutic strategies for endogenous inhibitors against PIK3CA is of great interest. Here, we explored the molecular mechanisms underlying the protective effects of miR-203a-3p (PIK3CA inhibitor) against excessive scar. Methods Bioinformatic analysis, immunohistochemistry, immunofluorescence, miRNA screening and fluorescence in situ hybridization assays were used to identify the possible pathways and target molecules mediating HS formation. A series of in vitro and in vivo experiments were used to clarify the role of PIK3CA and miR-203a-3p in HS. Mechanistically, transcriptomic sequencing, immunoblotting, dual-luciferase assay and rescue experiments were executed. Results Herein, we found that PIK3CA and the phosphatidylinositol 3-kinase (PI3K)/AKT/mTOR pathway were upregulated in scar tissues and positively correlated with fibrosis. We then identified miR-203a-3p as the most suitable endogenous inhibitor of PIK3CA. miR-203a-3p suppressed the proliferation, migration, collagen synthesis and contractility as well as the transdifferentiation of fibroblasts into myofibroblasts in vitro, and improved the morphology and histology of scars in vivo. Mechanistically, miR-203a-3p attenuated fibrosis by inactivating the PI3K/AKT/mTOR pathway by directly targeting PIK3CA. Conclusions PIK3CA and the PI3K/AKT/mTOR pathway are actively involved in scar fibrosis and miR-203a-3p might serve as a potential strategy for hypertrophic scar therapy through targeting PIK3CA and inactivating the PI3K/AKT/mTOR pathway.
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Affiliation(s)
- Shixin Zhao
- Department of Burns, The First Affiliated Hospital of Sun Yat-Sen University, No. 58 Zhongshan Second Road, Yuexiu District, Guangzhou, Guangdong, 510062, China
- Guangdong Provincial Engineering Technology Research Center of Burn and Wound Accurate Diagnosis and Treatment Key Technology and Series of Products, Sun Yat-Sen University, No. 58 Zhongshan Second Road, Yuexiu District, Guangzhou, Guangdong, 510062, China
| | - Hengdeng Liu
- Department of Burns, The First Affiliated Hospital of Sun Yat-Sen University, No. 58 Zhongshan Second Road, Yuexiu District, Guangzhou, Guangdong, 510062, China
- Guangdong Provincial Engineering Technology Research Center of Burn and Wound Accurate Diagnosis and Treatment Key Technology and Series of Products, Sun Yat-Sen University, No. 58 Zhongshan Second Road, Yuexiu District, Guangzhou, Guangdong, 510062, China
| | - Hanwen Wang
- Department of Burns, The First Affiliated Hospital of Sun Yat-Sen University, No. 58 Zhongshan Second Road, Yuexiu District, Guangzhou, Guangdong, 510062, China
- Guangdong Provincial Engineering Technology Research Center of Burn and Wound Accurate Diagnosis and Treatment Key Technology and Series of Products, Sun Yat-Sen University, No. 58 Zhongshan Second Road, Yuexiu District, Guangzhou, Guangdong, 510062, China
| | - Xuefeng He
- Department of Burns, The First Affiliated Hospital of Sun Yat-Sen University, No. 58 Zhongshan Second Road, Yuexiu District, Guangzhou, Guangdong, 510062, China
- Guangdong Provincial Engineering Technology Research Center of Burn and Wound Accurate Diagnosis and Treatment Key Technology and Series of Products, Sun Yat-Sen University, No. 58 Zhongshan Second Road, Yuexiu District, Guangzhou, Guangdong, 510062, China
| | - Jinming Tang
- Department of Burns, The First Affiliated Hospital of Sun Yat-Sen University, No. 58 Zhongshan Second Road, Yuexiu District, Guangzhou, Guangdong, 510062, China
- Guangdong Provincial Engineering Technology Research Center of Burn and Wound Accurate Diagnosis and Treatment Key Technology and Series of Products, Sun Yat-Sen University, No. 58 Zhongshan Second Road, Yuexiu District, Guangzhou, Guangdong, 510062, China
| | - Shaohai Qi
- Department of Burns, The First Affiliated Hospital of Sun Yat-Sen University, No. 58 Zhongshan Second Road, Yuexiu District, Guangzhou, Guangdong, 510062, China
- Guangdong Provincial Engineering Technology Research Center of Burn and Wound Accurate Diagnosis and Treatment Key Technology and Series of Products, Sun Yat-Sen University, No. 58 Zhongshan Second Road, Yuexiu District, Guangzhou, Guangdong, 510062, China
| | - Ronghua Yang
- Department of Burn and Plastic Surgery, Guangzhou First People's Hospital, South China University of technology, No. 1 Panfu Road, Yuexiu District, Guangzhou, Guangdong, 510062, China
| | - Julin Xie
- Department of Burns, The First Affiliated Hospital of Sun Yat-Sen University, No. 58 Zhongshan Second Road, Yuexiu District, Guangzhou, Guangdong, 510062, China
- Guangdong Provincial Engineering Technology Research Center of Burn and Wound Accurate Diagnosis and Treatment Key Technology and Series of Products, Sun Yat-Sen University, No. 58 Zhongshan Second Road, Yuexiu District, Guangzhou, Guangdong, 510062, China
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23
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Dong Y, Cao X, Huang J, Hu Z, Chen C, Chen M, Long Q, Xu Z, Lv D, Rong Y, Luo S, Wang H, Deng W, Tang B. Melatonin inhibits fibroblast cell functions and hypertrophic scar formation by enhancing autophagy through the MT2 receptor-inhibited PI3K/Akt /mTOR signaling. Biochim Biophys Acta Mol Basis Dis 2024; 1870:166887. [PMID: 37739092 DOI: 10.1016/j.bbadis.2023.166887] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 04/17/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/24/2023]
Abstract
Hypertrophic scar (HS) is a fibrotic skin condition and characterized by abnormal proliferation of myofibroblasts and accumulation of extracellular matrix. Melatonin, an endogenous hormone, can alleviate fibrosis in multiple models of diseases. This study examined the effect of melatonin on fibrosis in primary fibroblasts from human HS (HSFs) and a rabbit ear model and potential mechanisms. Melatonin treatment significantly decreased the migration and contraction capacity, collagen and α-smooth muscle actin (α-SMA) production in HSFs. RNA-sequencing and bioinformatic analyses indicated that melatonin modulated the expression of genes involved in autophagy and oxidative stress. Mechanistically, melatonin treatment attenuated the AKT/mTOR activation through affecting the binding of MT2 receptor with PI3K to enhance autophagy, decreasing fibrogenic factor production in HSFs. Moreover, melatonin treatment inhibited HS formation in rabbit ears by enhancing autophagy. The anti-fibrotic effects of melatonin were abrogated by treatment with an autophagy inhibitor (3-methyladenine, 3-MA), an Akt activator (SC79), or an MT2 selective antagonist (4-phenyl-2propionamidotetralin, 4-P-PDOT). Therefore, melatonin may be a potential drug for prevention and treatment of HS.
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Affiliation(s)
- Yunxian Dong
- Department of Burns, Wound Repair and Reconstruction, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Xiaoling Cao
- Department of Burns, Wound Repair and Reconstruction, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jinsheng Huang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Canter of Cancer Medicine, Guangzhou, China
| | - Zhicheng Hu
- Department of Burns, Wound Repair and Reconstruction, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Chufen Chen
- Department of Burns, Wound Repair and Reconstruction, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Miao Chen
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Canter of Cancer Medicine, Guangzhou, China
| | - Qian Long
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Canter of Cancer Medicine, Guangzhou, China
| | - Zhongye Xu
- Department of Burns, Wound Repair and Reconstruction, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Dongming Lv
- Department of Burns, Wound Repair and Reconstruction, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yanchao Rong
- Department of Burns, Wound Repair and Reconstruction, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Shengkang Luo
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Haibin Wang
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Wuguo Deng
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Canter of Cancer Medicine, Guangzhou, China.
| | - Bing Tang
- Department of Burns, Wound Repair and Reconstruction, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
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24
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Zhang XR, Ryu U, Najmiddinov B, Trinh TTT, Choi KM, Nam SY, Heo CY. Effect of Silicone Patch Containing Metal-organic Framework on Hypertrophic Scar Suppression. In Vivo 2024; 38:235-245. [PMID: 38148076 PMCID: PMC10756491 DOI: 10.21873/invivo.13430] [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: 08/11/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND/AIM Hypertrophic scars (HS) are an abnormal cutaneous condition of wound healing characterized by excessive fibrosis and disrupted collagen deposition. This study assessed the potential of a silicone patch embedded with chemically stable zirconium-based metal-organic frameworks (MOF)-808 structures to mitigate HS formation using a rabbit ear model. MATERIALS AND METHODS A silicone patch was strategically engineered by incorporating Zr-MOF-808, a composite structure comprising metal ions and organic ligands. Structural integrity of the Zr-MOF-808 silicone patch was validated using scanning electron microscopy and X-ray diffraction analysis. The animals were divided into three groups: a control, no treatment group (Group 1), a silicone patch treatment group (Group 2), and a group treated with a 0.2% loaded Zr-MOF-808 silicone patch (Group 3). HS suppression effects were quantified using scar elevation index (SEI), dorsal skin thickness measurements, and myofibroblast protein expression. RESULTS Histopathological examination of post-treatment HS samples revealed substantial reductions in SEI (34.6%) and epidermal thickness (49.5%) in Group 3. Scar hyperplasia was significantly diminished by 53.5% (p<0.05), while collagen density declined by 15.7% in Group 3 compared to Group 1. Western blot analysis of protein markers, including TGF-β1, collagen-1, and α-SMA, exhibited diminished levels by 8.8%, 12%, and 21.3%, respectively, in Group 3, and substantially higher levels by 21.9%, 27%, and 39.9%, respectively, in Group 2. On the 35th day post-wound generation, Zr-MOF-808-treated models exhibited smoother, less conspicuous, and flatter scars. CONCLUSION Zr-MOF-808-loaded silicone patch reduced HS formation in rabbit ear models by inducing the proliferation and remodeling of the wound healing process.
