Fibroblasts in Scar Formation: Biology and Clinical Translation

Abstract

Scarring, which develops due to fibroblast activation and excessive extracellular matrix deposition, can cause physical, psychological, and cosmetic problems. Fibroblasts are the main type of connective tissue cells and play important roles in wound healing. However, the underlying mechanisms of fibroblast in reaching scarless wound healing require more exploration. Herein, we systematically reviewed how fibroblasts behave in response to skin injuries, as well as their functions in regeneration and scar formation. Several biocompatible materials, including hydrogels and nanoparticles, were also suggested. Moreover, factors that concern transformation from fibroblasts into cancer-associated fibroblasts are mentioned due to a tight association between scar formation and primary skin cancers. These findings will help us better understand skin fibrotic pathogenesis, as well as provide potential targets for scarless wound healing therapies.

Visible light-driven photodynamic therapy for hypertrophic scars with MOF armored microneedles patch

“…HS is a fibroproliferative disease caused by the excessive proliferation of fibroblasts and ECM during wound healing ( Zhang et al, 2020 ). Previous studies have demonstrated that transforming growth factor-β1 (TGF-β1) has a fibrogenic effect in hypertrophic scar fibrosis and plays a crucial part in fibroblast differentiation by regulating the expression of α-smooth muscle actin (α-SMA) in fibroblasts ( Lu et al, 2005 ; Qian et al, 2022 ). α-SMA is a typical marker of the fibroblast contraction phenotype.…”

Clinical efficacy of ablative laser combined with pulsed dye laser in the treatment of pathological scars: A systematic review and meta‐analysis

“…This severe fibrosis dysfunction will appear as aesthetic and functional flaws, discomfort, itching, pain, psychological stress, and patient dissatisfaction, reducing range of motion and operational performance while attempting to impose a large cost on people and society. 32 Scar hyperplasia can be avoided and managed based on current knowledge of scar formation biology. 33 There are various effective treatment options for pathological scarring; however, the ideal one remains unknown.…”

“…Excessive fibroblast activation and ECM deposition result in pathological scars from overactive healing processes. This severe fibrosis dysfunction will appear as aesthetic and functional flaws, discomfort, itching, pain, psychological stress, and patient dissatisfaction, reducing range of motion and operational performance while attempting to impose a large cost on people and society 32 . Scar hyperplasia can be avoided and managed based on current knowledge of scar formation biology 33…”

Exploring the Potential of Ultrasound Therapy to Reduce Skin Scars: An In Vitro Study Using a Multi-Well Device Based on Printable Piezoelectric Transducers

“…Although hypertrophic scars and keloids differ in their histopathologic features and clinical appearance, they are both caused by an overproduction of collagen, which continues to be deposited at the site of the wound [2]. The main cells mediating extracellular matrix (ECM) protein turnover are dermal fibroblasts, which are thought to be dysregulated in abnormal scarring disorders, but the exact pathogenesis is still not fully understood [3]. While some scars may be considered as trivial aesthetic skin lesions, abnormal scars can cause a variety of problems ranging from itching, soreness, and pain at the site of injury to systemic effects, such as sleep disturbances, anxiety, depression, and impairment of daily activities.…”