The Communication from Immune Cells to the Fibroblasts in Keloids: Implications for Immunotherapy

Abstract

Keloids are a type of fibrotic disease characterized by excessive collagen production and extracellular matrix (ECM) deposition. The symptoms of pain and itching and frequent recurrence after treatment significantly impact the quality of life and mental health of patients. A deeper understanding of the pathogenesis of keloids is crucial for the development of an effective therapeutic approach. Fibroblasts play a central role in the pathogenesis of keloids by producing large amounts of collagen fibers. Recent evidence indicates that keloids exhibit high immune cell infiltration, and these cells secrete cytokines or growth factors to support keloid fibroblast proliferation. This article provides an update on the knowledge regarding the keloid microenvironment based on recent single-cell sequencing literature. Many inflammatory cells gathered in keloid lesions, such as macrophages, mast cells, and T lymphocytes, indicate that keloids may be an inflammatory skin disease. In this review, we focus on the communication from immune cells to the fibroblasts and the potential of immunotherapy for keloids. We hope that this review will trigger interest in investigating keloids as an inflammatory disease, which may open up new avenues for drug development by targeting immune mediators.

BMP1 Promotes Keloid by Inducing Fibroblast Inflammation and Fibrogenesis

“…As a represented skin fibrosis, keloid is characterized by impaired dermal function and structural abnormalities, which are caused by uncontrolled activation of fibroblasts and heavy deposition of extracellular matrix (ECM). Besides, persistent pain and itch significantly affect the quality of a patient's life [4]. However, due to limited treatments of keloid, unpredictable adverse effects, and the high risk of recurrence, antifibrotic strategies that aim to alleviate the disease process or revert the existing fibrosis are urgently needed [5].…”