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Affiliation(s)
- Xin Rui Zhang
- Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Unjin Ryu
- Department of Chemical and Biological Engineering, Sookmyung Women's University, Seoul, Republic of Korea
| | - Bakhtiyor Najmiddinov
- Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Thuy-Tien Thi Trinh
- Korean Institute of Nonclinical Study, H&Bio. Co. Ltd., Seongnam, Republic of Korea
| | - Kyung Min Choi
- Department of Chemical and Biological Engineering, Sookmyung Women's University, Seoul, Republic of Korea;
- R&D Center, LabInCube Co. Ltd., Cheongju, Republic of Korea
| | - Sun-Young Nam
- Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea;
| | - Chan Yeong Heo
- Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea;
- Korean Institute of Nonclinical Study, H&Bio. Co. Ltd., Seongnam, Republic of Korea
- Department of Medical Device Development, College of Medicine, Seoul National University, Seoul, Republic of Korea
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25
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Su L, Han J. Non-coding RNAs in hypertrophic scars and keloids: Current research and clinical relevance: A review. Int J Biol Macromol 2024; 256:128334. [PMID: 38007032 DOI: 10.1016/j.ijbiomac.2023.128334] [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: 07/23/2023] [Revised: 10/28/2023] [Accepted: 11/12/2023] [Indexed: 11/27/2023]
Abstract
Hypertrophic scars (HS) and keloids (KD) are lesions that develop as a result of excessive fibroblast proliferation and collagen deposition in response to dermal injury, leading to dysregulation of the inflammatory, proliferative, and remodeling phases during wound healing. HS and KD affect up to 90 % of the population and are associated with lower quality of life, physical health, and mental status in patients. Efficient targeted treatment represents a significant challenge, primarily due to our limited understanding of their underlying pathogenesis. Non-coding RNAs (ncRNAs), which constitute a significant portion of the human transcriptome with minimal or no protein-coding capacity, have been implicated in various cellular physiologies and pathologies and may serve as diagnostic indicators or therapeutic targets. NcRNAs have been found to be aberrantly expressed and regulated in HS and KD. This review provides a summary of the expression profiles and molecular mechanisms of three common ncRNAs, including microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and circular RNAs (circRNAs), in HS and KD. It also discusses their potential as biomarkers for the diagnosis and treatment of these diseases and provides novel insights into epigenetic-based diagnosis and treatment strategies for HS and KD.
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Affiliation(s)
- Linlin Su
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi 710032, China.
| | - Juntao Han
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi 710032, China.
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Zhou J, Hao F, Huang L, Fu Q, Yuan L, Luo G, Tan J. Treatment of hypertrophic scars with ablative fractional carbon dioxide laser assisted with different topical triamcinolone delivery ways. Heliyon 2023; 9:e22818. [PMID: 38125450 PMCID: PMC10730585 DOI: 10.1016/j.heliyon.2023.e22818] [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: 02/19/2023] [Revised: 11/17/2023] [Accepted: 11/20/2023] [Indexed: 12/23/2023] Open
Abstract
Objectives Ablative fractional carbon dioxide laser has been used with triamcinolone to treat hypertrophic scars, resulting in promising success rates. However, there are different topical triamcinolone delivery methods used in scar treatment. To assess the efficacy among the different triamcinolone delivery methods, this study was designed to compare the efficacy and safety of ablative fractional carbon dioxide laser followed by penetration and injection of topical triamcinolone into thicker hypertrophic scars (height score of VSS ≥2). Study design/materials and methods We performed a retrospective study of 155 thicker hypertrophic scar patients (height score of VSS ≥2), including 88 patients in the triamcinolone external application group and 67 patients in the triamcinolone intralesional injection group. One month after the patients had 3 treatment sessions at 4-week intervals, the scars were assessed by photography, the Vancouver Scar Scale (VSS), durometry and spectrocolorimetry. Any adverse effects were also evaluated. Results The VSS scores and the hardness of the scars in both groups improved significantly compared to baseline. Moreover, the patients in the triamcinolone intralesional injection group had higher treatment efficacy (19.77 ± 21.25 %) based on their VSS scores than the patients in the triamcinolone external application group (5.94 ± 24.07 %), especially in the improvement of scar pliability, height and hardness. Meanwhile, in the triamcinolone injection group, more patients had mild and moderate improvement than in the triamcinolone application group. However, there were no differences in the distribution of the adverse effects in either group. Conclusions This study demonstrated that using the ablative fractional carbon dioxide laser followed by different topical triamcinolone delivery methods is effective and safe for thicker hypertrophic scar improvement. The method of using the ablative fractional carbon dioxide laser assisted with triamcinolone injection had a better therapeutic outcome in thicker hypertrophic scars, as compared with triamcinolone penetration.
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Affiliation(s)
| | | | - Ling Huang
- Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injury, Chongqing Key Laboratory for Disease Proteomics, Southwest Hospital, Army Medical University, Chongqing, 400038, China
| | - Qingqing Fu
- Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injury, Chongqing Key Laboratory for Disease Proteomics, Southwest Hospital, Army Medical University, Chongqing, 400038, China
| | - Lili Yuan
- Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injury, Chongqing Key Laboratory for Disease Proteomics, Southwest Hospital, Army Medical University, Chongqing, 400038, China
| | - Gaoxing Luo
- Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injury, Chongqing Key Laboratory for Disease Proteomics, Southwest Hospital, Army Medical University, Chongqing, 400038, China
| | - Jianglin Tan
- Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injury, Chongqing Key Laboratory for Disease Proteomics, Southwest Hospital, Army Medical University, Chongqing, 400038, China
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Zhang Y, Ye R, Dong J, Bai Y, He Y, Ni W, Yao M. Efficacy and safety of ablative CO 2 fractional laser and narrowband intense pulsed light for the treatment of hypertrophic scars: a prospective, randomized controlled trial. J DERMATOL TREAT 2023; 34:2202287. [PMID: 37070799 DOI: 10.1080/09546634.2023.2202287] [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: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 04/19/2023]
Abstract
BACKGROUND AND OBJECTIVES Hypertrophic scarring is a complex process, and numerous methods have been introduced to treat scars. This study aims to evaluate the effect of combined CO2 fractional laser and narrowband intense pulsed light (IPL) compared to IPL alone in the treatment of hypertrophic scars. MATERIALS AND METHODS This was a prospective, randomized controlled study enrolled 138 patients with hypertrophic scars. The participants were randomly divided into two groups: CO2-IPL and IPL group, and received three sessions at 10-14-week intervals for 3-month follow-up. Two independent plastic surgeons evaluated the treatments using the Patient and Observer Scar Assessment Scales (POSAS). Overall satisfaction was evaluated using the Patient Satisfaction Scale (PSS). RESULTS 101 subjects completed the study. Compared to single IPL, the combination CO2-IPL group showed a significant improvement in itching, color, stiffness, thickness, and irregularity, except for pain, and an enhancement in vascularization, pigmentation, thickness, relief, and pliability of the scar, assessed by POSAS (p < .01). 100% patients in the combination group were satisfied compared to 84% in IPL alone. CONCLUSION The combination of CO2 fractional laser and narrowband IPL efficiently improved the appearance and profile of hypertrophic scars, offering a comprehensive and reliable approach for scar therapy.
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Affiliation(s)
- Yiqiu Zhang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Rongan Ye
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Jiying Dong
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Yubing Bai
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Yu He
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Wei Ni
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
- Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, China
| | - Min Yao
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
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Urban L, Čoma M, Lacina L, Szabo P, Sabová J, Urban T, Šuca H, Lukačín Š, Zajíček R, Smetana K, Gál P. Heterogeneous response to TGF-β1/3 isoforms in fibroblasts of different origins: implications for wound healing and tumorigenesis. Histochem Cell Biol 2023; 160:541-554. [PMID: 37707642 DOI: 10.1007/s00418-023-02221-5] [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] [Accepted: 07/03/2023] [Indexed: 09/15/2023]
Abstract
Identification of therapeutic targets for treating fibrotic diseases and cancer remains challenging. Our study aimed to investigate the effects of TGF-β1 and TGF-β3 on myofibroblast differentiation and extracellular matrix deposition in different types of fibroblasts, including normal/dermal, cancer-associated, and scar-derived fibroblasts. When comparing the phenotype and signaling pathways activation we observed extreme heterogeneity of studied markers across different fibroblast populations, even within those isolated from the same tissue. Specifically, the presence of myofibroblast and deposition of extracellular matrix were dependent on the origin of the fibroblasts and the type of treatment they received (TGF-β1 vs. TGF-β3). In parallel, we detected activation of canonical signaling (pSMAD2/3) across all studied fibroblasts, albeit to various extents. Treatment with TGF-β1 and TGF-β3 resulted in the activation of canonical and several non-canonical pathways, including AKT, ERK, and ROCK. Among studied cells, cancer-associated fibroblasts displayed the most heterogenic response to TGF-β1/3 treatments. In general, TGF-β1 demonstrated a more potent activation of signaling pathways compared to TGF-β3, whereas TGF-β3 exhibited rather an inhibitory effect in keloid- and hypertrophic scar-derived fibroblasts suggesting its clinical potential for scar treatment. In summary, our study has implications for comprehending the role of TGF-β signaling in fibroblast biology, fibrotic diseases, and cancer. Future research should focus on unraveling the mechanisms beyond differential fibroblast responses to TGF-β isomers considering inherent fibroblast heterogeneity.
