Human hypertrophic and keloid scar models: principles, limitations and future challenges from a tissue engineering...

Area of Science:

• Wound healing research
• Regenerative medicine
• Dermatology

Background:

• Most cutaneous wounds heal with scarring, but abnormal scars like hypertrophic scars and keloids can develop.
• Preventing adverse scar formation and understanding individual predispositions remain significant challenges in clinical practice and scientific research.
• Existing models for studying scar formation have limitations in addressing the specific mechanisms differentiating normotrophic, hypertrophic, and keloid scars.

Purpose of the Study:

• To review current in vitro and animal models for scar formation research.
• To highlight the limitations of existing models in explaining the development of abnormal scars.
• To identify future challenges and research directions for achieving scar-free wound healing.

Main Methods:

• Review of existing literature on scar formation models, including cell cultures, tissue-engineered models, and humanized mouse models.
• Analysis of the capabilities and limitations of current models in addressing key questions about scar development.
• Identification of knowledge gaps concerning the transition from normotrophic to abnormal scarring.

Main Results:

• Current high- and medium-throughput models do not adequately address why adverse scars form instead of normotrophic ones.
• Existing models struggle to differentiate the causes of hypertrophic scars versus keloids.
• The role of individual genetic predisposition and the immune system in scar formation is not fully elucidated by current models.

Conclusions:

• Significant limitations exist in current in vitro and animal models for studying scar formation.
• Understanding the genetic and immune system's involvement is crucial for developing effective scar prevention strategies.
• Future research must focus on developing advanced models that can address these complexities to achieve scar-free healing.