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糖皮质激素治疗瘢痕疙瘩的研究进展

苏滢泓 夏文政 黄昕 徐若清 邝依敏 昝涛

苏滢泓, 夏文政, 黄昕, 等. 糖皮质激素治疗瘢痕疙瘩的研究进展[J]. 中华烧伤与创面修复杂志, 2023, 39(9): 886-890. DOI: 10.3760/cma.j.cn501225-20230602-00198.
引用本文: 苏滢泓, 夏文政, 黄昕, 等. 糖皮质激素治疗瘢痕疙瘩的研究进展[J]. 中华烧伤与创面修复杂志, 2023, 39(9): 886-890. DOI: 10.3760/cma.j.cn501225-20230602-00198.
Su YH,Xia WZ,Huang X,et al.Research advances in the treatment of keloid with glucocorticoids[J].Chin J Burns Wounds,2023,39(9):886-890.DOI: 10.3760/cma.j.cn501225-20230602-00198.
Citation: Su YH,Xia WZ,Huang X,et al.Research advances in the treatment of keloid with glucocorticoids[J].Chin J Burns Wounds,2023,39(9):886-890.DOI: 10.3760/cma.j.cn501225-20230602-00198.

糖皮质激素治疗瘢痕疙瘩的研究进展

doi: 10.3760/cma.j.cn501225-20230602-00198
基金项目: 

国家自然科学基金面上项目 82272264, 82072177

上海市科委项目-上海市整形与修复重建临床医学研究中心 22MC1940300

详细信息
    通讯作者:

    昝涛,Email:zantao@sjtu.edu.cn

Research advances in the treatment of keloid with glucocorticoids

Funds: 

General Program of National Natural Science Foundation of China 82272264, 82072177

Shanghai Clinical Research Center of Plastic and Reconstructive Surgery Supported by Science and Technology Commission of Shanghai Municipality 22MC1940300

More Information
  • 摘要: 糖皮质激素作为一线经典药物,在大多数瘢痕疙瘩的联合治疗中均有应用。然而用糖皮质激素药物治疗瘢痕疙瘩有效率低、治疗后存在瘢痕疙瘩复发等,严重影响治疗效果。近年来,许多研究从不同角度探讨了影响糖皮质激素治疗瘢痕疙瘩效果的因素及糖皮质激素的作用机制。基于此,该文综述了糖皮质激素治疗瘢痕疙瘩的机制和影响其疗效的因素,探讨了提高糖皮质激素治疗效果的方式,旨在为改进糖皮质激素相关诊疗方案提供思路。

     

  • 参考文献(38)

