ASSOCIATION OF BLOOD COMPOSITION OF HORMONES, CYTOKINES AND LEUKOCYTES WITH LASER TREATMENT OUTCOMES OF KELOID SCARS
L.S. Vasilieva, M.V. Kobets
DOI: 10.22138/2500-0918-2022-19-2-71-81
Irkutsk State Medical University, Irkutsk, Russian Federation
Abstract. One of the topical aspects of the problem of keloid treatment is the lack information about biomarkers that can predict the success of the treatment of this pathology. The aim of the work is to identify the association of changed levels of hormones, cytokines and the number of leukocytes in the blood with the laser treatment result of keloid scars. Materials and methods. Hormonal, cytokine and leukocyte blood composition was studied in 45 women: 30 with keloid scars, 15 with normotrophic scars (control). Blood was taken before treatment on the 5th–7th day of the menstrual cycle. Keloids were treated with multiple laser perforations of the scar tissue. Clinical characteristics of keloid scars were assessed using the Vancouver scale before treatment and after 3 months. According to the result of treatment, two subgroups were formed: with positive dynamics of keloids and with no result of treatment. Data analysis was carried out using non-parametric statistics, the level of statistical significance was p<0.05. Results and discussion. In all patients with keloids, the blood level of cortisol is reduced, and tumor necrosis factor-alpha is increased, which promotes to the proliferation of fibroblasts with inhibition of apoptosis. In addition, in the subgroup with a positive result of treatment, the number of segmented neutrophils and the level of anti-inflammatory interleukin-10 were increased. Discriminant analysis confirmed the high informational significance of these indicators. In patients with no result of keloid treatment, the level of a growth hormone is sevenfold increased, the concentration of luteinizing hormone, prolactin, interleukin-10 are reduced. That can lead to a weakening of anti-inflammatory effects and stimulation of fibrosis. Discriminant analysis highlighted the high informational significance of cortisol, growth hormone and tumor necrosis factor-alpha. Regression analysis established the association of detected changes in blood composition with clinical parameters of keloids in each subgroup. Conclusion. The revealed differences in the blood composition in patients with keloid scars are associated with a positive or negative result of laser treatment of keloids.
Keywords: keloid scars, systemic factors, keloidogenesis
There is no conflict of interest.
Contact details of the corresponding author:
Maksim V. Kobets
kobetsmv@gmail.com
Received 05.04.2022
For citation:
Vasilieva L.S., Kobets M.V. Association of blood composition of hormones, cytokines and leukocytes with laser treatment outcomes of keloid scars. Vestn. Ural. Med. Akad. Nauki. = Journal of Ural Medical Academic Science. 2022, Vol. 19, no. 2, pp. 71–81. DOI: 10.22138/2500-0918-2022-19-2-71-81 (In Russ)
REFERENCES
1. Gauglitz G.G., Korting H.C., Pavicic T., Ruzicka T., Jeschke M.G. Hypertrophic scarring and keloids: pathomechanisms and current and emerging treatment strategies. Mol. Med. 2011; 17 (1-2): 113–125. Doi: 10.2119/molmed.2009.00153
2. Shih B., Garside E., Mc Grouther D.A., Bayat A. Molecular dissection of abnormal wound healing processes resulting in keloid disease. Wound Repair Regen. 2010; 18 (2): 139-153. Doi: 10.1111/j.1524-475X.2009.00553.x.
3. Tsai C-H., Ogawa R. Keloid research: current status and future directions. Scars. Burn. Heal. 2019; 5: аrt. 2059513119868659. Doi: 10.1177/2059513119868659
4. Glass D.A. Current Understanding of the Genetic Causes of Keloid Formation? J. Investig. Dermatol. Symp. Proc. 2017; 18(2): 50-53. Doi: 10.1016/j.jisp.2016.10.024.
5. Messias de Lima C.F., de Araújo Vieira L.F., de Carvalho Wanderley L.A., de Souza Ferro J.N., Smaniotto S. Topical Growth Hormone Accelerates Wound Healing in Mice. Wounds. 2017; 29(12): 387-392.
6. Xue X., Falcon D.M. The Role of Immune Cells and Cytokines in Intestinal Wound Healing. Int. J. Mol. Sci. 2019; 320(23): 6097. Doi: 10.3390/ijms20236097.
