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After treatment of hypertrophic scars with different concentrations of paclitaxel, there was a significant decrease in the density of fibroblasts in the scars treated with paclitaxel solution of 96 mg/L or higher comparing with the control group.
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Background and objective
The onset and progression of pathological scarring involves multiple cytokines and complex mechanisms. However, hyperplasia of fibroblasts and neovascularization plays important roles, which can be inhibited by paclitaxel. The aim of this study was to investigate the efficacy of paclitaxel in the treatment of hypertrophic s...
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Background
We investigated levels of the metal elements Ca, Mg, Zn, Fe, and Cu in blood, normal skin (NS), and different types of scar tissue and aimed to elucidate the pathogenesis of hypertrophic scars (HS).
Material/Methods
Tissue specimens were excised from 3 groups of research participants: scar-free, flat scar (FS), and HS groups. Levels of...
Citations
... Also, PCT treatment suppresses the production of TNF-α, IL-6 and TGF-β and inhibits the expression of α-SMA and collagen I in human KD fibroblast. PCT-cholesterol-loaded liposome showed a better ability to inhibit cell proliferation, migration and invasion, and effectively promoted apoptosis and arrested cell cycle in G2/M phase compared to PCT alone [133]. In the rabbit's ear model of HTS, PCT reduced the formation of HTS. ...
... Metabolites of mitomycin C also interfere with the synthesis of DNA, RNA and proteins [95][96][97]122]. Liposomal paclitaxel can suppress the production of TNF-α, IL-6 and TGF-β and inhibit the expression of α-SMA and collagen I in human KD fibroblast [133]. Tamoxifen decreases the expression of TGF-β1, with the consequent inhibitions of both fibroblast proliferation and collagen production [135]. ...
Keloids (KD) and hypertrophic scars (HTS), which are quite raised and pigmented and have increased vascularization and cellularity, are formed due to the impaired healing process of cutaneous injuries in some individuals having family history and genetic factors. These scars decrease the quality of life (QOL) of patients greatly, due to the pain, itching, contracture, cosmetic problems, and so on, depending on the location of the scars. Treatment/prevention that will satisfy patients’ QOL is still under development. In this article, we review pharmacotherapy for treating KD and HTS, including the prevention of postsurgical recurrence (especially KD). Pharmacotherapy involves monotherapy using a single drug and combination pharmacotherapy using multiple drugs, where drugs are administered orally, topically and/or through intralesional injection. In addition, pharmacotherapy for KD/HTS is sometimes combined with surgical excision and/or with physical therapy such as cryotherapy, laser therapy, radiotherapy including brachytherapy, and silicone gel/sheeting. The results regarding the clinical effectiveness of each mono-pharmacotherapy for KD/HTS are not always consistent but rather scattered among researchers. Multimodal combination pharmacotherapy that targets multiple sites simultaneously is more effective than mono-pharmacotherapy. The literature was searched using PubMed, Google Scholar, and Online search engines.
... The dressings were changed once a day after disinfecting with iodophor. Three weeks after wound induction, the scabs fell off naturally and hypertrophic scars were observed [8]. ...
Hypertrophic scars are usually the result of surgical trauma or burn,and more common in individuals with a darker skin color. They appear as red and raised lesions around the wound that continually expand over a period of weeks or months, causing itching, pain, burning sensation and discomfort. Severe scarring affects interpersonal and social relationships, and decreases the quality of life of the patients.The aim of this study was to evaluate the effect of carbon dioxide fractional laser as an early intervention against hypertrophic scars using a rabbit ear scar model, and explore the role of the TGFβ-1/ Smad3 signaling pathway in scar hyperplasia. Four wounds were made into each ear of rabbits, and divided into the untreated control and three laser-treatment groups. The experimental groups received laser intervention once, twice and thrice respectively. laser treatment significantly inhibited the formation of hypertrophic scars, and maximum benefits were seen in the wounds that received three laser treatments. Immunohistochemical staining showed that the in situ expression of TGFβ-1 and Smad3 in the scars decreased by varying degrees after laser intervention, and was most obvious after three laser interventions. Furthermore, the expression levels were the lowest at the end of 6 months after modeling. Therefore, we can assume that early intervention with carbon dioxide fractional laser can prevent formation of hypertrophic scars by regulating the TGF-β1/Smad3 pathway.
... Our methodology for creating the excision wound model in rabbits was adapted from the protocol established by Huang et al., 34 . Rabbits were anesthetized using a combination of ketamine and xylazine (40 mg/kg ketamine; 20 mg/ kg xylazine). ...
