Roles of lipid metabolism in keloid development

Abstract

Keloids are common cutaneous pathological scars that are characterised by the histological accumulation of fibroblasts, collagen fibres, and clinically significant invasive growth. Although increasing lines of research on keloids have revealed genetic and environmental factors that contribute to their formation, the etiology of these scars remains unclear. Several studies have suggested the involvement of lipid metabolism, from a nutritional point of view. However, the role that lipid metabolism plays in the pathogenesis and progression of keloids has not previously been reviewed. The progress that has been made in understanding the roles of the pro- and anti-inflammatory lipid mediators in inflammation, and how they relate to the formation and progression of keloids, is also outlined. In particular, the possible relationships between mechanotransduction and lipid metabolites in keloids are explored. Mechanotransduction is the process by which physical forces are converted into biochemical signals that are then integrated into cellular responses. It is possible that lipid rafts and caveolae provide the location of lipid signaling and interactions between these signaling pathways and mechanotransduction. Moreover, interactions between lipid signaling pathway molecules and mechanotransduction molecules have been observed. A better understanding of the lipid profile changes and the functional roles lipid metabolism plays in keloids will help to identify target molecules for the development of novel interventions that can prevent, reduce, or even reverse pathological scar formation and/or progression.

Novel Insights on Understanding of Keloid Scar: Article Review

“…Over the past 45 years, pressure therapy was one of the options in the treatment of both keloid and hypertrophic scares, 16,17 and it has been used as a standard option in the management of hypertrophic scars due to burns; it still used in many medical centers as first line treatment. 16,18 The recommended pressure is 24-30 mmHg for a period of 6-12 months.…”

“…16,18 The recommended pressure is 24-30 mmHg for a period of 6-12 months. According to Anzarut et al, following an extensive search of the literature which involved six randomized controlled trials that have around 300 patients to evaluate the effect of PGT on burns patient, evidence on the effectiveness of PGT is not significant.…”

“…16 The combination of surgery with steroid treatment has been shown to reduce the recurrence rate to less than 50%. 16 Intralesional cryosurgery is another modality of surgical treatment that was introduced in 1990 to focus on the destruction of keloid scar tissue with minimal dermal injury. Indeed, intralesional cryosurgery exhibits the ability to both decrease keloid scar size and treat the symptoms associated with it.…”

“…Further, the success rates after 2 sessions are ranged from 30 to 75% either by using spray or contact cryosurgery with liquid nitrogen, and it is lower in keloid than in hypertrophic scars. 16 Intralesional cryoneedle is the most effective method in treating keloid scar compared with contact and spray probes. 33 In Intralesional cryo-needle procedure, the skin surface of the hypertrophic or keloid scar is cleaned and anesthetized.…”

Up-to-date approach to manage keloids and hypertrophic scars: A useful guide

“…Increased interleukin-6 (IL-6), PDGF (platelet derived growth factor), α 1 β 1 -integrin and Ig A, G and M expression have all also been linked to keloid pathogenesis [3]. Besides that, keloid formation has been associated with immune alteration of sebaceous glands and enhanced androgen receptors expression with enhanced sebum secretion and lipid metabolism alteration, neurogenic inflammation, infection and mechanotransduction [12]. Regarding hypertrophic scars pathophysiology, activation of myofibroblasts has been classically reported to play a key role.…”