Huang Chenyu, Ogawa Rei
Department of Dermatology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan.
Scars Burn Heal. 2021 May 31;7:2059513120980320. doi: 10.1177/2059513120980320. eCollection 2021 Jan-Dec.
Keloids are pathological scars that are notorious for their chronic and relentless invasion into adjacent healthy skin, with commonly seen post-therapeutic recurrence after monotherapies.
An English literature review on keloid pathophysiology was performed by searching the PubMed, Embase and Web of Science databases, to find out the up-to-date relevant articles. The level of evidence was evaluated based on the included studies with the highest level of evidence first.
Keloid morphology, signs, symptoms and the histopathological changes that occur in the local cells and extracellular matrix components are described. The theories on the pathophysiology of keloidogenesis that have been proposed to date are also covered; these include endocrinological, nutritional, vascular, and autoimmunological factors. In addition, we describe the local mechanical forces (and the mechanosignalling pathways by which these forces shape keloid cell activities) that promote keloid formation and determine the direction of invasion of keloids and the body sites that are prone to them.
A better understanding of this pathological entity, particularly its mechanobiology, will aid the development of new diagnostic and therapeutic strategies for use in the clinic to prevent, reduce or even reverse the growth of this pathological scar.
Keloids are skin scars that are famous for their chronic invasion into healthy skin, with commonly seen recurrence after surgeries. Cells such as lymphocytes, macrophages, mast cells and endothelial cells are involved in keloid growth. Particularly, endocrinological, nutritional, vascular, autoimmunological and mechanical factors actively take part in keloid progression.
瘢痕疙瘩是病理性瘢痕，以其对邻近健康皮肤的慢性且持续侵袭而闻名，单一疗法治疗后通常会复发。
通过检索PubMed、Embase和Web of Science数据库对瘢痕疙瘩病理生理学进行英文文献综述，以找出最新的相关文章。根据纳入研究评估证据水平，优先纳入证据水平最高的研究。
描述了瘢痕疙瘩的形态、体征、症状以及局部细胞和细胞外基质成分中发生的组织病理学变化。还涵盖了迄今为止提出的瘢痕疙瘩形成病理生理学理论；这些理论包括内分泌、营养、血管和自身免疫因素。此外，我们描述了促进瘢痕疙瘩形成并决定其侵袭方向以及易发生部位的局部机械力（以及这些力塑造瘢痕疙瘩细胞活动的机械信号通路）。
更好地理解这种病理实体，尤其是其机械生物学，将有助于开发新的诊断和治疗策略，用于临床预防、减少甚至逆转这种病理性瘢痕的生长。
瘢痕疙瘩是因慢性侵袭健康皮肤而闻名的皮肤瘢痕，手术后常见复发。淋巴细胞、巨噬细胞、肥大细胞和内皮细胞等细胞参与瘢痕疙瘩的生长。特别是，内分泌、营养、血管、自身免疫和机械因素积极参与瘢痕疙瘩的进展。