    [1] 中国整形美容协会瘢痕医学分会常务委员会专家组.中国瘢痕疙瘩临床治疗推荐指南[J].中国美容整形外科杂志,2018,29(5):前插3-前插14.DOI: 10.3969/j.issn.1673-7040.2018.05.001.
    [2] OgawaR.The most current algorithms for the treatment and prevention of hypertrophic scars and keloids: a 2020 update of the algorithms published 10 years ago[J].Plast Reconstr Surg,2022,149(1):79e-94e.DOI: 10.1097/PRS.0000000000008667.
    [3] LeeHJ,JangYJ.Recent understandings of biology, prophylaxis and treatment strategies for hypertrophic scars and keloids[J].Int J Mol Sci,2018,19(3):711.DOI: 10.3390/ijms19030711.
    [4] SchmidtS,RainerJ,PlonerC,et al.Glucocorticoid-induced apoptosis and glucocorticoid resistance: molecular mechanisms and clinical relevance[J].Cell Death Differ,2004,11 Suppl 1:S45-55.DOI: 10.1038/sj.cdd.4401456.
    [5] ShengM,ChenY,LiH,et al.The application of corticosteroids for pathological scar prevention and treatment: current review and update[J/OL].Burns Trauma,2023,11:tkad009[2023-06-02].https://pubmed.ncbi.nlm.nih.gov/36950503/.DOI: 10.1093/burnst/tkad009.
    [6] ShimbaA,IkutaK.Control of immunity by glucocorticoids in health and disease[J].Semin Immunopathol,2020,42(6):669-680.DOI: 10.1007/s00281-020-00827-8.
    [7] WuWS,WangFS,YangKD,et al.Dexamethasone induction of keloid regression through effective suppression of VEGF expression and keloid fibroblast proliferation[J].J Invest Dermatol,2006,126(6):1264-1271.DOI: 10.1038/sj.jid.5700274.
    [8] WangQ,ZhongY,LiZ,et al.Multitranscriptome analyses of keloid fibroblasts reveal the role of the HIF-1α/HOXC6/ERK axis in keloid development[J/OL].Burns Trauma,2022,10:tkac013[2023-06-02].https://pubmed.ncbi.nlm.nih.gov/35547861/.DOI: 10.1093/burnst/tkac013.
    [9] SyedF,SinghS,BayatA.Superior effect of combination vs. single steroid therapy in keloid disease: a comparative in vitro analysis of glucocorticoids[J].Wound Repair Regen,2013,21(1):88-102.DOI: 10.1111/j.1524-475X.2012.00862.x.
    [10] RutkowskiD,SyedF,MatthewsLC,et al.An abnormality in glucocorticoid receptor expression differentiates steroid responders from nonresponders in keloid disease[J].Br J Dermatol,2015,173(3):690-700.DOI: 10.1111/bjd.13752.
    [11] Ramos-RamírezP,TlibaO.Glucocorticoid receptor β (GRβ): beyond its dominant-negative function[J].Int J Mol Sci,2021,22(7):3649.DOI: 10.3390/ijms22073649.
    [12] YangY,LiuL,WuX,et al.CO2 fractional laser-assisted transdermal delivery of silk nanofiber carriers in a rabbit ear hypertrophic scar model[J/OL].Burns Trauma,2022,10:tkac040[2023-06-02].https://pubmed.ncbi.nlm.nih.gov/36380852/.DOI: 10.1093/burnst/tkac040.
    [13] PhataleV,VaipheiKK,JhaS,et al.Overcoming skin barriers through advanced transdermal drug delivery approaches[J].J Control Release,2022,351:361-380.DOI: 10.1016/j.jconrel.2022.09.025.
    [14] SmithJC,BooneBE,OpalenikSR,et al.Gene profiling of keloid fibroblasts shows altered expression in multiple fibrosis-associated pathways[J].J Invest Dermatol,2008,128(5):1298-1310.DOI: 10.1038/sj.jid.5701149.
    [15] YinQ,LouterJ,NiessenFB,et al.Intralesional corticosteroid administration in the treatment of keloids: a scoping review on injection methods[J].Dermatology,2023,239(3):462-477.DOI: 10.1159/000529220.
    [16] AndrewsJP,MarttalaJ,MacarakE,et al.Keloids: the paradigm of skin fibrosis-pathomechanisms and treatment[J].Matrix Biol,2016,51:37-46.DOI: 10.1016/j.matbio.2016.01.013.
    [17] XuH,ZhuZ,HuJ,et al.Downregulated cytotoxic CD8+ T-cell identifies with the NKG2A-soluble HLA-E axis as a predictive biomarker and potential therapeutic target in keloids[J].Cell Mol Immunol,2022,19(4):527-539.DOI: 10.1038/s41423-021-00834-1.
    [18] SartawiZ,BlackshieldsC,FaisalW.Dissolving microneedles: applications and growing therapeutic potential[J].J Control Release,2022,348:186-205.DOI: 10.1016/j.jconrel.2022.05.045.
    [19] KohE,FreedmanBR,RamazaniF,et al.Controlled delivery of corticosteroids using tunable tough adhesives[J].Adv Healthc Mater,2023,12(3):e2201000.DOI: 10.1002/adhm.202201000.
