The influence of GSTT/GSTM null genotypes in scarring

Abstract

Background and aims. The process of scarring is a common denominator of interest for the medical field. From general medicine to dentistry, pathological scar tissue represents a challenge in providing optimal care to a patient. The present study aims to investigate whether a systemically reduced antioxidant potential, revealed by null isoforms of glutathione S transferase, affects the process of scarring in a group of female patients. Methods. The study is based on a group of 54 patients with physiological scars after a 6-month observation period, as well as 18 patients with hypertrophic or atrophic scars. Peripheral venous blood was collected, from which DNA was extracted using a commercial kit. Genotyping followed a Multiplex PCR protocol for GSTT1/GSTM1. Results. In a dominant model, the combination of wild type (heterozygous or homozygous) GSTT1 and GSTM1 was negatively associated with pathological scarring, with the wild type (heterozygous or homozygous) GSTM1 genotype being potentially responsible for this effect. Other factors affecting pathological scarring were investigated: family history, phototype, as well as scores on the POSAS and SCAR scales. Conclusions. The presence of GSTT1 and GSTM1 alleles brings forward an increased antioxidant capacity, serving as a protective factor for patients during scar formation.

A Scoping Review of the Methodology Used in Studies of Genetic Influences on the Development of Keloid or Hypertrophic Scarring in Adults and Children After Acute Wounding

“…Two of the surgical wound studies reported details of who conducted the assessment (study investigators or “trained examiners”). 28 , 30 Length of follow-up was 6 months in one study, 28 12–18 months in a second, 27 a mean of 13 months in the third study, 30 and unclear in the final study. 29 Further details in Table 4 .…”

“…Of the four surgical wound studies, two studies used a prospective cohort design. 27 , 30 One study was a nested case–control design 28 (all cases were identified from a cohort and matched controls selected from the same cohort) and the fourth used a case–control design. 29 Two studies focused on the role of genetic variation in the development of hypertrophic scarring, 28 , 30 one of keloid scarring, 29 and one of both hypertrophic and keloid scarring (although no cases of keloid scarring were detected).…”

“…Participants in all four acute surgical wound studies were ≥18 years. Surgery was cesarean section ( n = 2), 27 , 28 cardiac surgery ( n = 1), 29 and melanoma excision ( n = 1). 30 One study excluded people with recorded histories of pathological scar formation or benign or malignant tumors 27 and one excluded patients whose incision overlapped with previous surgeries or trauma.…”

“… 30 One study excluded people with recorded histories of pathological scar formation or benign or malignant tumors 27 and one excluded patients whose incision overlapped with previous surgeries or trauma. 28 …”

“…Two of the surgical wound studies assessed scarring using the VSS, 29 , 30 another used the patient and observer scar assessment scale (POSAS) and Scar Cosmesis Assessment and Rating (SCAR) Scale, 28 and the fourth study 27 did not use a rating scale, instead classifying scars as normal, hypertrophic, or keloid based on defined clinical features (time since surgery and physical appearance of the scar). There was variability in how the included studies operationalized the scales to determine scarring.…”