Reduced Postburn Hypertrophic Scarring and Improved Physical Recovery With Yearlong Administration of Oxandrolone and Propranolol

Herndon, David N.; Čapek, Karel; Ross, Evan; Jay, Jayson W.; Prasai, Anesh; Ayadi, Amina El; Foncerrada-Ortega, Guillermo; Blears, Elizabeth; Sommerhalder, Christian; McMullen, Kara; Amtmann, Dagmar; Cox, Robert A.; Hundeshagen, Gabriel; Jennings, Kristofer; Sousse, Linda E.; Suman, Oscar E.; Meyer, Walter J.; Finnerty, Celeste C.

doi:10.1097/sla.0000000000002926

Cited by 29 publications

(15 citation statements)

References 81 publications

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“…Administration of oxandrolone could decrease inflammation in the wounds, inhibit the activity of fibroblasts and myofibroblasts, reduce the deposition of collagen, and prevent the formation of hypertrophic scars. This scar-ameliorating effect of oxandrolone was further confirmed by a randomized clinical study that found significant improvement of scar and pliability in children after burn injury (51).…”

Section: Current Reagents Used In Scar Managementmentioning

confidence: 69%

The Roles of Inflammation in Keloid and Hypertrophic Scars

et al. 2020

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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.

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Section: Current Reagents Used In Scar Managementmentioning

confidence: 69%

The Roles of Inflammation in Keloid and Hypertrophic Scars

et al. 2020

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“…Particularly overabundance of inflammatory cells in the remodelling phase correlates with pathological scar formation, indicating the presence of a prolonged inflammatory phase overlapping with the later phases of healing. Inflammatory cell activation is vital for the prevention of infection in contaminated wounds particularly in the early stages of repair and can aid in cleaning the wound site and clearing debris ( 25 , 26 ). Blocking the inflammatory pathway completely would be detrimental to this process therefore, instead of blocking, by reducing excessive inflammation this would allow infection prevention but not lead to abnormal scarring.…”

Section: Discussionmentioning

confidence: 99%

“…In view of these important cell types being involved in the inflammatory process and their influence on the extent of scar formation, many scar therapies aim to target these cells in order to quench inflammation to improve scar outcome ( 25 – 29 ). However, most of these therapies have been evaluated in the remodelling phase of wound healing mainly due to the scar being most evident at this stage and the amount of inflammation is most noticeable when correlated to scar severity.…”

Section: Introductionmentioning

confidence: 99%

Controlling Inflammation Pre-Emptively or at the Time of Cutaneous Injury Optimises Outcome of Skin Scarring

Uddin

2022

Front. Immunol.

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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.

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“…It is noteworthy that patients with abnormal scar histories or family tendency are excluded in this study, and the administration of other hypertension drugs such as calcium channel blockers showed no association with the scar quality, a phenomenon that indirectly supports our hypothesis that adrenergic activation might be an independent risk factor for the pathogenesis of keloid and hypertrophic scars [25] . Noticeably, yearlong administration of oxandrolone and propranolol successfully reduced scar severity and pliability in the -post-burn hypertrophic scar patients and their emotional health state was also improved [26] . Encouraged by the findings of the propranolol-based study showingthe reduction in NE-induced IL-6 elevation with an altered prognosis of NSCLC patients and the studies outlined above, we strongly propose that it might be promising to use propranolol for targeting β-ARs on keloid cells to disrupt IL-6 mediated keloid pathogenesis.…”

Section: Stress Hormones Could Increase Il-6 Expression To Enhance Fimentioning

confidence: 92%

Psychological stress enhances keloid development via stress hormone-induced abnormal cytokine profiles and inflammatory responses

Yang¹,

Wu²,

Liu³

2020

Plast Aesthet Res

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Reduced Postburn Hypertrophic Scarring and Improved Physical Recovery With Yearlong Administration of Oxandrolone and Propranolol

Cited by 29 publications

References 81 publications

The Roles of Inflammation in Keloid and Hypertrophic Scars

The Roles of Inflammation in Keloid and Hypertrophic Scars

Controlling Inflammation Pre-Emptively or at the Time of Cutaneous Injury Optimises Outcome of Skin Scarring

Psychological stress enhances keloid development via stress hormone-induced abnormal cytokine profiles and inflammatory responses

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