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

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

上海交通大学医学院附属第九人民医院整复外科，上海　　200011

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

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出版历程
- 收稿日期: 2023-06-02

Research advances in the treatment of keloid with glucocorticoids

Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China

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

Corresponding author: Zan Tao, Email: zantao@sjtu.edu.cn

摘要

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。
- 瘢痕疙瘩 /
- 糖皮质激素类 /
- 受体，糖皮质激素 /
- 耐药
Abstract: As a first-line classical drug, glucocorticoids are used in most combination treatment regimens of keloid. However, there are issues such as poor treatment efficacy and recurrence of keloid after keloid was treated with glucocorticoids, which seriously affect the therapeutic effect. In recent years, many studies have explored the factors influencing the efficacy of glucocorticoids in treating keloid and the action mechanism of glucocorticoids from different perspectives. Based on this, this paper reviews the mechanism and the factors influencing the efficacy of glucocorticoids in treating keloid, and explores ways to improve the treatment efficacy of glucocorticoids, aiming to provide thoughts for improving glucocorticoid-related diagnostic and therapeutic strategies.
- Keloid /
- Glucocorticoids /
- Receptors, glucocorticoid /
- Drug resistance
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参考文献(38)

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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