Dynamics of matrix metalloproteinases when correcting immature hypertrophic scars with pulsed dye laser and fermencol phonophoresis

Abstract

The article analyzes the role of matrix metalloproteinases (MMP) in the pathogenesis of immature hypertrophic scars. The revealed decrease in the MMP level in the patients’ initial state against the background of an increased content of TIMP1 indicates a disorder in the mechanisms of regulation of collagen formation in a hypertrophic scar, as a result of which its synthesis significantly predominates over decay, contributing to the formation of a fibrous process. The obtained results convincingly prove that reduced expression of MMP against the background of an increased TIMP1 level is an important pathogenetic mechanism providing excessive deposition of extracellular matrix components in pathological skin scarring. The use of a pulsed dye laser (PDL) in combination with Fermencol phonophoresis promotes an increase in the MMP content in the blood serum of patients with immature hypertrophic scars. The reliable dynamics of the studied biomarkers indicates an increase in the processes of catabolism of the extracellular matrix components and an increase in the regenerative potential of the skin defect, which determine the intensity of the clinical effect during the treatment of immature hypertrophic scars. The correlation analysis between the level of membrane metalloproteinases and the parameters of the Vancouver Scar Scale revealed a set of significant relationships that confirm the clinical and pathogenetic significance of these biochemical variables in the development of fibroplastic processes and also act as informative criteria for the effectiveness of the therapy.