T his study aimed to evaluate the wound healing activity of an ointment containing the hydroethanolic extract of Salvia Tomentosa (S. tomentosa) in a dermal wound model using rabbits. Ointments with concentrations of 2.5% (w/v) and 5% (w/v) were prepared using the hydroethanolic extracts of S. tomentosa. An in vivo excisional wound model was embloyed with New Zealand rabbits (n = 35) to assess the wound healing activity of these ointments. Rabbits were randomly divided into five experimental groups: negative (received no treatment), vehicle (received only the ointment vehicle), positive control (treated with Fitokrem®), and those treated with 2.5% (w/v) and 5% (w/v) S. tomentosa ointments. Wound diameters were measured using calipers on the 4th, 8th, and 14th days, and histopathological examinations were conducted on the 3rd, 7th, and 14th days of treatment. The total phenolic content of the S. tomentosa hydroethanolic extract was determined to be 61.52 ± 2.33 μg of Gallic Acid Equivalents per mg of dry plant material. The total phenolic content and 2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging activity of the hydroethanolic extract of Salvia tomentosa were determined spectrophotometrically. In terms of wound closure, both 2.5% and 5% S. tomentosa ointments demonstrated wound healing activity comparable to that of Fitokrem®. In conclusion, S. tomentosa exibits a positive effect on dermal wound healing in rabbits.
... It has been found to inhibit the NF-kB pathway (48) and attenuate fibrosis by blocking STAT-3 signaling (49). This anti-inflammatory and anti-fibrosis effect has also been observed in animal models of keloid (50) and hypertrophic scars (51). In vitro studies have shown that the expression of IL-6 and TNF-a, as well as the production of a-SMA and collagen I, decreased in human keloid fibroblasts following paclitaxel administration (50). ...
Inflammation plays an active role during the wound healing process. There is a direct association between the extent of injury as well as inflammation and the amount of subsequent cutaneous scarring. Evidence to date demonstrates that high levels of inflammation are associated with excessive dermal scarring and formation of abnormal pathological scars such as keloids and hypertrophic scars. In view of the multiple important cell types being involved in the inflammatory process and their influence on the extent of scar formation, many scar therapies should aim to target these cells in order to control inflammation and by association help improve scar outcome. However, most current treatment strategies for the management of a newly formed skin scar often adopt a watch-and-wait approach prior to commencing targeted anti-inflammatory therapy. Moreover, most of these therapies have been evaluated in the remodelling phase of wound healing and the evaluation of anti-inflammatory treatments at earlier stages of healing have not been fully explored and remain limited. Taken together, in order to minimise the risk of developing a poor scar outcome, it is clear that adopting an early intervention prior to skin injury would be optimal, however, the concept of pre-emptively priming the skin prior to injury has not yet been thoroughly evaluated. Therefore, the aim of this review was to evaluate the available literature regarding scar therapies that aim to target inflammation which are commenced prior to when a scar is formed or immediately after injury, with a particular focus on the role of pre-emptive priming of skin prior to injury in order to control inflammation for the prevention of poor scarring outcome.
... For instance, PTX was found to inhibit NF-kB pathway (61) and attenuate interstitial fibrosis in mice kidneys by blocking STAT-3 signaling (62). This anti-inflammatory and anti-fibrosis effect was also observed in animal models of keloid (63) and hypertrophic scar (64). By using keloid-bearing nude mice model, Wang et al. demonstrated PTX had inhibitory effect on keloids growth (63). ...
... This is consistent with the conclusion drawn on a rabbit ear hypertrophic scar model. With paclitaxel treatment, fibroblast proliferation, collagen deposition, and micro-angiogenesis in hypertrophic scars were all downregulated (64). ...
The underlying mechanisms of wound healing are complex but inflammation is one of the determining factors. Besides its traditional role in combating against infection upon injury, the characteristics and magnitude of inflammation have dramatic impacts on the pathogenesis of scar. Keloids and hypertrophic scars are pathological scars that result from aberrant wound healing. They are characterized by continuous local inflammation and excessive collagen deposition. In this review, we aim at discussing how dysregulated inflammation contributes to the pathogenesis of scar formation. Immune cells, soluble inflammatory mediators, and the related intracellular signal transduction pathways are our three subtopics encompassing the events occurring in inflammation associated with scar formation. In the end, we enumerate the current and potential medicines and therapeutics for suppressing inflammation and limiting progression to scar. Understanding the initiation, progression, and resolution of inflammation will provide insights into the mechanisms of scar formation and is useful for developing effective treatments.
... This exuberant response produces immature leaky blood vessels. The production of new blood vessels provides an environment with easy access to necessary nutrients, signals, and cells essential for coordinating repair (Huang et al. 2015). ...
... The time of injecting drugs was 28th days after wounding when hypertrophic scar formation was on peak. Ten days after injection, results showed that in comparison of the control group, the paclitaxel in the concentration range 96 mg/L, 150 mg/L, and 162 mg/L reduced the formation of a scar; however, in higher concentration, > 400 mg/L local tissue necrosis occurred (Huang et al. 2015). ...
Abstract Hypertrophic scars (HTS) are raised, red, rigid, inflexible cell-like, and cosmetic problems precipitated due to multiple underlying dermal injuries such as burn, surgery, and trauma during which aberrant wound healing with more pathological deposition of the extracellular matrix than degradation leads to their spawning. Till date, well established and specific treatments for HTS have not been reported; hence, the need of recent developments is thrusted with novel drug delivery vision. This review will try to encompass all the agogs to HTS, definition, pathophysiology, mechanism of hypertrophic scar formation, the role of growth factors in hypertrophic scarring, and their difference with keloids. Further, it will illuminate the available medicaments and recent advances in novel topical drug delivery systems such as ethosomes, transethosomes, liposomes, solid lipid nanoparticles, and microsponges for treatment of HTS.
