desJardins-Park Heather E, Chinta Malini S, Foster Deshka S, Borrelli Mimi R, Shen Abra H, Wan Derrick C, Longaker Michael T
Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, Calif.
Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, Calif.
Plast Reconstr Surg Glob Open. 2020 Jun 23;8(6):e2927. doi: 10.1097/GOX.0000000000002927. eCollection 2020 Jun.
Fibroblasts' integral role in tissue development, maintenance, and disease represents a fast-growing field of basic science research. Although fibroblasts were long thought to be a homogeneous cell population, recent research has illuminated the unforeseen complexity of these cells, giving rise to the rapidly expanding research field of "fibroblast heterogeneity." Fibroblasts play a critical role in states of tissue fibrosis such as skin scarring, which affects hundreds of millions of patients annually and causes severe aesthetic, developmental, and functional morbidity. Beyond scarring, major organ fibrosis is an enormous public health concern responsible for nearly half of all deaths in the United States. Because fibrosis is a conserved response to tissue damage in all organs, the study of fibroblasts throughout the body may help us to understand their role in the conditions most relevant to plastic and reconstructive surgery-for instance, skin scarring (eg, from burns, traumatic lacerations, or surgical incisions), "pathological" scarring (hypertrophic scars, keloids), and capsular contracture. Here, we present a basic science review of fibroblast heterogeneity in wound healing, cancer, organ fibrosis, and human dermal architecture. The field of fibroblast heterogeneity is young, and many of the insights discussed have yet to be translated clinically. However, plastic surgeons stand in a unique position to bridge these discoveries into clinical realities. We hope this information can spur readers to consider both what questions in plastic surgery can be studied from the lens of fibroblast heterogeneity, and how these preclinical insights can be translated to improving care of our patients.
成纤维细胞在组织发育、维持和疾病中所起的重要作用代表了一个快速发展的基础科学研究领域。尽管长期以来人们一直认为成纤维细胞是一类同质的细胞群体，但最近的研究揭示了这些细胞出人意料的复杂性，从而催生了迅速发展的“成纤维细胞异质性”研究领域。成纤维细胞在组织纤维化状态中起着关键作用，比如皮肤瘢痕形成，每年影响着数亿患者，并导致严重的美学、发育和功能问题。除了瘢痕形成，主要器官的纤维化是一个巨大的公共卫生问题，在美国几乎占所有死亡人数的一半。由于纤维化是所有器官对组织损伤的一种保守反应，对全身成纤维细胞的研究可能有助于我们了解它们在与整形和重建手术最相关的病症中的作用，例如皮肤瘢痕形成（如烧伤、外伤性撕裂伤或手术切口所致）、“病理性”瘢痕形成（增生性瘢痕、瘢痕疙瘩）以及包膜挛缩。在此，我们对伤口愈合、癌症、器官纤维化和人类皮肤结构中的成纤维细胞异质性进行基础科学综述。成纤维细胞异质性领域尚年轻，许多讨论的见解尚未转化为临床应用。然而，整形外科医生处于将这些发现转化为临床现实的独特地位。我们希望这些信息能促使读者思考从成纤维细胞异质性的角度可以研究整形外科中的哪些问题，以及如何将这些临床前见解转化为改善对我们患者的护理。
