Effect of extracorporeal shock wave therapy on keratinocytes derived from human hypertrophic scars

Cui, Hui Song; Joo, So Young; Cho, Yoon Soo; Park, Ji Heon; Ro, Yu Mi; Kim, June-Bum; Seo, Cheong Hoon

doi:10.1038/s41598-021-96537-8

Cited by 10 publications

(7 citation statements)

References 43 publications

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“…Moreover, both filaggrin and involucrin (differentiation marker) were at abnormal levels in HTS tissues [ 38 ]. Recently, we also reported that levels of KRT1, KRT6, KRT17, and involucrin increased in keratinocytes derived from HTS compared with their levels in matched NHKs [ 39 ]. Conventionally, however, the filaggrin expression is reduced or absent in hyperproliferative diseases, such as psoriasis and atopic dermatitis [ 40 , 41 ].…”

Section: Discussionmentioning

confidence: 99%

“…This study was approved by the Hallym University Hangang Sacred Heart Hospital Institutional Review Board (HG 2019-016). Cell culture was performed as previously described [ 26 , 39 ]. Briefly, normal skin and HTS tissues were cut into small pieces, soaked in a Dispase II (1 U/mL; Gibco, Waltham, MA, USA) solution, and maintained at 4 °C overnight.…”

Section: Methodsmentioning

confidence: 99%

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Effect of Hypertrophic Scar Fibroblast-Derived Exosomes on Keratinocytes of Normal Human Skin

Cui

Joo

Lee

et al. 2023

IJMS

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Epidermal keratinocytes are highly activated, hyper-proliferated, and abnormally differentiated in the post-burn hypertrophic scar (HTS); however, the effects of scar fibroblasts (SFs) on keratinocytes through cell–cell interaction in HTS remain unknown. Here, we investigated the effects of HTSF-derived exosomes on the proliferation and differentiation of normal human keratinocytes (NHKs) compared with normal fibroblasts (NFs) and their possible mechanism to provide a reference for clinical intervention of HTS. Fibroblasts were isolated and cultured from HTS and normal skin. Both HTSF-exosomes and NF-exosomes were extracted via a column-based method from the cell culture supernatant. NHKs were treated for 24 or 48 h with 100 μg/mL of cell-derived exosomes. The expression of proliferation markers (Ki-67 and keratin 14), activation markers (keratins 6, 16, and 17), differentiation markers (keratins 1 and 10), apoptosis factors (Bax, Bcl2, caspase 14, and ASK1), proliferation/differentiation regulators (p21 and p27), and epithelial–mesenchymal transition (EMT) markers (E-cadherin, N-cadherin, and vimentin) was investigated. Compared with NF-exosomes, HTSF-exosomes altered the molecular pattern of proliferation, activation, differentiation, and apoptosis, proliferation/differentiation regulators of NHKs, and EMT markers differently. In conclusion, our findings indicate that HTSF-derived exosomes may play a role in the epidermal pathological development of HTS.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Effect of Hypertrophic Scar Fibroblast-Derived Exosomes on Keratinocytes of Normal Human Skin

Cui

Joo

Lee

et al. 2023

IJMS

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“…Specifically, results of animal experiments in vivo showed that ESWT could alleviate the infiltration extent of inflammatory cells, decrease the number and density of fibroblasts, improve collagen arrangement and reduce hypertrophic index of scars in a rabbit hypertrophic scar model 41,42 . Furthermore, experiments in vitro indicated that extracorporeal shock waves can regulate proliferation, migration and differentiation of keratinocytes and fibroblasts derived from scar tissue, reduce expression of transforming growth factor beta 1 (TGF‐β1), alpha smooth muscle actin (α‐SMA), collagen‐I, fibronectin and twist‐1, which might be responsible for the anti‐scarring effect of ESWT 43–46 . In Joo's study, mechanisms of ESWT were primarily attributed to a significant increase of micro‐perfusion in the PBPS area post ESWT 20 ; the latter can be achieved with both fESWT 47 and rESWT 48 …”

Section: Discussionmentioning

confidence: 99%

“…41,42 Furthermore, experiments in vitro indicated that extracorporeal shock waves can regulate proliferation, migration and differentiation of keratinocytes and fibroblasts derived from scar tissue, reduce expression of transforming growth factor beta 1 (TGF-β1), alpha smooth muscle actin (α-SMA), collagen-I, fibronectin and twist-1, which might be responsible for the antiscarring effect of ESWT. [43][44][45][46] In Joo's study, mechanisms of ESWT were primarily attributed to a significant increase of micro-perfusion in the PBPS area post ESWT 20 ; the latter can be achieved with both fESWT 47 and rESWT. 48 No serious adverse events after treating PBPS with ESWT + CRT were reported in the studies listed in Table 2.…”

