Comparison of Enalapril, Candesartan and Intralesional Triamcinolone in Reducing Hypertrophic Scar Development: An Experimental Study

Demir, Cansun; Ersöz, Muhammet Eren; Erten, Remzi; Koçak, Ömer Faruk; Sultanoğlu, Yılmaz; Başbuğan, Yıldıray

doi:10.1007/s00266-018-1073-6

Cited by 19 publications

(15 citation statements)

References 17 publications

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“…The mechanisms of immunomodulatory drugs are studied more intensively. Especially intralesional triamcinolone (TAC), a glucocorticoid suppressing the inflammatory response, and verapamil (a calcium channel antagonist reducing the synthesis of extracellular matrix) injections have been investigated with regard to their ability to alter the TGF‐β expression patterns, 23,24 and to positively influence collagen production 25 . 5‐Fluorouracil (5‐FU) as another rising substance in scar treatment is a pyrimidine anaologue modulating the inflammatory response by inhibiting cell growth, and inducing apoptosis and G2 cell‐cycle arrest among others 26,27 .…”

Section: Introductionmentioning

confidence: 99%

Evidence‐based therapy in hypertrophic scars: An update of a systematic review

Nischwitz

Rauch²,

Luze

et al. 2020

Wound Repair Regeneration

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Hypertrophic scars are still a major burden for numerous patients, especially after burns. Many treatment options are available; however, no evidence‐based treatment protocol is available with recommendations mostly emerging from experience or lower quality studies. This review serves to discuss the currently available literature. A systematic review was performed and the databases PubMed and Web of Science were searched for suitable publications. Only original articles in English that dealt with the treatment of hypertrophic scars in living humans were analyzed. Further, studies with a level of evidence lower than 1 as defined by the American Society of Plastic Surgeons were excluded. After duplicate exclusion, 1638 studies were screened. A qualitative assessment yielded 163 articles eligible for evidence grading. Finally nine studies were included. Four of them used intralesional injections, four topical therapeutics and one assessed the efficacy of CO2‐laser. Intralesional triamcinolone + fluorouracil injections, and topical pressure and/or silicone therapy revealed significant improvements in terms of scar height, pliability, and pigmentation. This systematic review showed that still few high‐quality studies exist to evaluate therapeutic means and their mechanisms for hypertrophic scars. Among these, most of them assessed the efficacy of intralesional triamcinolone injections with the same treatment protocol. Intralesional injection appears to be the best option for hypertrophic scar treatment. Future studies should focus on a possible optimization of infiltrative therapies, consistent end‐point evaluations, adequate follow‐up periods, and possibly intraindividual treatments.

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Section: Introductionmentioning

confidence: 99%

Evidence‐based therapy in hypertrophic scars: An update of a systematic review

Nischwitz

Rauch²,

Luze

et al. 2020

Wound Repair Regeneration

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“…tsRNA-23761 competes with the miRNA pool to regulate ACE expression. It is speculated that tsRNA-23761 may also affect the activity and proliferation of fibroblasts in hypertrophic scars via the regulation of certain mechanisms of ACE (63-65).…”

Section: Discussionmentioning

confidence: 99%

tRNA‑derived small RNAs: A novel class of small RNAs in human hypertrophic scar fibroblasts

Zhang

Deng

et al. 2019

Int J Mol Med

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tRNA-derived small RNAs (tsRNAs) have been shown to play regulatory roles in many physiological and pathological processes. However, their roles in hypertrophic scars remain unclear. The present study investigated differentially expressed tsRNAs in human hypertrophic scar fibroblasts and normal skin fibroblasts via high-throughput sequencing. Several dysregulated tsRNAs were validated by reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment, target prediction, coexpression networks and competing endogenous RNA (ceRNA) networks were evaluated to discover the principal functions of significantly differentially expressed tsRNAs. In total, 67 differentially expressed tsRNAs were detected, of which 27 were upregulated and 40 downregulated in hypertrophic scar fibroblasts. The GO analysis indicated that the dysregulated tsRNAs are associated with numerous biological functions, including 'nervous system development', 'cell adhesion', 'focal adhesion', 'protein binding', 'angiogenesis' and 'actin binding'. KEGG pathway analysis revealed that the most altered pathways include 'Ras signaling pathway', 'Rap1 signaling pathway' and 'cGMP-PKG signaling pathway'. The target genes of the differentially expressed tsRNAs participate in several signaling pathways important for scar formation. The results of RT-qPCR were consistent with those of sequencing. MicroRNA (miR)-29b-1-5p was identified as a target of tsRNA-23678 and was downregulated in hypertrophic scar fibroblasts, constituting a negative regulatory factor for scar formation. Furthermore, tsRNA-23761 acted as a ceRNA and bound to miR-3135b to regulate the expression of miR-3135b targets, including angiotensin-converting enzyme. collectively, these findings reveal that tsRNAs are differentially expressed in human hypertrophic scar fibroblasts, and may contribute to the molecular mechanism and treatment of hypertrophic scars.

