Altered angiogenic balance in keloids: a key to therapeutic intervention

Mogili, Nirupa Shyam; Krishnaswamy, V.; Meenakshi, J; Rajaram, Rama; Venkatraman, Alamelu; Korrapati, Purna Sai

doi:10.1016/j.trsl.2011.10.002

Cited by 48 publications

(50 citation statements)

References 29 publications

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“…Less scar formation in fetal skin and oral mucosa might be related to an inferior inflammatory response and a much faster maturation of newly formed capillary networks [57]. New therapies for hypertrophic scars or even keloids have therefore been suggested using anti-angiogenic treatments, although the distinct underlying mechanism is still unclear [57,60,61]. DiPietro [57] concluded in her review article that at first, it might seem odd to diminish angiogenesis during skin wound repair.…”

Section: Angiogenesis In Skin Wound Healingmentioning

confidence: 99%

Skin Wound Healing: An Update on the Current Knowledge and Concepts

Sorg

Tilkorn²,

Hager³

et al. 2016

Eur Surg Res

948

691

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Background: The integrity of healthy skin plays a crucial role in maintaining physiological homeostasis of the human body. The skin is the largest organ system of the body. As such, it plays pivotal roles in the protection against mechanical forces and infections, fluid imbalance, and thermal dysregulation. At the same time, it allows for flexibility to enable joint function in some areas of the body and more rigid fixation to hinder shifting of the palm or foot sole. Many instances lead to inadequate wound healing which necessitates medical intervention. Chronic conditions such as diabetes mellitus or peripheral vascular disease can lead to impaired wound healing. Acute trauma such as degloving or large-scale thermal injuries are followed by a loss of skin organ function rendering the organism vulnerable to infections, thermal dysregulation, and fluid loss. Methods: For this update article, we have reviewed the actual literature on skin wound healing purposes focusing on the main phases of wound healing, i.e., inflammation, proliferation, epithelialization, angiogenesis, remodeling, and scarring. Results: The reader will get briefed on new insights and up-to-date concepts in skin wound healing. The macrophage as a key player in the inflammatory phase will be highlighted. During the epithelialization process, we will present the different concepts of how the wound will get closed, e.g., leapfrogging, lamellipodial crawling, shuffling, and the stem cell niche. The neovascularization represents an essential component in wound healing due to its fundamental impact from the very beginning after skin injury until the end of the wound remodeling. Here, the distinct pattern of the neovascularization process and the special new functions of the pericyte will be underscored. At the end, this update will present 3 topics of high interest in skin wound healing issues, dealing with scarring, tissue engineering, and plasma application. Conclusion: Although wound healing mechanisms and specific cell functions in wound repair have been delineated in part, many underlying pathophysiological processes are still unknown. The purpose of the following update on skin wound healing is to focus on the different phases and to brief the reader on the current knowledge and new insights. Skin wound healing is a complex process, which is dependent on many cell types and mediators interacting in a highly sophisticated temporal sequence. Although some interactions during the healing process are crucial, redundancy is high and other cells or mediators can adopt functions or signaling without major complications.

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Section: Angiogenesis In Skin Wound Healingmentioning

confidence: 99%

Skin Wound Healing: An Update on the Current Knowledge and Concepts

Sorg

Tilkorn²,

Hager³

et al. 2016

Eur Surg Res

948

691

View full text Add to dashboard Cite

show abstract

“…A prenatal or oral injury leads to a less pronounced inflammatory reaction as well as angiogenesis and is accompanied by (almost) scar-free wound healing (Table 1) [47,48]. Further studies have also shown that increased VEGF levels and increased vascularity could be observed in patients with hypertrophic or keloid scars (Table 1) [49,50]. The blockade of VEGF or an anti-angiogenic therapy, e.g., using bevacizumab, showed significantly reduced formation of intra-abdominal adhesions and hypertrophic scars [51,52].…”

