Pittet B, Rubbia-Brandt L, Desmoulière A, Sappino A P, Roggero P, Guerret S, Grimaud J A, Lacher R, Montandon D, Gabbiani G
Department of Surgery, University Hospital of Geneva, Switzerland.
Plast Reconstr Surg. 1994 May;93(6):1224-35. doi: 10.1097/00006534-199405000-00018.
Hypertrophic scars and Dupuytren's disease are characterized by the presence of modified fibroblasts or myofibroblasts which are allegedly responsible for tissue retraction and excessive connective tissue production. gamma-Interferon, a cytokine produced by T-helper lymphocytes, has been shown to decrease fibroblast replication, alpha-smooth-muscle actin (the actin isoform characterizing myofibroblasts) expression, and collagen production. We have investigated in an open pilot study the possibility that intralesional injections of gamma-interferon exert a beneficial effect on the evolution of hypertrophic scars and Dupuytren's disease. In the 14 selected patients, gamma-interferon decreased the symptoms and the size of the lesions of both diseases; in hypertrophic scars, immunofluorescence examination showed that alpha-smooth-muscle actin expression also was decreased in myofibroblasts. Moreover, in fibroblasts cultured from 4 patients with hypertrophic scars, gamma-interferon decreased replication and alpha-smooth-muscle actin expression in vitro. Our results suggest that gamma-interferon could represent a useful adjunct to the nonsurgical therapy of hypertrophic scars and Dupuytren's disease. Larger controlled clinical studies, however, should test the validity of these preliminary observations.
肥厚性瘢痕和掌腱膜挛缩症的特征是存在经过修饰的成纤维细胞或肌成纤维细胞,据称这些细胞导致组织收缩和过多的结缔组织生成。γ-干扰素是一种由辅助性T淋巴细胞产生的细胞因子,已被证明可减少成纤维细胞的复制、α-平滑肌肌动蛋白(肌成纤维细胞的特征性肌动蛋白异构体)的表达以及胶原蛋白的生成。我们在一项开放性初步研究中调查了病灶内注射γ-干扰素对肥厚性瘢痕和掌腱膜挛缩症病情发展产生有益影响的可能性。在14例选定的患者中,γ-干扰素减轻了两种疾病的症状并减小了病灶大小;在肥厚性瘢痕中,免疫荧光检查显示肌成纤维细胞中的α-平滑肌肌动蛋白表达也有所降低。此外,在从4例肥厚性瘢痕患者培养的成纤维细胞中,γ-干扰素在体外减少了细胞复制和α-平滑肌肌动蛋白的表达。我们的结果表明,γ-干扰素可能是肥厚性瘢痕和掌腱膜挛缩症非手术治疗的一种有用辅助手段。然而,需要更大规模的对照临床研究来检验这些初步观察结果的有效性。