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“…A scar elevation index (SEI) was calculated to quantify the degree of scar proliferation using H&E stained slides of the wounds. The SEI is defined as the ratio of the length of a line of the scar to that of normal skin, which is perpendicular to the ear surface and is measured from the top point of the scar/skin epithelium to the surface of the ear cartilage as previously described 2 . The SEI of each wound was measured using an Image‐Pro Plus 6.0 software (Media Cybernetics, Rockville, Maryland) by a blinded examiner.…”

Section: Methodsmentioning

confidence: 99%

“…Hypertrophic scar (HS) is a common fibro‐proliferative disorder causing pain, itch, and contractures with limited joint mobility, and disfigured deformities, which significantly affects psychological health of the patients 1 . HS is characterised by hyperproliferation of dermal fibroblasts, overproduction of collagen, and excess deposition of extracellular matrix (ECM) elicited by deep burn and traumatic injuries, and even acne 2 . Normal inflammatory response can stimulate collagen synthesis and promote wound healing.…”

Section: Introductionmentioning

confidence: 99%

“… 1 HS is characterised by hyperproliferation of dermal fibroblasts, overproduction of collagen, and excess deposition of extracellular matrix (ECM) elicited by deep burn and traumatic injuries, and even acne. 2 Normal inflammatory response can stimulate collagen synthesis and promote wound healing. Whereas, excessive inflammatory reaction, a process with excessive secretion of inflammatory cytokines released from wound fibroblasts and inflammatory cells such as interleukin (IL)‐1β, IL‐6, and IL‐8, can promote fibroblast proliferation, boost collagen overproduction, and aggravate other ECM synthesis, which ultimately result in pathological scar formation, including HS and keloid.…”

Section: Introductionmentioning

confidence: 99%

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Inhibition of hypertrophic scar formation with oral asiaticoside treatment in a rabbit ear scar model

Huang

Zhou

Xia

et al. 2021

International Wound Journal

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Hypertrophic scar (HS) is a fibrotic skin disease characterised by over‐productive collagen and excessive inflammatory reaction, which can be functionally and cosmetically problematic. A scar‐prone constitute will accelerate HS formation and functional disorder, which deserves systemic therapy with oral medicine. To examine the oral therapeutic effectiveness on HS with convincing evidence of gross view and histological improvement, a rabbit ear HS model was employed with oral administration of asiaticoside (AS) at the doses of 12 and 24 mg kg−1 d−1 daily for 60 consecutive days. Gross observation and histological findings showed that oral AS treatment could significantly inhibit HS formation in a dose dependent manner. Semi‐quantification of scar elevation index at days 7, 15, 30, and 60, and quantitative polymerase chain reaction at days 30 and 60 also provided the evidences of reduced scar thickness and inhibited fibrotic gene expressions of collagens I, III, TGF‐β1, interleukins 1β, 6 and 8, and enhanced gene expression of SMAD 7 and PPAR‐γ with a dose‐dependent manner. These results indicated that AS is likely to serve as a systemic therapeutic agent of HS treatment for those who may have scar‐prone constitute via anti‐inflammation, inhibiting fibrotic process, and enhancing matrix degradation.

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Comparison of Enalapril, Candesartan and Intralesional Triamcinolone in Reducing Hypertrophic Scar Development: An Experimental Study

Abstract: 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 .

Cited by 19 publications

References 17 publications

Evidence‐based therapy in hypertrophic scars: An update of a systematic review

Evidence‐based therapy in hypertrophic scars: An update of a systematic review

tRNA‑derived small RNAs: A novel class of small RNAs in human hypertrophic scar fibroblasts

Inhibition of hypertrophic scar formation with oral asiaticoside treatment in a rabbit ear scar model

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