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Affiliation(s)
- Lukáš Urban
- Department of Pharmacology, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, 040 11, Košice, Slovak Republic
- Department of Biomedical Research, East-Slovak Institute of Cardiovascular Diseases Inc, Ondavská, 040 11, Košice, Slovak Republic
| | - Matúš Čoma
- Department of Pharmacology, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, 040 11, Košice, Slovak Republic
- Department of Biomedical Research, East-Slovak Institute of Cardiovascular Diseases Inc, Ondavská, 040 11, Košice, Slovak Republic
| | - Lukáš Lacina
- Institute of Anatomy, First Faculty of Medicine, Charles University, U Nemocnice 2, 128 00, Prague, Czech Republic
- BIOCEV, First Faculty of Medicine, Charles University, 252 50, Vestec, Czech Republic
- Department Dermatovenereology, First Faculty of Medicine, Charles University and General University Hospital, 128 08, Prague, Czech Republic
| | - Pavol Szabo
- Institute of Anatomy, First Faculty of Medicine, Charles University, U Nemocnice 2, 128 00, Prague, Czech Republic
- BIOCEV, First Faculty of Medicine, Charles University, 252 50, Vestec, Czech Republic
| | - Jana Sabová
- Department of Pharmacology, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, 040 11, Košice, Slovak Republic
| | - Tomáš Urban
- Prague Burn Center, Third Faculty of Medicine, Charles University and University Hospital Královské Vinohrady, 100 00, Prague, Czech Republic
| | - Hubert Šuca
- Prague Burn Center, Third Faculty of Medicine, Charles University and University Hospital Královské Vinohrady, 100 00, Prague, Czech Republic
| | - Štefan Lukačín
- Department of Heart Surgery, East-Slovak Institute of Cardiovascular Diseases Inc, 040 11, Košice, Slovak Republic
| | - Robert Zajíček
- Prague Burn Center, Third Faculty of Medicine, Charles University and University Hospital Královské Vinohrady, 100 00, Prague, Czech Republic
| | - Karel Smetana
- Institute of Anatomy, First Faculty of Medicine, Charles University, U Nemocnice 2, 128 00, Prague, Czech Republic.
- BIOCEV, First Faculty of Medicine, Charles University, 252 50, Vestec, Czech Republic.
| | - Peter Gál
- Department of Pharmacology, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, 040 11, Košice, Slovak Republic.
- Department of Biomedical Research, East-Slovak Institute of Cardiovascular Diseases Inc, Ondavská, 040 11, Košice, Slovak Republic.
- Prague Burn Center, Third Faculty of Medicine, Charles University and University Hospital Královské Vinohrady, 100 00, Prague, Czech Republic.
- Department of Pharmacognosy and Botany, Faculty of Pharmacy, Comenius University, 832 32, Bratislava, Slovak Republic.
- Institute of Neurobiology, Biomedical Research Center of the Slovak Academy of Sciences, 040 01, Košice, Slovak Republic.
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Xu Z, Cheng C, Zhang Y, Yang D, Jing W, Liu X, Li X. Lipopolysaccharide induces skin scarring through the TLR4/Myd88 inflammatory signaling pathway in dermal fibroblasts. Burns 2023; 49:1997-2006. [PMID: 37821278 DOI: 10.1016/j.burns.2023.06.005] [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: 12/07/2022] [Revised: 04/19/2023] [Accepted: 06/12/2023] [Indexed: 10/13/2023]
Abstract
Skin scarring is a frequent complication of the wound healing process. Bacterial contamination and prolonged inflammation in wounds are thought to play significant roles during scar formation, but little is known about their specific mechanisms of action. In this study, hypertrophic scar derived fibroblasts (HSFs) and paired normal skin derived fibroblasts (NSFs) were used to evaluate the effects of lipopolysaccharide (LPS) on inflammation-induced skin scarring and explore the inflammation-mediated mechanism of activity of LPS on dermal fibroblasts. LPS was found to significantly upregulate the expression of the proinflammatory molecules TLR4, Myd88, TRAF6, and p65, and the fibrosis-related proteins Col I, Col III, and α-SMA, in NSFs. Blocking Myd88 expression with T6167923 downregulated the expression of Col I, Col III, and α-SMA, whereas activating Myd88 expression with CL075 significantly upregulated their expression in LPS-treated NSFs. LPS was found to delay wound healing and increase skin scarring in cell and mouse models. These results showed that LPS could induce scar formation through the TLR4/Myd88 signaling pathway in dermal fibroblasts, suggesting that the downregulation of excessive inflammation in wound tissues inhibits skin scarring and improves scar appearance.
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Affiliation(s)
- Zhigang Xu
- Department of Dermatology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi Wu Road, No 157, Xi'an 710004, China; Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, West Chang-le Road, No 127, Xi'an 710032, China
| | - Chuantao Cheng
- Department of Dermatology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi Wu Road, No 157, Xi'an 710004, China
| | - Yangang Zhang
- Department of Dermatology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi Wu Road, No 157, Xi'an 710004, China
| | - Danyang Yang
- Department of Dermatology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi Wu Road, No 157, Xi'an 710004, China
| | - Wenwen Jing
- Department of Dermatology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi Wu Road, No 157, Xi'an 710004, China
| | - Xin Liu
- Department of Dermatology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi Wu Road, No 157, Xi'an 710004, China
| | - Xiaoli Li
- Department of Dermatology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi Wu Road, No 157, Xi'an 710004, China.
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Huang PP, Zhang R, Zhang XF, Xu ZT, Zeng DC, Sun FB, Zhang WJ. Effects of ultrashort wave diathermy on skin wounds in rabbit ears. Connect Tissue Res 2023; 64:569-578. [PMID: 37550846 DOI: 10.1080/03008207.2023.2242655] [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: 12/06/2022] [Revised: 07/11/2023] [Accepted: 07/13/2023] [Indexed: 08/09/2023]
Abstract
PURPOSE Ultrashort wave diathermy (USWD) is commonly used in diseases associated with osteoarticular and soft tissue injuries. However, while accelerating wound healing and preventing joint stiffness, there have been few reports on whether it leads to excessive hypertrophic scarring. The aim was to investigate the effects of different doses of USWD on hypertrophic scars. MATERIALS AND METHODS A rabbit model of hypertrophic scars was used to determine which dose of USWD reduced scar hyperplasia. The scar thickness was calculated using Sirius red staining. All protein expression levels were determined by western blotting, including fibrosis, collagen deposition, and neoangiogenesis related proteins. Subsequently, flow cytometry and ELISAs were used to determine the proportions of macrophage and inflammatory levels. RESULTS The wounds with USWD in histopathology showed the dermis was more markedly thickened in the 120 mA group, whereas the wounds with the 60 mA were less raised, comparing with the 0 mA; all detected protein levels were increased significantly, the 120 mA group comparing with the others, including heat shock, fibrosis, and neoangiogenesis, whereas the collagen deposition relative protein levels were decreased, the 60 mA group comparing with Sham group; Finally, in the proportion of macrophages and inflammatory levels the 120 mA group were the highest, and the group Sham was lower than group 60 mA. CONCLUSIONS In hypertrophic scars, the 60 mA USWD could relieve scar formation and inflammatory reactions; however, higher doses could result in opposite consequences.
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Affiliation(s)
- Peng-Peng Huang
- Center for Rehabilitation Medicine, Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital(Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Rui Zhang
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xiao-Feng Zhang
- Center for Rehabilitation Medicine, Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital(Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Zhi-Tao Xu
- Center for Rehabilitation Medicine, Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital(Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Du-Chun Zeng
- Center for Rehabilitation Medicine, Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital(Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Feng-Bao Sun
- Center for Rehabilitation Medicine, Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital(Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Wen-Jie Zhang
- Center for Rehabilitation Medicine, Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital(Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
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Bharadia SK, Burnett L, Gabriel V. Hypertrophic Scar. Phys Med Rehabil Clin N Am 2023; 34:783-798. [PMID: 37806697 DOI: 10.1016/j.pmr.2023.05.002] [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] [Indexed: 10/10/2023]
Abstract
Hypertrophic scars frequently develop post-burn, and are characterized by their pruritic, painful, raised, erythematous, dyschromic, and contractile qualities. This article aims to synthesize knowledge on the clinical and molecular development, evolution, management, and measurement of hypertrophic burn scar for both patient and clinician knowledge.
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Affiliation(s)
- Shyla Kajal Bharadia
- Cumming School of Medicine, University of Calgary, Foothills Medical Centre, 1403-29 Street Northwest, Calgary, Alberta T2N 2T9, Canada
| | - Lindsay Burnett
- Alberta Health Services, University of Calgary, Foothills Medical Centre, 1403-29 Street Northwest, Calgary, Alberta T2N 2T9, Canada
| | - Vincent Gabriel
- Department of Clinical Neurosciences, University of Calgary, Foothills Medical Centre, 1403-29 Street Northwest, Calgary, Alberta T2N 2T9, Canada; Department of Surgery, University of Calgary, Foothills Medical Centre, 1403-29 Street Northwest, Calgary, Alberta T2N 2T9, Canada; Medical Director, Calgary Firefighters Burn Treatment Centre, Foothills Medical Centre, 1403-29 Street Northwest, Calgary, Alberta T2N 2T9, Canada.
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He T, Bai X, Li Y, Zhang D, Xu Z, Yang X, Hu D, Han J. Insufficient SIRT1 in macrophages promotes oxidative stress and inflammation during scarring. J Mol Med (Berl) 2023; 101:1397-1407. [PMID: 37707556 DOI: 10.1007/s00109-023-02364-x] [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: 02/22/2023] [Revised: 08/18/2023] [Accepted: 08/18/2023] [Indexed: 09/15/2023]
Abstract
Macrophage is a critical regulator in wound healing and scar formation, and SIRT1 is related to macrophage activation and polarization, while the specific mechanism is still unclear. To explore the specific effects of SIRT1 in scarring, we established a skin incision mouse model and LPS-induced inflammation cell model. The expression of SIRT1 in tissue and macrophage was detected, and the level of SIRT1 was changed to observe the downstream effects. LPS-induced macrophages with or without SIRT1 deficiency were used for TMT-based quantitative proteomic analysis. SIRT1 was suppressed in scar while increased in macrophages of scar tissue. And macrophages were proven to be necessary for wound healing. In the early stage of wound healing, knockout of SIRT1 in macrophage could greatly strengthen inflammation and finally promote scarring. NADH-related activities and oxidoreductase activities were differentially expressed in TMT-based quantitative proteomic analysis. We confirmed that ROS production and NOX2 level were elevated after LPS stimulation while the Nrf2 pathway and the downstream proteins, such as Nqo-1 and HO-1, were suppressed. In contrast, the suppression of SIRT1 strengthened this trend. The NF-κB pathway was remarkably activated compared with the control group. Insufficient increase of SIRT1 in macrophage leads to over activated oxidative stress and activates NF-κB pathways, which then promotes inflammation in wound healing and scarring. Further increasing SIRT1 in macrophages could be a promising method to alleviate scarring. KEY MESSAGES: SIRT1 was suppressed in scar while increased in macrophages of scar tissue. Inhibition of SIRT1 in macrophage leads to further activated oxidative stress. SIRT1 is negatively related to oxidative stress in macrophage. The elevation of SIRT1 in macrophage is insufficient during scarring.
