The Potential Molecular Mechanism of Autologous Adipose Tissue Grafting in Treating Keloid Patients: a Case-control Study

Abstract

Background: Keloids represent the dysregulation of cutaneous wound healing caused by aberrant fibroblast activities. Adipose-derived stem cells have been recognized as a promising treatment for keloids. However, their molecular mechanisms have not been fully elucidated. Methods: Skin biopsies were obtained from 10 keloid patients and 9 healthy volunteers. Fibroblasts isolated from all samples were divided into 2 groups, one co-cultured with adipose-derived stem cells, the other growing independently. Between each group, we compared the wound healing rate, fibroblasts’ survival rate, apoptosis rates, mRNA expressions and protein level of Col-1, Col-3, CTGF, P-4-HB. Results: In our research, no significant differences between normal fibroblasts and keloid fibroblasts in terms of wound-healing rate, survival rate, or apoptosis rate were found at the baseline. Adipose-derived stem cells strongly suppressed keloid fibroblasts’ proliferative and invasive behavior, but negatively regulated keloid fibroblast apoptosis. The further measurement of key components in keloid formation showed that adipose-derived stem cells upregulated Col-3 and CTGF levels in normal fibroblasts but downregulated protein expression of CTGF and P-4-HB in keloid fibroblasts. Conclusions: Adipose-derived stem cells had the potential to serve as a promising alternative for keloid treatment.