The Role of Intercellular Interactions in the Formation of Keloid Scars

Abstract

Pathological scarring at the present stage does not have a clear pathogenetic justification, it is characterized by unpredictability and constant growth of keloid scars, the absence of regression for many years and reasonable pathogenetic treatment. Despite the fact that there is the possibility of extirpation of excess tissue, it is almost impossible to remove keloid scars without recurrence. The paper presents phenotyping data in the structure of cellular ensembles of scars with the disclosure of signaling mechanisms of fibroblast differentiation into specialized cells that secrete collagen and the main matrix of the intercellular substance with pronounced hyalinization. It has been shown that the number of macrophages in the tissue of developing keloid scars is reduced in comparison with areas of normal reparative skin regeneration and in the structure of hypertrophic scars. Given the responsibility of macrophages for the secretion of angiogenesis factors and, accordingly, further oxygenation of the tissue healing zone, the authors point to a decrease in the number of macrophages as one of the main factors inducing keloid scarring and connective tissue metaplasia.