Section: T a B L E 1 Study Design And Patient Characteristics Of Incl...mentioning

confidence: 99%

Safety and efficacy of treating post‐burn pathological scars with extracorporeal shock wave therapy: A meta‐analysis of randomised controlled trials

Yang

Kang

Jiang

et al. 2022

Wound Repair Regeneration

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The clinical application of shockwave therapy has expanded to the treatment of pathological scars. The objective of this systematic review and meta‐analysis is to quantitatively evaluate the efficacy and safety of extracorporeal shockwave therapy combined with comprehensive rehabilitation therapy on post‐burn pathological scars compared to comprehensive rehabilitation therapy alone. The randomised controlled trials of extracorporeal shockwave therapy for post‐burn pathological scars published in English and Chinese languages before October 2021 were included. The methodological quality and risk of bias of the selected articles were assessed with the Cochrane Collaboration's ‘risk of bias’ tool. RevMan software was applied for data analysis. This is the first systematic review and meta‐analysis considering the effectiveness and safety of extracorporeal shockwave therapy on post‐burn pathological scars. And nine randomised controlled trials involving 422 patients were included in this meta‐analysis. The meta‐analysis results showed that, compared with comprehensive rehabilitation therapy alone, extracorporeal shockwave therapy combined with comprehensive rehabilitation therapy was more effective in relieving pain (standardized mean difference [SMD] = −0.59, 95% confidence interval [CI]: [−0.87 to −0.31], p < 0.0001) and pruritus related to pathological scars (SMD = −0.94; 95% CI: [−1.25 to −0.63], p = 0.004), improving scars' appearance (SMD = −1.78, 95% CI: [−3.37 to −0.19], p = 0.03) and elasticity (SMD = 0.25, 95% CI: [0.29–0.21], p < 0.00001), decreasing scars thickness (SMD = −0.13, 95% CI: [−0.25 to −0.01], p = 0.04) and promoting the maturation status of scars (SMD = −2.86, 95% CI: [−3.96 to −1.76], p < 0.00001). There were no reported serious adverse events during and after extracorporeal shockwave therapy in the included studies. Available data preliminarily suggested that the combination of extracorporeal shockwave therapy and comprehensive rehabilitation therapy had better therapeutic effect on post‐burn pathological scars than comprehensive rehabilitation therapy alone, without obvious side effects. However, further clinical well‐controlled randomised controlled trials are needed. Systematic review registration ID: PROSPERO CRD42022297573.

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“…The wide range of applications highlights the versatile benefits and regenerative potential of ESWT. 4 5 6 7 8 9 10 11 ESWT transmits a mechanical force via an acoustic wave to facilitate wound healing. The force stimulates the release of neuropeptides from nerve endings and improves wound healing.…”

Section: Introductionmentioning

confidence: 99%

Extracorporeal Shock Wave Therapy for Hypertrophic Scars

et al. 2022

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Background Hypertrophic scars cause aesthetic concerns and negatively affect the quality of life. A gold standard treatment for hypertrophic scars has not been established due to various responses of modalities. Extracorporeal shock wave therapy (ESWT) is a noninvasive and affects scar remodeling by fibroblast regulation. This study investigated the effectiveness of ESWT for hypertrophic scars. Methods Twenty-nine patients were enrolled. All patients underwent ESWT once a week for 6 consecutive weeks. Their scars were assessed using the Patient and Observer Scar Assessment Scale (POSAS), erythema index, melanin index, and scar pliability before treatment and again 4 weeks after treatment completion. Results Thirty-four hypertrophic scars in this study had persisted for between 6 months and 30 years. Most scars developed after surgical incision (55.88%). The chest and upper extremities were the predominant areas of occurrence (35.29% each). Most of the POSAS subscales and total scores were significantly improved 4 weeks after treatment (p < 0.05). Furthermore, the pain, itching, and pigmentation subscale were improved. The pliability, melanin index, and erythema index were also improved, but without significance. The patients were satisfied with the results and symptoms alleviation, although subjective score changes were insignificant. No serious adverse events were found. The patients reported pruritus in 62.5% and good pain tolerance in 37.5%. Subgroup analyses found no differences in scar etiologies or properties at different parts of the body. Conclusion The ESWT is a modality for hypertrophic scar treatment with promising results. Most of POSAS subscales were significantly improved.

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Effect of extracorporeal shock wave therapy on keratinocytes derived from human hypertrophic scars

Cited by 10 publications

References 43 publications

Effect of Hypertrophic Scar Fibroblast-Derived Exosomes on Keratinocytes of Normal Human Skin

Effect of Hypertrophic Scar Fibroblast-Derived Exosomes on Keratinocytes of Normal Human Skin

Safety and efficacy of treating post‐burn pathological scars with extracorporeal shock wave therapy: A meta‐analysis of randomised controlled trials

Extracorporeal Shock Wave Therapy for Hypertrophic Scars

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