Prananda Arya Tjipta, Nugraha Sony Eka, Situmorang Putri Cahaya, Syahputra Rony Abdi
Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.
Department of Pharmaceutical Biology, Faculty of Pharmacy, Universitas Sumatera Utara, Medan, Indonesia.
Front Pharmacol. 2025 Jul 16;16:1576851. doi: 10.3389/fphar.2025.1576851. eCollection 2025.
Keloids are a challenging dermatological condition characterized by excessive scar formation beyond the original wound site, high recurrence rates, and limited treatment efficacy. Current therapies, such as corticosteroids, surgery, and radiotherapy, often yield suboptimal outcomes and adverse effects. This review evaluates the potential of plant-derived metabolites as safer and more effective alternatives for keloid management. Preclinical and clinical studies demonstrate that compounds like curcumin, epigallocatechin gallate (EGCG), and asiaticoside exhibit anti-fibrotic, anti-inflammatory, and antioxidant properties by modulating key pathways (e.g., TGF-β/Smad, NF-κB, and oxidative stress). Espite promising preclinical and early clinical findings, critical challenges hinder the clinical translation of these metabolites. These include poor and variable bioavailability, inconsistencies in extract standardization, and a paucity of large-scale, rigorously designed trials. Moreover, some metabolites may yield conflicting results or exhibit off-target effects in in vitro systems, necessitating caution in interpreting their true therapeutic potential. Future research should focus on optimizing drug delivery systems, conducting large-scale trials, and integrating personalized medicine approaches. Plant-derived metabolites represent a multi-targeted therapeutic strategy with the potential to address unmet needs in keloid treatment.
瘢痕疙瘩是一种具有挑战性的皮肤病，其特征是在原始伤口部位以外形成过度瘢痕、复发率高且治疗效果有限。目前的治疗方法，如皮质类固醇、手术和放疗，往往效果欠佳且有不良反应。本综述评估了植物源代谢物作为瘢痕疙瘩治疗更安全、更有效替代方案的潜力。临床前和临床研究表明，姜黄素、表没食子儿茶素没食子酸酯（EGCG）和积雪草苷等化合物通过调节关键途径（如TGF-β/Smad、NF-κB和氧化应激）表现出抗纤维化、抗炎和抗氧化特性。尽管临床前和早期临床研究结果很有前景，但关键挑战阻碍了这些代谢物的临床转化。这些挑战包括生物利用度差且不稳定、提取物标准化不一致，以及缺乏大规模、设计严谨的试验。此外，一些代谢物在体外系统中可能产生相互矛盾的结果或表现出脱靶效应，因此在解释其真正的治疗潜力时需要谨慎。未来的研究应专注于优化药物递送系统、开展大规模试验以及整合个性化医疗方法。植物源代谢物代表了一种多靶点治疗策略，有潜力满足瘢痕疙瘩治疗中未满足的需求。