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Affiliation(s)
- Ting He
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, 127 Changle West Road, Xi'an, Shaanxi, 710032, China
| | - Xiaozhi Bai
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, 127 Changle West Road, Xi'an, Shaanxi, 710032, China
| | - Yan Li
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, 127 Changle West Road, Xi'an, Shaanxi, 710032, China
| | - Dongliang Zhang
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, 127 Changle West Road, Xi'an, Shaanxi, 710032, China
| | - Zhigang Xu
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, 127 Changle West Road, Xi'an, Shaanxi, 710032, China
| | - Xuekang Yang
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, 127 Changle West Road, Xi'an, Shaanxi, 710032, China
| | - Dahai Hu
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, 127 Changle West Road, Xi'an, Shaanxi, 710032, China.
| | - Juntao Han
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, 127 Changle West Road, Xi'an, Shaanxi, 710032, China.
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Menchaca AD, Style CC, Lazar DA, Mushin O, Olutoye OO. Serum Amyloid P Attenuates Hypertrophic Scarring in Large Animal Models. J Surg Res 2023; 290:285-292. [PMID: 37327638 DOI: 10.1016/j.jss.2023.05.013] [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: 10/26/2022] [Revised: 05/01/2023] [Accepted: 05/16/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION This study's purpose was to (1)determine the effect of locally administered serum amyloid P (SAP) on the development of hypertrophic scars (HTS) in porcine and rabbit HTS models and (2)determine the pharmacokinetics of systemically administered SAP and its effect on circulating fibrocyte quantities. METHODS Two large animal (New Zealand White Rabbit and Female Red Duroc Pigs) HTS models were utilized to study the effects of daily local injections of SAP immediately post wounding (x5 d in rabbits; x7 d in pigs) on HTS development as measured by scar elevation index , scar area, wound closure, and molecular expression studies of scar components. For SAP pharmacokinetics, total and human SAP levels in porcine blood were measured at regular intervals following intravenous administration of human SAP. Fibrocyte quantities were determined prior to and 1 h following human SAP intravenous administration. RESULTS In the rabbit model, local SAP significantly decreased the level of tissue inhibitor of metalloproteinases-1 mRNA expression and maintained matrix mettaloproteinase-9 expression, while control and vehicle groups significantly declined. In the pig model, there was a significant decrease in the trend of scar elevation indexes treated with local SAP versus controls over the study period. This decrease was statistically significant at days 14 and 84. Human SAP administered intravenously is degraded within 24 h and does not influence circulating fibrocyte quantities. CONCLUSIONS This is the first study to demonstrate attenuation of HTS formation using locally administered SAP in large animal HTS models. Local SAP administration reduces HTS formation by maintaining matrix mettaloproteinase-9 and decreasing tissue inhibitor of metalloproteinases-1. Intravenous administration of SAP is not as effective.
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Affiliation(s)
- Alicia D Menchaca
- Center for Regenerative Medicine, Nationwide Children's Hospital, Columbus, Ohio; Department of General Surgery, Indiana University, Indianapolis, Indiana
| | - Candace C Style
- Center for Regenerative Medicine, Nationwide Children's Hospital, Columbus, Ohio; Department of Surgery, Texas Children's Hospital, Baylor School of Medicine, Houston, Texas
| | - David A Lazar
- Department of Surgery, Texas Children's Hospital, Baylor School of Medicine, Houston, Texas; Rady Children's Hospital San Diego, UC San Diego School of Medicine, San Diego, California
| | - Oren Mushin
- Department of Surgery, Texas Children's Hospital, Baylor School of Medicine, Houston, Texas; Memorial Cosmetic & Reconstructive Surgery, Houston, Texas
| | - Oluyinka O Olutoye
- Center for Regenerative Medicine, Nationwide Children's Hospital, Columbus, Ohio; Department of Surgery, Texas Children's Hospital, Baylor School of Medicine, Houston, Texas; Department of Surgery, The Ohio State University, Columbus, Ohio.
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Zhang P, Wu Q, Ding H, Bai R, Meng F, Xu X, Chen M. Efficacy and Safety of Pressure Therapy Alone and in Combination with Silicone in Prevention of Hypertrophic Scars: A Systematic Review with Meta-analysis of Randomized Controlled Trials. Aesthetic Plast Surg 2023; 47:2159-2174. [PMID: 37648929 DOI: 10.1007/s00266-023-03591-w] [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: 03/22/2023] [Accepted: 07/23/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND At present, there are many kinds of hypertrophic scar treatment methods, among which pressure therapy and silicone therapy are very common and standard therapies, but whether they are used alone or in combination is still controversial. Therefore, the purpose of this systematic review was to compare the efficacy and safety of the combination of pressure therapy and silicone therapy (PTS) with pressure therapy alone (PT) in the treatment of hypertrophic scars to provide clinicians with information so that they can make better decisions. METHODS Relevant randomized controlled trials (RCTs) were collected by searching PubMed, Ovid MEDLINE, Embase, ScienceDirect, Web of Science, The Cochrane Library, Scopus, and Google Scholar databases to assess scar scores (The Vancouver Scar Scale, VSS; Visual Analog Scale, VAS) and adverse effects. RESULTS We screened 1270 articles and included 6 RCTs including 228 patients. We found that height (MD = 0.15, 95%CI 0.10-0.21, p < 0.01) and pliability (MD = 0.35, 95%CI 0.25-0.46, p <0.01) had a significant difference, these two measures showed that the PTS group was superior to the PT group. Results in other aspects, such as VSS, vascularity, pigmentation, VAS, and adverse effects were similar between the two groups. CONCLUSIONS There was no significant difference between PTS and PT in the overall treatment efficacy of hypertrophic scars with similar VSS and adverse effects, but PTS might have potential benefits for height and pliability. Additional studies with larger sample size and sound methodological quality are needed to confirm our conclusions. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Peixuan Zhang
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Fourth Medical Center of PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 100048, China
- Medical School of Chinese PLA, Beijing, China
| | - Qian Wu
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Fourth Medical Center of PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 100048, China
- Department of Medical Service, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Hongfan Ding
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Fourth Medical Center of PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 100048, China
| | - Ruiqi Bai
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Fourth Medical Center of PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 100048, China
| | - Fanting Meng
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Fourth Medical Center of PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 100048, China
| | - Xiao Xu
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Fourth Medical Center of PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 100048, China.
- Department of Ophthalmology, The Third Medical Center of Chinese PLA General Hospital, Beijing, China.
| | - Minliang Chen
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Fourth Medical Center of PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 100048, China.
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Kyei MY, Nyinah MA, Ayamba A, Kyei JM, Mensah JE. Multiple bladder calculi after radical prostatectomy due to bladder neck stenosis in a patient with hypertrophic scar: A case report. Int J Surg Case Rep 2023; 111:108829. [PMID: 37716062 PMCID: PMC10514407 DOI: 10.1016/j.ijscr.2023.108829] [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: 08/12/2023] [Revised: 09/06/2023] [Accepted: 09/09/2023] [Indexed: 09/18/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Bladder calculi after radical prostatectomy is rare and usually associated with migrated clips into the bladder forming a nidus. We present a patient with multiple bladder calculi resulting from bladder neck stenosis after radical prostatectomy causing bothersome lower urinary tract symptoms. He had an associated hypertrophic scar. CASE PRESENTATION A 60-year-old man of African ancestry presented with recent onset of irritative urinary symptoms three years after radical prostatectomy. Abdomen pelvic ultrasound and pelvic X-ray revealed a urinary bladder calculus. Examination of the previous radical prostatectomy scar found him to have a hypertrophic scar. He had urethroscopy with bladder neck incision for bladder neck stenosis and cystolithotomy with resolution of the symptoms. CLINICAL DISCUSSION The presentation was that of dysuria and frequency three years after radical prostatectomy. The cause of the symptoms was diagnosed after an abdomen pelvic ultrasound and pelvic X-ray as multiple bladder calculi. This is a rare finding with the few reported cases associated with clips that migrated to the urinary bladder forming a nidus for the calculi. This was of consideration in the case presented, however, the findings at urethroscopy revealed bladder neck stenosis suggesting stasis as possible cause of the bladder calculi. The symptoms resolved after bladder neck incision and cystolithotomy. CONCLUSION In addition to clips forming a nidus for calculi in the urinary bladder after radical prostatectomy, bladder neck stenosis being the cause of urinary bladder calculi should be considered in a patient with hypertrophic scar.
