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基于发病机制和治疗方法的瘢痕疙瘩未来研究方向

Future Directions About Keloid Scars Based on Pathogenesis and Therapies.

作者信息

Zhang Guiyun, Liu Zhe, Li Zhen, Xu Yangchun

机构信息

Department of Dermatology, The Second Hospital of Jilin University, Changchun, 130041, People's Republic of China.

Department of Medical Administration, The Second Hospital of Jilin University, Changchun, 130041, People's Republic of China.

出版信息

Clin Cosmet Investig Dermatol. 2024 Oct 25;17:2391-2408. doi: 10.2147/CCID.S470650. eCollection 2024.

Abstract

Keloids are pathologic scars that pose a significant functional and cosmetic burden. While the literature on keloid management continues to expand, the absence of standardized guidelines or treatment protocols endorsed by academic governing bodies remains a significant challenge. The pathogenesis of keloid scars is not fully elucidated. This review delves into the intricate pathogenesis of keloids, exploring the molecular and cellular mechanisms underlying their formation. Conventional therapies are analyzed in-depth considering their efficacy and limitations, including surgical excision, pharmacotherapies, radiotherapy, cryotherapy, silicone-based product, pressure therapy, and light-based therapy. The emergence of novel therapeutic approaches is discussed, including pharmacotherapies, physical therapies, and biological therapies, shedding light on their potential in treating keloid scars. We also contemplate future directions in the field, encompassing the application of targeted therapies, gene-editing tools, tissue engineering, and regenerative medicine, together with psychosocial support and patient education. In synthesizing current knowledge, scrutinizing therapeutic modalities, and envisioning future avenues, this review aims to provide a comprehensive reference for clinicians, researchers, and stakeholders engaged in the intricate field of keloid management.

摘要

瘢痕疙瘩是病理性瘢痕,会造成严重的功能和美容负担。尽管关于瘢痕疙瘩治疗的文献不断增加,但学术管理机构认可的标准化指南或治疗方案的缺失仍是一项重大挑战。瘢痕疙瘩的发病机制尚未完全阐明。本综述深入探讨瘢痕疙瘩复杂的发病机制,探究其形成背后的分子和细胞机制。对传统疗法进行了深入分析,考量了它们的疗效和局限性,包括手术切除、药物治疗、放射治疗、冷冻治疗、硅基产品、压力治疗和光疗。讨论了新型治疗方法的出现,包括药物治疗、物理治疗和生物治疗,阐明了它们在治疗瘢痕疙瘩方面的潜力。我们还思考了该领域的未来方向,包括靶向治疗、基因编辑工具、组织工程和再生医学的应用,以及心理社会支持和患者教育。通过综合当前知识、审视治疗方式并展望未来途径,本综述旨在为从事瘢痕疙瘩复杂治疗领域的临床医生、研究人员和利益相关者提供全面的参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6a1/11520916/b7bd598d830b/CCID-17-2391-g0001.jpg

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