7. Shafranov V.V., Borkhunova E.N., Taganov A.V., Korotkiy N.G., Vissarionov V.A., Stenko A.G. Keloid scars: etiology, clinical, morphological, physical diagnosis and microwave treatment — cryogenic method. Moscow: 2003. (in Russian)
8. Zhang G.Y, Wu L.C, Liao T, et al. Altered circulating endothelial progenitor cells in patients with keloid. Clin Exp Dermatol. 2016; 41: 152-155. Doi: 10.1111/ced.12695.
9. Mogili N.S., Krishnaswamy V.R., Jayaraman M., Rajaram R., Venkatraman A., Korrapati P.S. Altered angiogenic balance in keloids: a key to therapeutic intervention. Transl Res. 2012; 159: 182-189. Doi: 10.1016/j.trsl.2011.10.002.
10. Khattab F.M., Samir M.A. Correlation between serum IL 37 levels with keloid severity. J Cosmet Dermatol. 2020; 19(9): 2428-2431. Doi: 10.1111/jocd.13290.
11. Shafranov V.V, Taganov A.V, Barkhunova E.N, Geraskin A.V. The use of the Vancouver scalefor assessing the effectiveness of treatment of patients with keloid scars by microwave destruction. Russian Journal of Pediatric Surgery. 2009; 5: 29–32 (inRussian).
12. Cruz-Topete D., Cidlowski J.A. One hormone, two actions: anti- and pro-inflammatory effects of glucocorticoids. Neuroimmunomodulation. 2015; 22(1–2): 20–32. Doi: 10.1159/000362724.
13. Slominski A.T., Zmijewski M.A. Glucocorticoids Inhibit Wound Healing: Novel Mechanism of Action. J. Invest. Dermatol. 2017; 137(5): 1012-1014. Doi: 10.1016/j.jid.2017.01.024.
14. Levine S., Muneyyirci-Delale O. Stress-Induced Hyperprolactinemia: Pathophysiology and Clinical Approach. Obstet Gynecol Int. 2018; art. 9253083. Doi: 10.1155/2018/9253083.
15. Li Q., Cheng F., Zhou K., Fang L., Wu J., Xia Q., Cen Y., Chen J., Qing Y. Increased sensitivity to TNF-alpha promotes keloid fibroblast hyperproliferation by activating the NF-kappa B, JNK and p38 MAPK pathways. Exp. Ther. Med. 2021; 21(5): 502. Doi:10.3892/etm.2021.9933.
16. Wang P.H., Huang B.S., Horng H.C., Yeh C.C., Chen Y. J. Wound healing. J. Chin. Med. Assoc. 2018; 81: 94–101. Doi:10.1016/j.jcma.2017.11.002.
17. Shi C-K., Zhao Y-P., Ge P., Huang G-B. Therapeutic effect of interleukin-10 in keloid fibroblasts by suppression of TGF-β/Smad pathway. Eur Rev. Med. Pharmacol. Sci. 2019; 23(20): 9085-9092. Doi: 10.26355/eurrev 201910 19311.
18. Ghazawi F. M., Zargham R., Gilardino M. S., Sasseville D., Jafarian F. Insights into the Pathophysiology of Hypertrophic Scars and Keloids: How Do They Differ? Advances in Skin & Wound Care. 2018; 31(1): 582-595. Doi: 10.1097/01.ASW.0000527576.27489
19. Hu Z.C., Tang B., Guo D., Zhang J., Liang Y.Y., Ma D., Zhu J.Y. Expression of insulin-like growth factor-1 receptor in keloid and hypertrophic scar. Clin. Exp. Dermatol. 2014; 39(7): 822–828. Doi: 10.1111/ced.12407.
20. Kanda N., Watanabe S. Regulatory roles of sex hormones in cutaneous biology and immunology. J. Dermatol. Sci. 2005; 38(1): 1-7. Doi: 10.1016/j.jdermsci.2004.10.011
21. Duffy D. M., Ko C.M., Jo M., Brannstrom M., Curry T. E. Ovulation: Parallels With Inflammatory Processes. Endocr. Rev. 2019; 40(2): 369–416. Doi: 10.1210/er.2018-00075.
Authors
Lyudmila S. Vasilieva
DB, Professor, Head Department of Histology, Embryology, Cytology
lsvirk@mail.ru
ORCID 0000-0003-3495-1560
Maksim V. Kobets
Graduate student of the Department of Pathological Physiology
kobetsmv@gmail.com
ORCID 0000-0002-7759 1078
Irkutsk State Medical University
1 Krasnogo Vosstaniya st., Irkutsk, 664003, Russian Federation