THORACIC SURGERY Genetic basis of keloid formation in wounds after cardiac surgery

Abstract

Keloid disease is the abnormal formation of scar tissue in genetically predisposed people. Among many genes which may be related to the development of keloids, transforming growth factor β1 (TGF-β1) is one of the most mentioned. It encodes cytokinin, which is responsible for the production of extracellular matrix and takes part in healing. Any abnormalities which arise during synthesis of the protein as a result of polymorphism or gene mutation may be the cause of healing disorders (scarring of the body); thus it is responsible for the development of keloids. The objective of this study is to determine the single nucleotide polymorphism of the gene TGF-β1, at the position -509(rs1800469)509, to compare the obtained results in the form of three different genotypes within the analysed group (keloids) and within the control group (healthy scars), and to analyse the correlation between obtained genotypes and the occurrence of keloid disease.Seventy-three patients after cardiac surgery with scars on their sternums were examined (22 women and 51 men) in the age group from 38 to 84 years. Two groups of patients were distinguished: 37 with keloids and 36 with healthy scars. DNA taken from patients was analysed and polymorphism C(-509)T of the gene TGF-β1 was determined.On the basis of the study it was found that the allele T in the position −509 of the gene TGF-β1 is associated with a lower risk of keloid formation regardless of age and gender.

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

“… 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). 27 …”

“…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.…”

TGF-β1 -509C/T polymorphism and susceptibility to keloid disease: a systematic review and meta-analysis

“…A total of 564 keloid cases and 620 healthy controls were included in the five case-control studies. 10 , 12 – 15 The publishing years ranged from 2003 to 2015. Two of the five studies were conducted in Chinese populations and the remaining three studies were conducted in Caucasian, Malay and Polish populations, respectively.…”

“…CT or TT genotype) of TGF-β1 -509C/T was related to a significantly lower risk of KD in a Polish population (OR = 0.321, 95% CI = 0.119–0.870, P = 0.03). 13 There were two studies on the relationship between the TGF-β1 -509C/T polymorphism and susceptibility to KD in a Chinese population. Song et al found that Chinese individuals with allele C (i.e.…”

“…Among the two studies being identified as moderate quality, we found that in the study by Kulawczuk et al, patients enrolled in their case group and control group both suffered from cardiac diseases and consequently underwent cardiac surgery. 13 Likewise, in the study by Xie et al, the individuals in their control group were those patients with healthy scars after surgery. 14 The potential selection biases for cases or controls in the two studies lowered the final scores of NOS.…”