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Affiliation(s)
- Mathew Yamoah Kyei
- Department of Surgery and Urology, University of Ghana Medical School, Box GPO 4236, Accra, Ghana.
| | | | - Ali Ayamba
- University of Health and Allied Sciences, PMB 31, Ho, Ghana.
| | - Josephine Mpomaa Kyei
- School of Nursing and Midwifery, University of Ghana, Box LG 43, Legon, Accra, Ghana.
| | - James Edward Mensah
- Department of Surgery and Urology, University of Ghana Medical School, Box GPO 4236, Accra, Ghana
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Chen J, Yu W, Xiao C, Su N, Han Y, Zhai L, Hou C. Exosome from adipose-derived mesenchymal stem cells attenuates scar formation through microRNA-181a/SIRT1 axis. Arch Biochem Biophys 2023; 746:109733. [PMID: 37652148 DOI: 10.1016/j.abb.2023.109733] [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: 06/09/2023] [Revised: 08/17/2023] [Accepted: 08/27/2023] [Indexed: 09/02/2023]
Abstract
Pathological scarring is the greatest challenge after injury. Exosome from adipose-derived mesenchymal stem cells has been reported effective to improve hypertrophic scar. This study focused on the possible mechanisms during this process. Exosomes from adipose-derived mesenchymal stem cells were extracted first. Hypertrophic scar tissue and paired normal skin tissue were collected from patients. Mice skin incision model and fibroblasts model were established. TGF-β1 was used to stimulate fibroblasts to myofibroblasts transdifferentiation. It was found that exosomes injection could decrease collagen sediment after wound healing. During which, the expression of microRNA-181a decreased. Further, we found that expression of microRNA-181a in scar tissue was higher than in normal skin. Then hypertrophic scar-derived fibroblasts were used for in vitro study. It was found that similar to the use of exosomes, microRNA-181a inhibitor decreased the expression of collagen and α-SMA. While microRNA-181a mimics suppressed the effects of exosomes. During fibroblast to myofibroblast trans-differentiation, level of microRNA-181a well as levels of scar-related molecules also decreased with the use of exosomes and vice versa. SIRT1 was confirmed one of the downstream targets of microRNA-181a. Suppression of SIRT1 led to diminished effects of exosomes in hypertrophic scar derived fibroblasts. In mice skin incision model, injection of SIRT1 inhibitor led to increased collagen synthesis. In conclusion, exosomes from Adipose-derived mesenchymal stem cells are promising to antagonize scarring through the regulation of microRNA-181a/SIRT1 axis.
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Affiliation(s)
- Jie Chen
- Department of Plastic Surgery, The Second Affiliated Hospital of Xi'an Medical College, China; Department of Burns and Cutaneous Surgery, Xijing Hospital, The Fourth Military Medical University, China
| | - Wenjuan Yu
- Department of Plastic Surgery, The Second Affiliated Hospital of Xi'an Medical College, China
| | - Chao Xiao
- Department of Plastic Surgery, The Second Affiliated Hospital of Xi'an Medical College, China
| | - Na Su
- Department of Plastic Surgery, The Second Affiliated Hospital of Xi'an Medical College, China
| | - Yubo Han
- Department of Plastic Surgery, The Second Affiliated Hospital of Xi'an Medical College, China
| | - Liang Zhai
- Department of Plastic Surgery, The Second Affiliated Hospital of Xi'an Medical College, China
| | - Chen Hou
- Shaanxi Provincial People's Hospital, China.
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Worley B, Kim K, Jain-Poster K, Reynolds KA, Merkel EA, Kang BY, Dirr MA, Anvery N, Christensen RE, Hisham FI, Ibrahim SA, Asadbeigi SN, Poon E, Alam M. Treatment of traumatic hypertrophic scars and keloids: a systematic review of randomized control trials. Arch Dermatol Res 2023; 315:1887-1896. [PMID: 36781457 DOI: 10.1007/s00403-023-02535-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 12/08/2022] [Revised: 12/08/2022] [Accepted: 01/12/2023] [Indexed: 02/15/2023]
Abstract
Exaggerated healing and remodeling after skin injury may cause hypertrophic and keloidal scars, which are associated with functional and quality of life impairment. There is limited guidance available regarding the relative effectiveness of therapies for hypertrophic scars and keloids. In this review, we aim to compare the effectiveness of treatments for hypertrophic scars and keloids. MEDLINE, Embase, Scopus, and the Cochrane Collaboration database were searched from inception to March 2019 for randomized control trials of treatments for hypertrophic and keloid scars that included 20 or more patients. Outcomes evaluated included the standardized mean reduction in scarring and adverse events. The type of scar and the demographic features were analyzed for their effect on clinical outcome. Based on 25 included clinical trials, intralesional injection (64.1% [95% CI 60.8-67.5%]) may be more effective than physical (29.9% [95% CI 28.9-30.9%]) or topical treatments (34% [95% CI 31.8-36.8%]). Combination of 5-fluorouracil and triamcinolone (9:1 dilution) appeared superior among intralesional treatments for keloids. Ablative laser and pulsed-dye laser were the most useful laser treatments. Regression modeling showed laser treatment response was linked to Fitzpatrick skin type (p = 0.002). Adverse events were uncommon for all treatments and mostly transient. Intralesional treatments for keloid and hypertrophic scars may be the most reliable treatment option to improve pathologic scars, while laser treatment may have specific benefits for Fitzpatrick skin types I-III over types IV-VI. Management of pathological scars is an area of critical need, where appropriate treatment can have a significant impact on quality of life.
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Affiliation(s)
- Brandon Worley
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N Saint Clair, Suite 1600, Chicago, IL, 60611, USA
| | - Kathyrn Kim
- University of Illinois at Chicago College of Medicine, Chicago, IL, USA
| | - Ketan Jain-Poster
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N Saint Clair, Suite 1600, Chicago, IL, 60611, USA
| | - Kelly A Reynolds
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N Saint Clair, Suite 1600, Chicago, IL, 60611, USA
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Emily A Merkel
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N Saint Clair, Suite 1600, Chicago, IL, 60611, USA
| | - Bianca Y Kang
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N Saint Clair, Suite 1600, Chicago, IL, 60611, USA
| | - McKenzie A Dirr
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N Saint Clair, Suite 1600, Chicago, IL, 60611, USA
| | - Noor Anvery
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N Saint Clair, Suite 1600, Chicago, IL, 60611, USA
| | - Rachel E Christensen
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N Saint Clair, Suite 1600, Chicago, IL, 60611, USA
| | - Farhana Ikmal Hisham
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N Saint Clair, Suite 1600, Chicago, IL, 60611, USA
| | - Sarah A Ibrahim
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N Saint Clair, Suite 1600, Chicago, IL, 60611, USA
| | - Sepideh Nikki Asadbeigi
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N Saint Clair, Suite 1600, Chicago, IL, 60611, USA
| | - Emily Poon
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N Saint Clair, Suite 1600, Chicago, IL, 60611, USA
| | - Murad Alam
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N Saint Clair, Suite 1600, Chicago, IL, 60611, USA.
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
- Department of Otolaryngology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
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Xia W, Wang Q, Lin S, Wang Y, Zhang J, Wang H, Yang X, Hu Y, Liang H, Lu Y, Zhu Z, Liu D. A high-salt diet promotes hypertrophic scarring through TRPC3-mediated mitochondrial Ca 2+ homeostasis dysfunction. Heliyon 2023; 9:e18629. [PMID: 37588604 PMCID: PMC10425910 DOI: 10.1016/j.heliyon.2023.e18629] [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: 05/23/2023] [Revised: 07/13/2023] [Accepted: 07/21/2023] [Indexed: 08/18/2023] Open
Abstract
Diet High in salt content have been associated with cardiovascular disease and chronic inflammation. We recently demonstrated that transient receptor potential canonical 3 (TRPC3) channels regulate myofibroblast transdifferentiation in hypertrophic scars. Here, we examined how high salt activation of TRPC3 participates in hypertrophic scarring during wound healing. In vitro, we confirmed that high salt increased the TRPC3 protein expression and the marker of myofibroblast alpha smooth muscle actin (α-SMA) in wild-type mice (WT) primary cultured dermal fibroblasts but not Trpc3-/- mice. Activation of TRPC3 by high salt elevated cytosolic Ca2+ influx and mitochondrial Ca2+ uptake in dermal fibroblasts in a TRPC3-dependent manner. High salt activation of TRPC3 enhanced mitochondrial respiratory dysfunction and excessive ROS production by inhibiting pyruvate dehydrogenase action, that activated ROS-triggered Ca2+ influx and the Rho kinase/MLC pathway in WT mice but not Trpc3-/- mice. In vivo, a persistent high-salt diet promoted myofibroblast transdifferentiation and collagen deposition in a TRPC3-dependent manner. Therefore, this study demonstrates that high salt enhances myofibroblast transdifferentiation and promotes hypertrophic scar formation through enhanced mitochondrial Ca2+ homeostasis, which activates the ROS-mediated pMLC/pMYPT1 pathway. TRPC3 deficiency antagonizes high salt diet-induced hypertrophic scarring. TRPC3 may be a novel target for hypertrophic scarring during wound healing.
