The Molecular Mechanisms Involved in the Hypertrophic Scars Post-Burn Injury.

IF 2.5 3区 工程技术 Q2 BIOLOGY Yale Journal of Biology and Medicine Pub Date : 2023-12-29 eCollection Date: 2023-12-01 DOI:10.59249/RHUF5686
Mugdha Pradhan, Prasad Pethe
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Abstract

Scar formation is a normal response to skin injuries. During the scar-remodeling phase, scar tissue is usually replaced with normal, functional tissue. However, after deep burn injuries, the scar tissue may persist and lead to contractures around joints, a condition known as hypertrophic scar tissue. Unfortunately, current treatment options for hypertrophic scars, such as surgery and pressure garments, often fail to prevent their reappearance. One of the primary challenges in treating hypertrophic scars is a lack of knowledge about the molecular mechanisms underlying their formation. In this review, we critically analyze studies that have attempted to uncover the molecular mechanisms behind hypertrophic scar formation after severe burn injuries, as well as clinical trials conducted to treat post-burn hypertrophic scars. We found that most clinical trials used pressure garments, laser treatments, steroids, and proliferative inhibitors for hypertrophic scars, with outcomes measured using subjective scar scales. However, fundamental research using human burn injury biopsies has shown that pathways such as Transforming Growth factor β (TGFβ), Phosphatase and tensin homolog (PTEN), and Toll-like receptors (TLRs) could be potentially regulated to reduce scarring. Therefore, we conclude that more testing is necessary to determine the efficacy of these molecular targets in reducing hypertrophic scarring. Specifically, double-blinded clinical trials are needed, where the outcomes can be measured with more robust quantitative molecular parameters.

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烧伤后肥厚性疤痕的分子机制
疤痕形成是皮肤损伤的正常反应。在疤痕重塑阶段,疤痕组织通常会被正常的功能性组织取代。然而,在深度烧伤后,疤痕组织可能会持续存在,并导致关节周围挛缩,这种情况被称为增生性疤痕组织。遗憾的是,目前治疗增生性疤痕的方法,如手术和压力衣,往往无法防止疤痕的再次出现。治疗增生性疤痕的主要挑战之一是对其形成的分子机制缺乏了解。在这篇综述中,我们认真分析了试图揭示严重烧伤后增生性疤痕形成背后的分子机制的研究,以及治疗烧伤后增生性疤痕的临床试验。我们发现,大多数临床试验都使用压力衣、激光治疗、类固醇和增殖抑制剂来治疗增生性疤痕,并使用主观疤痕量表来测量结果。然而,利用人体烧伤活组织进行的基础研究表明,转化生长因子β(TGFβ)、磷酸酶和天丝蛋白同源物(PTEN)以及Toll样受体(TLRs)等通路有可能被调节以减少疤痕。因此,我们认为有必要进行更多测试,以确定这些分子靶点对减少增生性瘢痕的功效。具体来说,需要进行双盲临床试验,用更可靠的定量分子参数来衡量结果。
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来源期刊
Yale Journal of Biology and Medicine
Yale Journal of Biology and Medicine Biochemistry, Genetics and Molecular Biology-General Biochemistry,Genetics and Molecular Biology
CiteScore
5.00
自引率
0.00%
发文量
41
期刊介绍: The Yale Journal of Biology and Medicine (YJBM) is a graduate and medical student-run, peer-reviewed, open-access journal dedicated to the publication of original research articles, scientific reviews, articles on medical history, personal perspectives on medicine, policy analyses, case reports, and symposia related to biomedical matters. YJBM is published quarterly and aims to publish articles of interest to both physicians and scientists. YJBM is and has been an internationally distributed journal with a long history of landmark articles. Our contributors feature a notable list of philosophers, statesmen, scientists, and physicians, including Ernst Cassirer, Harvey Cushing, Rene Dubos, Edward Kennedy, Donald Seldin, and Jack Strominger. Our Editorial Board consists of students and faculty members from Yale School of Medicine and Yale University Graduate School of Arts & Sciences. All manuscripts submitted to YJBM are first evaluated on the basis of scientific quality, originality, appropriateness, contribution to the field, and style. Suitable manuscripts are then subject to rigorous, fair, and rapid peer review.
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