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The Keloid Disorder: Heterogeneity, Histopathology, Mechanisms and Models
Grace C Limandjaja1, Frank B Niessen2, Rik J Scheper3
1Department of Molecular Cell Biology and Immunology, Amsterdam University Medical Center (location VUmc), Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
Frontiers in Cell and Developmental Biology
|June 13, 2020
Summary
Keloids are abnormal scars resulting from fibroproliferative wound healing. Research highlights their histopathology, heterogeneity, and pathogenesis, emphasizing the need for human in vitro models for better treatment strategies.
Area of Science:
- Dermatology and wound healing research.
- Fibroproliferative disorders and scar research.
Background:
- Keloids represent an abnormal fibroproliferative wound healing response, exceeding original wound boundaries.
- Histopathological characteristics, including collagen and α-SMA immunoreactivity, show conflicting results and are also present in keloid epidermis.
- Keloid heterogeneity exists within and between keloids, with at least two distinct phenotypes (superficial-spreading and bulging/raised).
Purpose of the Study:
- To provide a comprehensive overview of keloid research, covering histopathology, heterogeneity, pathogenesis, and model systems.
- To discuss the factors contributing to keloid formation, including patient, topological, and environmental influences.
- To evaluate existing keloid research models and identify promising avenues for future study.
Main Methods:
- Review of existing literature on keloid histopathology, heterogeneity, pathogenesis, and model systems.
- Analysis of conflicting histopathological findings and discussion of keloid phenotypes.
- Evaluation of in vivo and in vitro keloid research models.
Main Results:
- Histopathological abnormalities are found in keloid epidermis and surrounding skin, not just within the scar.
- Keloids exhibit significant heterogeneity, impacting research interpretations and treatment approaches.
- Human in vitro direct co-culture systems generating full-thickness keloid equivalents show promise for advancing research.
Conclusions:
- Keloids are complex fibroproliferative disorders, not merely cosmetic scars.
- Understanding keloid heterogeneity and utilizing relevant human in vitro models are crucial for advancing pathogenesis research and treatment.
- Further research into keloid pathogenesis is essential for developing effective therapeutic strategies.