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Affiliation(s)
- Weijie Xia
- Department of Plastic & Cosmetic Surgery, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing 400042, PR China
| | - Qianran Wang
- Department of Hypertension and Endocrinology, Center for Hypertension and Metabolic Diseases, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing 400042, PR China
| | - Shaoyang Lin
- Department of Hypertension and Endocrinology, Center for Hypertension and Metabolic Diseases, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing 400042, PR China
| | - Yuanyuan Wang
- Department of Plastic & Cosmetic Surgery, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing 400042, PR China
| | - Junbo Zhang
- Department of Plastic & Cosmetic Surgery, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing 400042, PR China
| | - Hailin Wang
- Department of Plastic & Cosmetic Surgery, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing 400042, PR China
| | - Xia Yang
- Department of Wound Infection and Drug, State Key Laboratory of Trauma, Burn and Combined Injury, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing 400042, PR China
| | - Yingru Hu
- Department of Hypertension and Endocrinology, Center for Hypertension and Metabolic Diseases, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing 400042, PR China
| | - Huaping Liang
- Department of Wound Infection and Drug, State Key Laboratory of Trauma, Burn and Combined Injury, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing 400042, PR China
| | - Yuangang Lu
- Department of Plastic & Cosmetic Surgery, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing 400042, PR China
| | - Zhiming Zhu
- Department of Hypertension and Endocrinology, Center for Hypertension and Metabolic Diseases, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing 400042, PR China
| | - Daoyan Liu
- Department of Hypertension and Endocrinology, Center for Hypertension and Metabolic Diseases, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing 400042, PR China
- Department of Wound Infection and Drug, State Key Laboratory of Trauma, Burn and Combined Injury, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing 400042, PR China
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Kim EY, Hussain A, Khachemoune A. Evidence-based management of keloids and hypertrophic scars in dermatology. Arch Dermatol Res 2023; 315:1487-1495. [PMID: 36504113 DOI: 10.1007/s00403-022-02509-x] [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: 09/08/2022] [Revised: 11/27/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022]
Abstract
While normal, controlled wound-healing results in scars that are nearly imperceptible, hypertrophic scars (HTS) and keloids are the result of an abnormal wound-healing process that can leave unsightly, difficult-to-treat lesions. While such scars are classically associated with surgical incisions, they may also result from burns or accidental trauma to the skin. Several different measures can be taken to prevent the formation of scars or treat those that have already formed. Prevention focuses on reducing inflammation during the wound-healing process, and minimizing tension in the lesion when appropriate. Treatments range from non-invasive modalities such as pressure therapy, topicals, and symptom management, to invasive methods such as injections, lasers, and even surgery. While some treatments, such as corticosteroid injections, have been used in the treatment of HTS and keloids for decades, other newer therapies have only been described in case reports or are still in early phases of clinical trials. Because optimal scar management will not be the same for every patient, further investigation of newer agents and methods is warranted and may benefit a great number of patients. This paper will review the evidence-based management of scars, including current widely used treatment options and promising newly emerging therapies.
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Affiliation(s)
- Emily Y Kim
- Georgetown University School of Medicine, Washington, DC, USA
| | - Aamir Hussain
- MedStar Washington Hospital Center/Georgetown University Dermatology Residency Program, Washington, DC, USA
| | - Amor Khachemoune
- Department of Dermatology, Veterans Affairs Medical Center, SUNY Downstate, 800 Poly Place, Brooklyn, NY, 11209, USA.
- Department of Dermatology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, NY, USA.
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Cai H, Liu X, Liu D, Liu B. GEO data mining identifies potential immune-related genes in hypertrophic scar and verities in a rabbit model. Heliyon 2023; 9:e17266. [PMID: 37455989 PMCID: PMC10338295 DOI: 10.1016/j.heliyon.2023.e17266] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 06/02/2023] [Accepted: 06/12/2023] [Indexed: 07/18/2023] Open
Abstract
Objective Hypertrophic scar (HTS), the secondary major abnormal tissue after wound healing, is the most frequent and severe type of skin scar. Dysregulated immune response plays an important role in HTS formation. In this study, we identified the potential immune-related genes in HTS and explored their potential therapeutic significance. Methods We first screened out the potential immune-related genes in HTS microarrays via bioinformatics analysis using public datasets. We then constructed a rabbit model of ear scar to investigate the morphological features of HTS and verify the basic expression of potential immune-related genes in HTS tissue. Finally, we used AlphaFold to determine the protein homology between human and rabbit scar tissues. Results Bioinformatics analysis revealed 22 differentially expressed genes (DEGs) and a single differential infiltration of immune cells (naïve B cells) in HTS and normal tissues. Six of the DEGs were correlated with naïve B cell numerically. CCL2, PLXDC2 and FOXF2 were expressed in rabbit ear scar model. PLXDC2 and FOXF2 showed relatively high homology between human and rabbit scar tissues. Conclusions PLXDC2 and FOXF2, both closely related to immune cell infiltration and specifically expressed in HTS, represent potential therapeutic targets in HTS.
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Affiliation(s)
- Hong Cai
- Department of Dermatology, Air Force Medical University Air Force Medical Center, Beijing, 100142, China
- Air Force Clinical College, Anhui Medical University Beijing, 100142, China
- The Fifth School of Clinical Medicine, Anhui Medical University, Hefei, 230032, Anhui Province, China
| | - Xuan Liu
- Department of Surgery, Central Medical Branch of PLA General Hospital, Beijing, 100120, China
| | - Dingbin Liu
- State Key Laboratory of Medicinal Chemical Biology, Research Center for Analytical Sciences, Tianjin Key Laboratory of Molecular Recognition and Biosensing, College of Chemistry, Nankai University, Tianjin, 300071, China
| | - Bin Liu
- .Cancer Research Center, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, 101149, China
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Thanh LTV, Quan TS, Anh LV, Hung TQ, Vuong NL. The Efficacy of Intense Pulsed Light in the Treatment of Keloids and Hypertrophic Scars. J Lasers Med Sci 2023; 14:e13. [PMID: 37583494 PMCID: PMC10423960 DOI: 10.34172/jlms.2023.13] [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: 12/21/2022] [Accepted: 02/07/2023] [Indexed: 08/17/2023]
Abstract
Introduction: Different therapies have been applied to keloids and hypertrophic scars. Intense pulsed light (IPL) has recently been used but the evidence is limited. This study was to evaluate the effectiveness and safety of IPL as monotherapy for keloids and hypertrophic scars. Methods: This was a before-and-after interventional study on 16 patients with 50 scars who underwent IPL. Seven scars receive one IPL session, seven received two sessions, and 36 received three sessions. Outcomes were evaluated by the Vancouver Scar Scale (VSS), Patient and Observer Scar Assessment Scale (POSAS), scar ultrasound, colorimeter for pigmentation and erythema, and side effects. Results: After the treatment, most outcomes significantly improved except that the pigmentation of the scars did not change. Scar thickness significantly reduced by nearly 10% after the first IPL session, 15% after the second session, and>20% after the third session. All side effects were mild with crust (33.3-46%), blisters (8.3-40%), and hyperpigmentation around the scar (0-14%); the pain was moderate as assessed by the patients. Conclusion: IPL is a safe and effective treatment for keloids and hypertrophic scars. More studies are required to confirm our results.
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Affiliation(s)
- Le Thai Van Thanh
- Department of Dermatology and Skin Aesthetics, University Medical Center at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Dermatology and Venereology, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Tran So Quan
- Department of Dermatology and Skin Aesthetics, University Medical Center at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Le Vi Anh
- Department of Dermatology and Skin Aesthetics, University Medical Center at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Ta Quoc Hung
- Department of Dermatology and Skin Aesthetics, University Medical Center at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Nguyen Lam Vuong
- Department of Medical Statistics and Informatics, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
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Han F, Wang K, Shen K, Wang J, Han S, Hu D, Wu G. Extracellular vesicles from Lactobacillus druckerii inhibit hypertrophic scar fibrosis. J Nanobiotechnology 2023; 21:113. [PMID: 36978136 PMCID: PMC10053340 DOI: 10.1186/s12951-023-01861-y] [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: 02/13/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Hypertrophic scars (HS) affect millions of people each year and require better treatment strategies. Bacterial extracellular vesicles (EVs) are advantaged by low cost and high yield which was commonly used in the treatment of diseases. Here, we investigated the therapeutic efficacy of EVs obtained from Lactobacillus druckerii in hypertrophic scar. In vitro, the effects of Lactobacillus druckerii-derived EVs (LDEVs) on Collagen I/III and α-SMA in fibroblasts obtained from HS. In vivo, a scleroderma mouse model was used to investigate the effects of LDEVs on fibrosis. The impact of LDEVs on excisional wound healing was explored. The different proteins between PBS and LDEVs treated fibroblasts derived from hypertrophic scar were studied by untargeted proteomic analysis. RESULTS In vitro, LDEVs treatment significantly inhibited the expression of Collagen I/III and α-SMA and cell proliferation of fibroblasts derived from HS. In vivo, LDEVs withdrawn the hypertrophic scar formation in scleroderma mouse model and decreased the expression of α-SMA. LDEVs promoted the proliferation of skin cells, new blood vessel formation and wound healing in excisional wound healing mice model. Moreover, proteomics has shown that LDEVs inhibit hypertrophic scar fibrosis through multiple pathways. CONCLUSIONS Our results indicated that Lactobacillus druckerii-derived EVs has the potential application in the treatment of hypertrophic scars and any other fibrosis diseases.
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Affiliation(s)
- Fu Han
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, Xi'an, 710032, Shaanxi, China
| | - Kejia Wang
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, Xi'an, 710032, Shaanxi, China
| | - Kuo Shen
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, Xi'an, 710032, Shaanxi, China
| | - Jing Wang
- Department of Nursing, Air Force Medical University, Xi'an, 710032, Shaanxi, China
| | - Shichao Han
- Department of Urology, Xijing Hospital, Air Force Medical University, Xi'an, 710032, Shaanxi, China
| | - Dahai Hu
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, Xi'an, 710032, Shaanxi, China.
| | - Gaofeng Wu
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, Xi'an, 710032, Shaanxi, China.
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Zhou X, Ye H, Wang X, Sun J, Tu J, Lv J. Ursolic acid inhibits human dermal fibroblasts hyperproliferation, migration, and collagen deposition induced by TGF-β via regulating the Smad2/3 pathway. Gene 2023; 867:147367. [PMID: 36931410 DOI: 10.1016/j.gene.2023.147367] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 02/21/2023] [Accepted: 03/10/2023] [Indexed: 03/17/2023]
Abstract
Hypertrophic scar (HS) is a skin condition characterized by excessive fibrosis with disordered collagens from skin fibroblasts, which causes abnormal esthetic and even functional symptoms, thereby affecting millions of people. Ursolic acid (UA) is widely used in skincare and exerts anti-fibrotic effects. The present study aimed to delve into the impact of UA on HS and the mechanism. Fibroblasts (FBs) were incubated with TGF-β to investigate physiological characteristics compared with FBs isolated from normal skin (NSFBs) and hyperplastic scars (HSFBs). TGF-β-incubated FBs were subjected to treatment with UA (0-20 μM). The expressions of Vimentin, α-SMA, Collagen I, and Collagen III were examined using immunofluorescence, RT-qPCR, and western blot. Cell viability, proliferation, apoptosis, migration, and contractility were examined by CCK-8, EdU, Annexin V-FITC/PI, Transwell, and collagen gel contraction assays, respectively. The activation of Smad2/3 signaling was also determined by western blot. The binding sites for UA of TGF-βR1 (ALK5) were predicted by the Autodock tool. Compared with NSFBs, the cell proliferation, migration, and contractility of both HSFBs and TGF-β-incubated FBs were all significantly up-regulated. UA markedly impaired the TGF-β-induced increase in cell proliferation, migration, and contractility, α-SMA, collagen I, and Collagen III expression of FBs. UA significantly inhibited the phosphorylation levels of Smad2/3 in TGF-β-incubated FBs with no influence on TGF-βR1 and TGF-βR2 expressions, which might be because of the binding of UA to the catalytic domain of ALK5 protein. UA attenuated TGF-β1-induced hyperproliferation, migration, and collagen deposition in FBs via regulating the Smad2/3 pathway.