    [20] TanC,TanWD,SrivastavaR,et al.Dissolving triamcinolone-embedded microneedles for the treatment of keloids: a single-blinded intra-individual controlled clinical trial[J].Dermatol Ther (Heidelb),2019,9(3):601-611.DOI: 10.1007/s13555-019-00316-3.
    [21] YangY,XiaL,NingX,et al.Enhanced drug permeation into human keloid tissues by sonophoresis-assisted microneedling[J].SLAS Technol,2021,26(6):660-666.DOI: 10.1177/24726303211024568.
    [22] TheocharidisG,ThomasBE,SarkarD,et al.Single cell transcriptomic landscape of diabetic foot ulcers[J].Nat Commun,2022,13(1):181.DOI: 10.1038/s41467-021-27801-8.
    [23] 刘欣健,崔正军,张树堂,等.曲安奈德联合5-氟尿嘧啶与单独曲安奈德治疗瘢痕疙瘩效果的荟萃分析[J].中华烧伤杂志,2020,36(12):1191-1198.DOI: 10.3760/cma.j.cn501120-20190930-00390.
    [24] LaRangerR,Karimpour-FardA,CostaC,et al.Analysis of keloid response to 5-fluorouracil treatment and long-term prevention of keloid recurrence[J].Plast Reconstr Surg,2019,143(2):490-494.DOI: 10.1097/PRS.0000000000005257.
    [25] 中国整形美容协会瘢痕医学分会.瘢痕早期治疗全国专家共识(2020版)[J].中华烧伤杂志,2021,37(2):113-125.DOI: 10.3760/cma.j.cn501120-20200609-00300.
    [26] YuanB,UptonZ,LeavesleyD,et al.Vascular and collagen target: a rational approach to hypertrophic scar management[J].Adv Wound Care (New Rochelle),2023,12(1):38-55.DOI: 10.1089/wound.2020.1348.
    [27] OgawaR,AkitaS,AkaishiS,et al.Diagnosis and treatment of keloids and hypertrophic scars-Japan Scar Workshop consensus document 2018[J/OL].Burns Trauma,2019,7:39[2023-06-02].https://pubmed.ncbi.nlm.nih.gov/31890718/.DOI: 10.1186/s41038-019-0175-y.
    [28] WenandeE,AndersonRR,HaedersdalM.Fundamentals of fractional laser-assisted drug delivery: an in-depth guide to experimental methodology and data interpretation[J].Adv Drug Deliv Rev,2020,153:169-184.DOI: 10.1016/j.addr.2019.10.003.
    [29] 光电技术治疗皮肤创伤性瘢痕专家共识(2018版)编写组.光电技术治疗皮肤创伤性瘢痕专家共识(2018版)[J].中华烧伤杂志,2018,34(9):593-597.DOI: 10.3760/cma.j.issn.1009-2587.2018.09.007.
    [30] CavaliéM,SillardL,MontaudiéH,et al.Treatment of keloids with laser-assisted topical steroid delivery: a retrospective study of 23 cases[J].Dermatol Ther,2015,28(2):74-78.DOI: 10.1111/dth.12187.
    [31] TawaranurakN,PliensiriP,TawaranurakK.Combination of fractional carbon dioxide laser and topical triamcinolone vs intralesional triamcinolone for keloid treatment: a randomised clinical trial[J].Int Wound J,2022,19(7):1729-1735.DOI: 10.1111/iwj.13775.
    [32] HuangH,WangW.Molecular mechanisms of glucocorticoid resistance[J].Eur J Clin Invest,2023,53(2):e13901.DOI: 10.1111/eci.13901.
    [33] QuaxRA,ManenschijnL,KoperJW,et al.Glucocorticoid sensitivity in health and disease[J].Nat Rev Endocrinol,2013,9(11):670-686.DOI: 10.1038/nrendo.2013.183.
    [34] LiJ,Hlavka-ZhangJ,ShrimpJH,et al.PRC2 inhibitors overcome glucocorticoid resistance driven by NSD2 mutation in pediatric acute lymphoblastic leukemia[J].Cancer Discov,2022,12(1):186-203.DOI: 10.1158/2159-8290.CD-20-1771.
    [35] LiLB,LeungDY,MartinRJ,et al.Inhibition of histone deacetylase 2 expression by elevated glucocorticoid receptor beta in steroid-resistant asthma[J].Am J Respir Crit Care Med,2010,182(7):877-883.DOI: 10.1164/rccm.201001-0015OC.
    [36] XavierAM,AnunciatoAK,RosenstockTR,et al.Gene expression control by glucocorticoid receptors during innate immune responses[J].Front Endocrinol (Lausanne),2016,7:31.DOI: 10.3389/fendo.2016.00031.
    [37] SevillaLM,Jiménez-PanizoA,Alegre-MartíA,et al.Glucocorticoid resistance: interference between the glucocorticoid receptor and the MAPK signalling pathways[J].Int J Mol Sci,2021,22(18):10049.DOI: 10.3390/ijms221810049.
    [38] ZhuH,LiJ,LiY,et al.Glucocorticoid counteracts cellular mechanoresponses by LINC01569-dependent gluco-corticoid receptor-mediated mRNA decay[J].Sci Adv,2021,7(9):eabd9923.DOI: 10.1126/sciadv.abd9923.
  • 表1  糖皮质激素治疗瘢痕疙瘩的机制与具体效应

    作用机制 具体效应
    抗炎 诱导抗炎基因、蛋白表达,抑制激活蛋白1、核因子κB表达,减少促炎性细胞因子表达
    影响免疫调节 抑制Th1和Th17参与的细胞免疫反应,促进Th2和Treg的分化和激活
    抑制细胞增殖 抑制成纤维细胞增殖,促进成纤维细胞凋亡
    抑制ECM沉积 抑制Ⅰ、Ⅲ型胶原合成;减少胶原酶抑制物,加速胶原降解
    影响血管生成 下调血管内皮生长因子和血小板衍生生长因子表达,影响血管内皮细胞增殖
    注:ECM为细胞外基质,Th为辅助性T淋巴细胞,Treg为调节性T细胞
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  • 收稿日期:  2023-06-02

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