Section: Phase 2: Anti-angiogenic Phase or Regressionmentioning

confidence: 99%

Panta Rhei: Neovascularization, Angiogenesis and Nutritive Perfusion in Wound Healing

et al. 2018

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Background: In response to tissue damage, angiogenesis is an extremely dynamic process that is finely regulated by signals from cells, the surrounding extracellular matrix (ECM), and derived mediators. As the only process, angiogenesis remains of decisive importance in the context of the entire wound healing process and is subject to constant change. The dissolution of the endothelial basement membrane, the migration of endothelial cells, and the development of new capillary vessels during wound healing depend not only on the cells and cytokines present, but also on the production and organization of ECM components in the immediate wound. Summary: Angiogenesis in wound healing can be divided into two main phases. During the pro-angiogenic phase at the beginning of wound healing, excessive neo-formation of blood vessels, some of which are poorly differentiated, occurs, which restore blood flow and thus nutritive perfusion as quickly as possible. This is followed by an anti-angiogenic phase in which the initially established vascular network undergoes a maturing process, which, however, is accompanied by a significant reduction in the number of vessels. Key Messages: Although many mechanisms and specific cell functions in wound healing have already been described, many underlying pathophysiological processes remain unknown. Because angiogenesis and its maturation is a very fast but also very long-lasting process, the understanding of the underlying mechanisms is of crucial importance. This article will give an overview of the current understanding and controversy in this sub-step of wound healing.

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“…3 VEGF was not only highly expressed in local keloid tissues, but also elevated in serum in patients with keloids scars compared with normal population. 31 June 2017…”

Section: Vascular Endothelial Growth Factor (Vegf)mentioning

confidence: 99%

The Characteristics of Blood Supply and Tissue Hypoxia in Pathological Scars

李梓菲¹,

Li²,

刘清亮³

et al. 2017

Chinese Medical Sciences Journal

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Blood supply is believed to be an important aspect in the development of pathological scars. However, there are controversies about vascular distribution, vascular structure and blood flow in pathological scars. Additionally, hypoxic microenvironment plays an important role in the vascularization of pathological scar tissues, and hypoxic conditions can be reflected by metabolic indexes and some cytokines. Furthermore, the correlation between blood supply and tissue hypoxia is controversial. The aim of this article is to review the literature on the characteristics of blood supply and tissue hypoxia in pathological scars, from which we can see pathological scars have unique characteristics of blood supply that are closely associated with tissue hypoxia. Moreover, development in the treatment of pathological scars is herein reviewed.Chin Med Sci J 2017; 32(2):113-118. DOI:10.24920/J1001-9294.2017.014 ATHOLOGICAL scars include hypertrophic scar and keloid. They influence appearance and even cause functional disturbance, and place tremendous physiological and psychological burdens on patients. Therefore, pathological scars have been a challenge in plastic surgery and the focus of research.Blood supply is believed to be an important aspect in the development of pathological scars, and has thus attracted more attentions in recent years. However, there are controversies about blood supply in pathological scars.Hereby we summarized the advances of research on the blood supply in pathological scars, and explored future research directions. The vascular structure of pathological scars has different manifestations between hypertrophic scars and keloids. In terms of spatial vascular structure, blood vessels within hypertrophic scar tissues have a structure perpendicular to the skin surface, whereas those within keloid tissues present a typical dispersed, extended vascular structure. VASCULARITY OF PATHOLOGICAL SCARS 5,6The diameter or patency of the blood vessels of pathological scar remains controversial. Thaís et al used stereological methods to obtain information on pathological scar tissues with a microscope, and proposed that the blood vessels within the pathological scars were dilated compared with those in normal skin and normal scars.

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Altered angiogenic balance in keloids: a key to therapeutic intervention

Cited by 48 publications

References 29 publications

Skin Wound Healing: An Update on the Current Knowledge and Concepts

Skin Wound Healing: An Update on the Current Knowledge and Concepts

Panta Rhei: Neovascularization, Angiogenesis and Nutritive Perfusion in Wound Healing

The Characteristics of Blood Supply and Tissue Hypoxia in Pathological Scars

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