الفهرس 
KeloidsOnly 14 pages are availabe for public view
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Abstract
SUMMARY
W
ound healing is a complex process requiring the collaborative efforts of different tissues and cell lineages, and involving the coordinated interplay of several phases of proliferation, migration, matrix synthesis and contraction. A keloid is an abnormal proliferation of scar tissue that forms at the site of cutaneous injury. The fact that some people have keloidal tendency while others don’t remains not fully understood.
Osteopontin is a multifunctional matricellular protein produced by a wide range of body cells including T cells, macrophages and fibroblasts, and research has defined a role for OPN in maintenance and reconfiguration of tissue integrity during inflammatory processes. Moreover, OPN regulates fibroblast behavior and myofibroblast differentiation. Expression of OPN in normal, healthy skin is low but increased during wound healing.
Whether OPN contributes to the increased incidence of keloidal formation in certain individuals needs to be explored. Therefore, our aim was to study a possible link between OPN expression in serum and tissue and keloid pathogenesis and tendency. To our knowledge, this is the first study in published literature to undertake such attempt.
Twenty patients presenting with keloids were recruited, and followed a specified inclusion and exclusion criteria. 20 subjects not having keloids, not having any of the exclusion criteria, and age and sex matched with the investigated patients, were used as control population. Serum and tissue OPN were measured for all patients and controls.
Serum and tissue OPN levels showed a highly statistically significant increase in patients with keloids when compared with controls. On comparing OPN levels in different subgroups of patients, a significantly higher level of serum and tissue OPN was found in female patients compared to male patients. Patients with positive family history harbored significantly higher levels of serum OPN than those with negative family history. In addition, serum OPN levels showed highly significant difference between different degrees of vascularity being highest in purple lesions. Similarly, serum OPN level was significantly higher in keloids associated with pain compared to painless lesions. Serum OPN levels also showed highly significant difference between different pliability subgroups being highest in rope lesions followed by firm and fine lesions.
Accordingly, OPN seems to a significant play a role in keloid formation and we suggest that serum OPN can be used as a prognostic marker or a risk factor for fibrotic tendencies.
We recommend that patients with fibrotic tendencies should be treated post-trauma by anti-OPN therapy to prevent occurrence of keloid and we also recommend further studies regarding OPN gene polymorphism in patients with keloidal tendency and studies regarding possible increased risk of infection after administering anti-OPN therapy.