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Affiliation(s)
- Xiaoliang Zhou
- Department of Burns and Plastic Surgery, Ganzhou People's Hospital, Ganzhou, Jiangxi, China.
| | - Hua Ye
- Department of Burns and Plastic Surgery, Ganzhou People's Hospital, Ganzhou, Jiangxi, China.
| | - Xianlin Wang
- Department of Burns and Plastic Surgery, Ganzhou People's Hospital, Ganzhou, Jiangxi, China.
| | - Junfeng Sun
- Department of Burns and Plastic Surgery, Ganzhou People's Hospital, Ganzhou, Jiangxi, China.
| | - Jiajin Tu
- Department of Burns and Plastic Surgery, Ganzhou People's Hospital, Ganzhou, Jiangxi, China.
| | - Jing Lv
- Department of Rheumatic and Immunity, Ganzhou People's Hospital, Ganzhou, Jiangxi, China.
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Lee SY, Cho YS, Kim L, Joo SY, Seo CH. The Intra-rater reliability and validity of ultrasonography in the evaluation of hypertrophic scars caused by burns. Burns 2023; 49:344-352. [PMID: 35459576 DOI: 10.1016/j.burns.2022.03.016] [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: 03/18/2021] [Revised: 03/16/2022] [Accepted: 03/22/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Hypertrophic scars that occur after burns are less flexible and less elastic than normal skin. Objective measurement tools are required to assess hypertrophic scars after thermal injury. Cutometer® MPA 580 has been widely used for evaluating the properties of hypertrophic scars. Ultrasonography can evaluate elasticity, stiffness, and structure of tissues simultaneously using elastography and B-mode. This study aimed to investigate the intra-rater reliability and validity of elastography to visualize hypertrophic scars. METHODS Sixteen participants with a total of 96 scars were evaluated. The measurement sequence was elastography, Cutometer®, and elastography every 10 min. We then analyzed the intra-rater reliability using intraclass correlation coefficients (ICC). The results measured using elastography on the hypertrophic scars and surrounding normal skin were compared. The relationships between the elastographic and Cutometer® measurements using the 2-and 8-mm probes were compared. RESULTS The intra-rater reliability of elastographic measurements was acceptable for clinical use in terms of strain ratio (SR), shear-wave elastography (SWE), shear-wave speed (SWS), and SWE ratio ( ICC = 0.913, ICC=0.933, ICC = 0.842, and ICC = 0.921). The average SWS and SWE in hypertrophic scars were significantly greater than that for normal skin ( p < 0.001 and p < 0.001). SWE showed correlations with the R0 (r = -0.32, p = 0.002) and R8 (r = -0.30, p = 0.003) measured with the 8-mm probe. The SWE ratio was correlated with the R7 (r = -0.34, p = 0.001) measured with the 2-mm probe. The thickness of hypertrophic scars showed correlations with the R5 (r = 0.33, p < 0.001), R6 (r = 0.44, p < 0.001) and R8 (r = -0.35, p < 0.001) measured with the 8-mm probe. R0-R9 measured with 2-mm Cutometer® probes were not correlated with scar thickness ( r < 0.30, P > 0.05). The total scores of mVSS showed correlations with the R0 (r = 0.35, p < 0.001), R1(r = 0.32., p = 0.001), R3 (r = 0.38, p < 0.001), R4 (r = 0.38, p < 0.001), R8 (r = 0.34, p = 0.001), and R9 (r = 0.34, p = 0.001) measured with the 2-mm probe. R0-R9 measured with 8-mm Cutometer® probes were not correlated with mVSS ( r < 0.30, P > 0.05). The thickness of hypertrophic scars showed correlations with the SWE (r = 0.38, p < 0.001) and SWE ratio (r = 0.35, p < 0.001). Elastographic findings were not correlated with mVSS ( r < 0.30, P > 0.05). CONCLUSION In this study, together with the Cutometer®, ultrasound was confirmed as an evaluation tool that can objectively compare and analyze the difference between normal skin and hypertrophic scars.
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Affiliation(s)
- Seung Yeol Lee
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, South Korea
| | - Yoon Soo Cho
- Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, South Korea
| | - Laurie Kim
- Kirk Kerkorian School of Medicine, University of Nevada Las Vegas, Las Vegas, NV, USA
| | - So Young Joo
- Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, South Korea
| | - Cheong Hoon Seo
- Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, South Korea.
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Delaleu J, Charvet E, Petit A. Keloid disease: Review with clinical atlas. Part I: Definitions, history, epidemiology, clinics and diagnosis. Ann Dermatol Venereol 2023; 150:3-15. [PMID: 36494213 DOI: 10.1016/j.annder.2022.08.010] [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: 02/09/2022] [Revised: 05/06/2022] [Accepted: 08/30/2022] [Indexed: 12/12/2022]
Abstract
Keloids are chronic progressive dermal pseudo-tumors that can grow considerably in volume and surface area but do not invade other tissues. They are usually triggered by dermal injury or inflammation, but they are not scars in the normal sense of the word, since they enlarge and progress over decades. The phenomenon usually referred to as "hypertrophic scars" represents a kind of keloidal process that does not extend beyond the initial site of injury and spontaneously regresses in 12-24 months. The multiplication of keloids and hypertrophic scars in a single patient is known as keloid disease. Keloid disease is due to a familial predisposition (autosomal dominant) that preferentially affects people of non-European ancestry, especially those of sub-Saharan African descent. Keloid disease has a deep impact on quality of life, not only because of disfiguring lesions, but also because of the frequency of associated intense neurogenic pruritus and pain, as well as recurrent bouts of suppuration. Diagnosis relies primarily on a good knowledge of the clinical characteristics of keloids, thus warranting the inclusion of a clinical atlas in the first part of the review. The second part will deal with the pathology, pathophysiology and treatment of keloid disease.
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Affiliation(s)
- J Delaleu
- Service de dermatologie, APHP Hôpital Saint-Louis, Paris, France
| | - E Charvet
- Service de dermatologie, APHP Hôpital Saint-Louis, Paris, France
| | - A Petit
- Service de dermatologie, APHP Hôpital Saint-Louis, Paris, France.
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De Decker I, Hoeksema H, Vanlerberghe E, Beeckman A, Verbelen J, De Coninck P, Speeckaert MM, Blondeel P, Monstrey S, Claes KEY. Occlusion and hydration of scars: moisturizers versus silicone gels. Burns 2023; 49:365-379. [PMID: 35550830 DOI: 10.1016/j.burns.2022.04.025] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 04/20/2022] [Accepted: 04/24/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND The mainstay of non-invasive scar management, consists of pressure therapy with customized pressure garments often combined with inlays, hydration by means of silicones and/or moisturizers as well as UV protection. It is generally accepted that scar dehydration resulting from impaired barrier function of the stratum corneum and expressed by raised trans epidermal water loss (TEWL) values, can lead to increased fibroblast activity and thereby hypertrophic scar formation. However, we have reached no consensus on exactly what optimal scar hydration is nor on barrier function repair: by means of silicone sheets, liquid silicone gels or moisturizers. Occlusive silicone sheets almost completely prevent TEWL and have been shown to be effective. Nevertheless, many important disadvantages due to excessive occlusion such as difficulties in applying the sheets exceeding 10-12 h, pruritus, irritation, and maceration of the skin are limiting factors for its use. To avoid these complications and to facilitate the application, liquid silicone gels were developed. Despite a reduced occlusion, various studies have shown that the effects are comparable to these of the silicone sheets. However, major limiting factors for general use are the long drying time, the shiny aspect after application, and the high cost especially when used for larger scars. Based on excellent clinical results after using three specific moisturizers for scar treatment in our patients, we wanted to investigate whether these moisturizers induce comparable occlusion and hydration compared to both each other and the widely recognized liquid silicone gels. We wanted to provide a more scientific basis for the kind of moisturizers that can be used as a full-fledged and cost-effective alternative to silicone gel. METHODS A total of 36 healthy volunteers participated in this study. Increased TEWL was created by inducing superficial abrasions by rigorous (20x) skin stripping with Corneofix® adhesive tape in squares of 4 cm². Three moisturizers and a fluid silicone gel were tested: DermaCress, Alhydran, Lipikar and BAP Scar Care silicone gel respectively. TEWL reducing capacities and both absolute (AAH) and cumulative (CAAH) absolute added hydration were assessed using a Tewameter® TM300 and a Corneometer® CM825 at different time points for up to 4 h after application. RESULTS We found an immediate TEWL increase in all the zones that underwent superficial abrasions by stripping. Controls remained stable over time, relative to the ambient condition. The mean percentage reduction (MPR) in TEWL kept increasing over time with Alhydran and DermaCress, reaching a maximum effect 4 h after application. Silicone gel reached maximal MPR almost immediately after application and only declined thereafter. The silicone gel never reached the minimal MPR of Alhydran or DermaCress. Hydration capacity assessed through CAAH as measured by the Corneometer was significantly less with silicone gel compared to the moisturizers. Compared to silicone gel Lipikar provided similar occlusion and the improvement in hydration was highly significant 4 h after application. CONCLUSION Based on the results of both our previous research and this study it is clearly demonstrated that the occlusive and hydrative effect of fluid silicone gel is inferior to the moisturizers used in our center. Lipikar hydrates well but is less suitable for scar treatment due to the lack of occlusion. A well-balanced occlusion and hydration, in this study only provided by Alhydran and DermaCress, suggests that moisturizers can be used as a scar hydration therapy that replaces silicone products, is more cost-effective and has a more patient-friendly application.