... AEîäíèé ç öèõ òåðàïåâòè÷íèõ ï³äõîä³â ñàìî-ñò³éíî àáî â êîìá³íàö³¿ íå çàáåçïå÷óº ñòàá³ëüíó â³äñóòí³ñòü ðåöèäèâó á³ëüøå 70-80 % [10]. Ñïðèéíÿòòÿ êåëî¿äíîãî ðóáöÿ ÿê äîáðîÿê³ñíî¿ ïóõëèíè çóìîâèëî âèêîðèñòàííÿ äëÿ éîãî ë³êóâàííÿ öèòîñòà-òèê³â: 5-ôòîðóðàöèëó [4], áëåîì³öèíó [21] òà ïàêë³òàêñåëó [17]. ...
Relevance. A lot of conservative approaches have been proposed to the management of keloids, but none of them provides a guaranteed positive result and a stable absence of relapse.
Objective: to evaluate the effectiveness and side effects of triple keloid scar therapy.
Materials and methods. Thirty-three patients aged 18-69 years, who received treatment of keloids by triple medicine combination therapy, were investigated retrospectively. All patients were divided into two groups. In first one (16 patients) intralesional injections of mixture of 5-fluorouracil, triamcinolone acetonide and bovine origin hyaluronidase were performed. In the second group (17 patients) instead of triamcinolone betamethasone suspension was used. Four sessions of therapy were performed with a monthly interval. Results were assessed 1 month and 6 months after the last session. The planimetric investigation and measurement of scars’ volume were performed. The influence of treatment on the number of telangiectasias within the scar was performed with the help of our method of computer processing of its digital photographs.
Results. There was not statistically significant difference in linear size, area and volume of the scars in patients of two groups before beginning of the treatment. One month after the fourth session scars’ width increased statistically significantly. Their length and area also increased but difference did not reach statistically significant level. At the same time maximal height of the scars over surrounding tissues (p
The aim of this study was to investigate and evaluate the effects of colloidal silver and hypochlorous acid solutions on wound healing. To evaluate the wound healing activity of colloidal silver solution and hypochlorous acid solutions, an in vivo excisional wound model was applied in New Zealand rabbits (n = 21). The rabbits were randomly divided into 3 groups with seven individuals in each group. Group 1 was used as a negative control and no treatment was applied. Groups 2 and 3 were treated with crystalline (hypochlorous acid) and colloidal silver, respectively. The treatments were applied topically (in the form of spray) to the wound area of each rabbit daily. Wound diameters were measured on days 4, 8 and 12 using calipers and histopathological examinations were performed on days 4, 8 and 12 of the treatment. In terms of wound closure, both hypochlorous acid and colloidal silver solutions showed comparable wound healing activity with the control group. In conclusion, hypochlorous acid and colloidal silver have a positive effect on dermal wound healing in rabbits.
Unlabelled:
Significance: The aberrant inflammation during wound healing results in pathological scarring, such as hypertrophic scars and keloids. This adversely affects the quality of life of patients due to the disfiguring appearance as well as the symptoms of itch and pain. This review summarizes the up-to-date knowledge of the immunopathogenesis and treatment options for pathological scars.
Recent advances:
With the advent of new technologies, combined with in vitro and in vivo wound models, several inflammatory cells have been shown to have both direct or indirect effects on both wound healing and pathological scarring.
Critical issues:
Expansion of pro-fibrotic immune cells such as M2 macrophages, dendritic cells, mast cells, and Th2 cells leads to fibroblast transition to myofibroblasts via TGF-β1 signaling pathway. Appropriate management of such inflammatory responses during wound healing remains a critical issue during clinical practice.
Future directions:
Regulating inflammation response during wound healing may be a potential therapeutic option for avoiding or reducing pathological scars.
Hypertrophic scar (HS) is a typical pathological response during skin injury, which can lead to pain, itching, and contracture in patients and even affect their physical and mental health. The complexity of the wound healing process leads to the formation of HS affected by many factors. Several treatments are available for HS, whereas some have more adverse reactions and can even cause new injuries with exacerbated scarring. Traditional Chinese Medicine (TCM) has a rich source, and most botanical drugs have few side effects, providing new ideas and methods for treating HS. This paper reviews the formation process of HS, the therapeutic strategy for HS, the research progress of TCM with its relevant mechanisms in the treatment of HS, and the related new drug delivery system of TCM, aiming to provide ideas for further research of botanical compounds in the treatment of HS, to promote the discovery of more efficient botanical candidates for the clinical treatment of HS, to accelerate the development of the new drug delivery system and the final clinical application, and at the same time, to promote the research on the anti-HS mechanism of multiherbal preparations (Fufang), to continuously improve the quality control and safety and effectiveness of anti-HS botanical drugs in clinical application.
