Innovations in preventing scars

IntroductionScars are distressing memorial signs of a healed wound which can remain all through the life of a patient. Scars are a result of prolonged inflammatory phases and abnormal fibroproliferative responses in wounds. The most outstanding products for reducing scars, were TGF-β3 and IL-10 which failed in phase III clinical trial on their way to reach market. Applying molecular and cellular mechanisms imitating the fetal scarless wound healing, brings about new and effective therapeutic strategies for alleviating scars. This review is concentrated on innovative approaches which simultaneously target multiple effective pathways in reducing scars.MethodsIn this review the multi targeting remedies for reducing scar and their effective in vitro and in vivo mechanisms are discussed in details. There is also some evidence in translation of these investigations in to clinical trials.ResultsSince most of the molecular based therapies are not adequate individually and have limitations in targeting different pathways, thus miRNAs and cell based therapies have attracted many attentions. MiRNAs are unique molecular components with pleiotropic actions which target multiple signaling pathways in scar at the same time. Fetal cells, mesenchymal stem cells and oral mucosal cells secrete a natural relevant concentration of growth factors and cytokines that are effective in scar reduction. Fat grafting is a promising treatment for scars, providing an appropriate extra cellular matrix with its homing mesenchymal stem cells.ConclusionIncreasing the concentration of one growth factor or cytokine overexpressed in fetal scarless wound healing is not sufficient individually in scar reduction. Despite the profound effects of cells in scars, using biomimetic materials which mimic the fetal cell microenviroment should also be taken into account

کلیدواژه ها:

Scarless wound healing ، miRNA ، fetal cells ، Mesenchymal stem cell ، Oral mucusa ، Fat grafting