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Affiliation(s)
- Ignace De Decker
- Burn Center, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium.
| | - Henk Hoeksema
- Burn Center, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium; Department of Plastic Surgery, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Els Vanlerberghe
- Burn Center, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Anse Beeckman
- Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Jozef Verbelen
- Burn Center, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Petra De Coninck
- Burn Center, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Marijn M Speeckaert
- Department of Nephrology, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Phillip Blondeel
- Burn Center, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium; Department of Plastic Surgery, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Stan Monstrey
- Burn Center, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium; Department of Plastic Surgery, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Karel E Y Claes
- Burn Center, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium; Department of Plastic Surgery, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
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Li J, Yin Y, Zhang E, Gui M, Chen L, Li J. Peptide deregulated in hypertrophic scar-1 alleviates hypertrophic scar fibrosis by targeting focal adhesion kinase and pyruvate kinase M2 and remodeling the metabolic landscape. Int J Biol Macromol 2023; 235:123809. [PMID: 36828096 DOI: 10.1016/j.ijbiomac.2023.123809] [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: 10/04/2022] [Revised: 12/13/2022] [Accepted: 02/18/2023] [Indexed: 02/24/2023]
Abstract
Hypertrophic scarring is a fibrotic skin disease characterized by excessive deposition of collagens. Emerging evidence has suggested important roles for peptides in fibrosis-related diseases. Here, we demonstrate that a skin-derived endogenous peptide, peptide deregulated in hypertrophic scar-1 (PDHS1), with the sequence IATTTASAATAAAIGATPRAK, inhibits cell proliferation, promotes apoptosis, decreases the proportion of cells in S phase, and decreases collagen synthesis in hypertrophic scar fibroblasts. Additionally, treatment with PDHPS1 alleviates hypertrophic scarring in a rabbit ear model. PDHPS1 was found to bind to focal adhesion kinase (FAK) and to decrease its activity. PDHPS1 was also shown to bind to pyruvate kinase M2 (PKM2) and to decreased its expression. Smad2 phosphorylation is also inhibited by treatment with PDHPS1. Overexpression of FAK rescues the decreased expression of COL3A1 induced by PDHPS1 treatment. Targeted metabolomics revealed that PDHPS1 reprogramed metabolism that related to amino acid synthesis, leading to decreases of the key glycolysis intermediates glucose-6-phosphate and fructose-6-phosphate. These results demonstrated that the endogenous peptide PDHPS1 alleviates hypertrophic scar fibrosis in vitro and in vivo by targeting FAK and PKM2 and remodeling the metabolic landscape. Overall, treatment with PDHPS1 is a potential therapeutic strategy for hypertrophic scarring.
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Affiliation(s)
- Jingyun Li
- Nanjing Maternal and Child Health Medical Institute, Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), 123rd Tianfei Street, Mochou Road, Nanjing 210004, China.
| | - Yiliang Yin
- Department of Plastic&Cosmetic Surgery, Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), 123rd Tianfei Street, Mochou Road, Nanjing 210004, China
| | - Enyuan Zhang
- Department of Plastic&Cosmetic Surgery, Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), 123rd Tianfei Street, Mochou Road, Nanjing 210004, China
| | - Mang Gui
- Yangzhou Maternal and Child Health Hospital (Affiliated Hospital of Yangzhou University), Yangzhou, China
| | - Ling Chen
- Department of Plastic&Cosmetic Surgery, Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), 123rd Tianfei Street, Mochou Road, Nanjing 210004, China
| | - Jun Li
- Department of Plastic&Cosmetic Surgery, Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), 123rd Tianfei Street, Mochou Road, Nanjing 210004, China.
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Chong CH, Sun JM, Liu YX, Tsai YT, Zheng DN, Zhang YF, Yu L. Salvianolic Acid B Attenuates Hypertrophic Scar Formation In Vivo and In Vitro. Aesthetic Plast Surg 2023. [PMID: 36810832 DOI: 10.1007/s00266-023-03279-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 01/28/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Hypertrophic scars (HTSs) are a fibroproliferative disorder that occur following skin injuries. Salvianolic acid B (Sal-B) is an extractant from Salvia miltiorrhiza that has been reported to ameliorate fibrosis in multiple organs. However, the antifibrotic effect on HTSs remains unclear. This study aimed to determine the antifibrotic effect of Sal-B in vitro and in vivo. METHODS In vitro, hypertrophic scar-derived fibroblasts (HSFs) were isolated from human HTSs and cultured. HSFs were treated with (0, 10, 50, 100 μmol/L) Sal-B. Cell proliferation and migration were evaluated by EdU, wound healing, and transwell assays. The protein and mRNA levels of TGFβI, Smad2, Smad3, α-SMA, COL1, and COL3 were detected by Western blots and real-time PCR. In vivo, tension stretching devices were fixed on incisions for HTS formation. The induced scars were treated with 100 μL of Sal-B/PBS per day according to the concentration of the group and followed up for 7 or 14 days. The scar condition, collagen deposition, and α-SMA expression were analyzed by gross visual examination, H&E, Masson, picrosirius red staining, and immunofluorescence. RESULTS In vitro, Sal-B inhibited HSF proliferation, migration, and downregulated the expression of TGFβI, Smad2, Smad3, α-SMA, COL1, and COL3 in HSFs. In vivo, 50 and 100 μmol/L Sal-B significantly reduced scar size in gross and cross-sectional observations, with decreased α-SMA expression and collagen deposition in the tension-induced HTS model. CONCLUSIONS Our study demonstrated that Sal-B inhibits HSFs proliferation, migration, fibrotic marker expression and attenuates HTS formation in a tension-induced HTS model in vivo. NO LEVEL ASSIGNED This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Nobari NN, Tabavar A, Sadeghi S, Dehghani A, Kalantari Y, Ghassemi M, Atefi N, Goodarzi A. A systematic review of the comparison between needling (RF-needling, meso-needling, and micro-needling) and ablative fractional lasers (CO 2, erbium YAG) in the treatment of atrophic and hypertrophic scars. Lasers Med Sci 2023; 38:67. [PMID: 36749436 DOI: 10.1007/s10103-022-03694-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 09/22/2022] [Accepted: 11/08/2022] [Indexed: 02/08/2023]
Abstract
The aim of this study is to compare needling (RF-needling, meso-needling, micro-needling) and ablative fractional lasers (CO2, erbium-YAG) in the treatment of atrophic and hypertrophic scars in a systematic review. The database was searched, and 10 articles were selected that were relevant in terms of content, topic, and purpose and met the inclusion criteria. Of all the articles reviewed in this study, there were 2 randomized split-face trials (20%), 1 controlled nonrandomized trial (10%), 1 controlled randomized phase III clinical trial (10%), 1 prospective trial (10%), 1 prospective nonrandomized open-label trial (10%), and 1 randomized comparative trial (10%), with the type of study not reported in 3 articles. We used Endnote X8 to review the articles and extract data. After review, the studies were analyzed and categorized. No statistically significant difference was found between the two methods, laser and micro-needling, in the treatment of atrophic and hypertrophic scars in 60% of the articles studied, and both showed significant improvement (70% or more improvement to complete response). Significant improvement was noted in 20% of the studies reviewed for the laser and micro-needling treatment methods. The results of this study show that needling and ablative fractional lasers are tolerable and safe procedures with no significant difference in the treatment of skin scars in sixty percent of the studies.
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Affiliation(s)
- Niloufar Najar Nobari
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Anahita Tabavar
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Sara Sadeghi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
- Division of Dermatology, Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada
| | - Abbas Dehghani
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Yasamin Kalantari
- Department of Dermatology, Razi Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Ghassemi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Najmolsadat Atefi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Azadeh Goodarzi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran.
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Zhao B, Shi X, Feng D, Han J, Hu D. MicroRNA let-7d attenuates hypertrophic scar fibrosis through modulation of iron metabolism by reducing DMT1 expression. J Mol Histol 2023; 54:77-87. [PMID: 36705783 DOI: 10.1007/s10735-023-10113-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 01/05/2023] [Indexed: 01/28/2023]
Abstract
Hypertrophic scar is an unavoidable result of wound healing following burns and trauma, which remains a challenging problem for clinicians. Previously, we demonstrated that exosomal microRNAs (miRs) of human amniotic epithelial cells accelerated wound healing and inhibited scar formation. However, the underlying mechanism is still unclear. In this particular study, we found that miR-let-7d reduced collagen deposition, and this was accompanied by decreased level of iron content in myofibroblasts. Importantly, inhibition of miR-let-7d in myofibroblasts accelerated collagen deposition and promoted cell proliferation. In addition, bioinformatics prediction combined with classical dual-luciferase reporter gene assay demonstrated that the cellular iron importer divalent metal transporter 1 (DMT1) was a target gene of miR-let-7d, and the miR-let-7d mimics inhibited the expression of DMT1 in myofibroblasts. Moreover, silencing of DMT1 with small interfering RNA (siRNA) reduced the deposition of extracellular matrix. Consistent with the results in vitro, the miR-let-7d mimics effectively ameliorated hypertrophic scar fibrosis in a rabbit ear hypertrophic scar model. Taken together, our results indicated for the first time that miR-let-7d attenuated hypertrophic scar fibrosis through modulation of iron metabolism by reducing iron uptake through DMT1, which may provide a novel therapeutic strategy for hypertrophic scar.
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