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Genetic susceptibility to raised dermal scarring
1Plastic and Reconstructive Surgery Research, Dermatological Sciences, Manchester Interdisciplinary Biocentre, University of Manchester, Manchester, UK.
The British Journal of Dermatology
|June 11, 2009
Summary
Genetic factors significantly influence raised skin scars like keloids. Specific human leucocyte antigen (HLA) alleles increase keloid scarring risk, suggesting a complex genetic and immune basis for these conditions.
Area of Science:
- Dermatology
- Genetics
- Immunology
Background:
- Raised skin scars, including keloid and hypertrophic scars, frequently develop after dermal wounding.
- Familial predisposition, ethnic variations, and twin studies indicate a significant genetic component in scar formation.
- The exact causes of these scar aberrations remain incompletely understood.
Purpose of the Study:
- To systematically review existing literature on genetic susceptibility to raised dermal scarring.
- To identify candidate genes and chromosomal regions associated with keloid and hypertrophic scars.
- To explore the role of the major histocompatibility complex (MHC) in scar development.
Main Methods:
- Systematic literature search across relevant databases and search engines.
- Inclusion of studies using keywords such as keloid disease, hypertrophic scarring, linkage analysis, gene expression, and HLA.
- Analysis of candidate genes, linkage regions, and association studies, including twin and family studies.
Main Results:
- Numerous candidate genes and chromosomal linkage regions associated with raised scarring have been identified.
- Specific major histocompatibility complex (MHC) alleles, notably HLA-DRB1*15, HLA-DQA1*0104, DQB1*0501, and DQB1*0503, are linked to increased keloid scarring risk.
- Distinct immunophenotypical profiles differentiate keloid from hypertrophic scars.
Conclusions:
- Raised dermal scarring likely involves a complex interplay of multiple genes and environmental factors, rather than a single gene.
- A strong immunogenic component, particularly involving MHC genes, is implicated in dermal fibrosis.
- Assessing individual genetic susceptibility could enable personalized management strategies for raised scars in the future.
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