Current concepts related to hypertrophic scarring in burn injuries

Chiang, Ryan S.; Borovikova, Anna A.; King, Kassandra; Banyard, Derek A.; Lalezari, Shadi; Toranto, Jason D.; Paydar, Keyianoosh Z.; Wirth, Garrett A.; Evans, Gregory R. D.; Widgerow, Alan D.

doi:10.1111/wrr.12432

Cited by 94 publications

(58 citation statements)

References 91 publications

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“…Fibroproliferative disorders of the skin, such as hypertrophic scarring (HTS), are characterized by dysregulated collagen production and result in raised, thick, and inflexible scars [1][2][3]. HTS occurs most commonly after burn injury, surgery, or excessive inflammation and can dramatically diminish patient quality of life [1,[3][4][5]. HTS contractures and rigidity can limit range of motion and impair day-to-day activities.…”

Section: Introductionmentioning

confidence: 99%

Pirfenidone reduces profibrotic responses in human dermal myofibroblasts, in vitro

Hall

Wells

Leung

2018

Laboratory Investigation

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Pirfenidone (PFD) is a synthetic small molecule inhibitor with demonstrated anti-inflammatory and antifibrotic properties in vitro and in vivo. The exact mechanism(s) of PFD action remain unclear, due in part to the broad effects of this drug on the complex processes involved in inflammation and fibrosis. While PFD is FDA-approved for the treatment of idiopathic pulmonary fibrosis, the efficacy of this compound for the treatment of dermal fibrosis has not yet been fully characterized. Dermal fibrosis is the pathological formation of excess fibrous connective tissue of the skin, usually the result of traumatic cutaneous injury. Fibroproliferative scarring, caused by delayed wound healing and prolonged inflammation, remains a major clinical concern with considerable morbidity. Despite efforts to identify a therapeutic that targets the fibrotic pathways involved in wound healing to mitigate scar formation, no satisfactory dermal antifibrotic has yet been identified. We aim to better elucidate the antifibrotic mechanism(s) of PFD activity using an in vitro model of dermal fibrosis. Briefly, cultured human dermal fibroblasts were stimulated with TGF-β1 to induce differentiation into profibrotic myofibroblast cells. A dose-dependent reduction in cellular proliferation and migration was observed in TGF-β1-stimulated cells when treated with PFD. We observed a clear inhibition in the development of essential myofibroblast mechanoregulatory machinery, including contractile F-actin stress fibers containing α-SMA and large super-mature focal adhesions. PFD treatment significantly reduced protein levels of major ECM components type I and type III collagen. PFD targeted the p38 MAPK signaling pathway and mitigated profibrotic gene expression profiles. This in vitro data promotes PFD as a potential therapeutic agent for the treatment of dermal fibrosis.

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Section: Introductionmentioning

confidence: 99%

Pirfenidone reduces profibrotic responses in human dermal myofibroblasts, in vitro

Hall

Wells

Leung

2018

Laboratory Investigation

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“…This migration facilitates wound closure rat, re-epithelialization and angiogenesis [92]. Adipose-derived (ADSCs) and mesenchymal stem cells(MSCs)have been commonly investigated for scar treatment [93].…”

Section: Stem Cellsmentioning

confidence: 99%

A Review of Scar Treatment Related to Acne and Burn

Behrangi¹,

Goodarzi²,

Roohaninasab³

et al. 2020

jcr

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Introduction: Annually in the developed world about 100 million patients get scars, several of them are a source of significant problems, as a result of elective operations or operations following trauma. It is assessed 11 million keloid scars and 4 million burn scars occur each year that 70% of these scars arise in children. People that have unusual skin with scarring may confront aesthetic, physical, social, and psychological consequences. One of the main reasons for skin scarring is acne and burn. Objective: The aim of this study is a review of therapeutic method for scar treatment related to burn and acne. Material and method: Broad research was conducted on some medical, pharmacological and surgical database of life sciences such as PubMed, EMBASE, MEDLINE, LILACS database, global independent network of Cochrane. By referencing these databases, a comprehensive literature review was carried out through combining numerous recent studies in terms of skin scaring, burn, acne treatment and management in accordance with many related articles published from 2000 to 2020 which could cover this area of recommendations. Conclusion: Significant advancements have been seen in scare related burn and acne treatment in the recent decade, including advances in novel skin substitutes, pharmacological interventions, advanced surgical approaches such as laser therapy, fat grafting, skin grafting and coverage options for burn scar. For acne scaring treatment the laser therapy, cosmetic filler and pharmacological method have been introduced. As a result, by these new methods, treatment of scars improves significantly, however improvement of scar related to burn looks is more difficultly and numerous challenges still is essential to improve current scare.

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“…Hypertrophic scar (HS) reflects the dysfunctional response from the skin during injury especially burns and surgery, which leads to excessive deposition of fibroblast and collagen and thick elevated scar/fibrosis [1]. Post-burn HS presents an emotional and physical burden on the patient owing to excessive pain, pruritus, discomfort, disability (joint contracture) and disfigurements [2]. Epidemiological studies have indicated that about 40 -70 % of thermal injury (burn wound) result in HS.…”

Section: Introductionmentioning

confidence: 99%

Suppressive effect of bacoside A on hypertrophic scar formation by downregulation of TGF-β1

Chen¹,

Lü²

2018

Trop. J. Pharm Res

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Purpose:To determine the anti-scarring property of bacoside A (BA) in a rabbit model of post-burns hypertrophic scar (HS). Methods: A total of 16 healthy male rabbits were divided into four groups (4 rabbits/group). The rabbits were subjected to full-thickness burn wound by placing a 10-mm brass rod at 90 ºC on their ears for 20 s, and were untreated (HS group). The remaining rabbits also underwent HS process but were topically treated daily with 0.2, 0.4 or 0.6 % BA gel (HS + 0.2, 0.4, and 0.6 % BA groups) from day 8 to day 34. Results: The mean values of collagen (types I & III), hydroxyproline (precursor of collagen) and hexosamine, as well as scar index significantly (p < 0.001) decreased after 28 days of topical treatment with BA. Moreover, BA application resulted in improved histological changes with proper arrangement of collagen fibers. Significant (p < 0.001) upregulation or downregulation of transforming growth factor beta-1 (TGF-β1) and matrix metalloproteinase-1 (MMP-1) were observed in the BA-treated rabbits. Conclusion: Treatment with BA significantly lowers the scarring area of burn wounds by downregulation of TGF-β1. Thus, BA can potentially be developed into a drug for managing injury scars. This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest

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Current concepts related to hypertrophic scarring in burn injuries

Cited by 94 publications

References 91 publications

Pirfenidone reduces profibrotic responses in human dermal myofibroblasts, in vitro

Pirfenidone reduces profibrotic responses in human dermal myofibroblasts, in vitro

A Review of Scar Treatment Related to Acne and Burn

Suppressive effect of bacoside A on hypertrophic scar formation by downregulation of TGF-β1

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