Endothelial Dysfunction in Keloid Formation and Therapeutic Insights.

Area of Science:

• Dermatology
• Pathology
• Vascular Biology

Background:

• Keloids are benign fibroproliferative tumors causing significant morbidity.
• Fibroblast hyperproliferation and extracellular matrix deposition are key, but vascular factors are understudied.
• Endothelial dysfunction (ED) is increasingly recognized in keloid pathogenesis.

Purpose of the Study:

• To review the role of vascular dysregulation and ED in keloid formation.
• To explore mechanisms linking ED to keloid progression.
• To comprehensively review treatments targeting angiogenesis and ED.

Main Methods:

• Literature review focusing on vascular and endothelial mechanisms in keloids.
• Analysis of direct and indirect pathways of ED in keloid progression.
• Compilation of current and emerging therapeutic strategies.

Main Results:

• Abnormal angiogenesis, vascular irregularities, and endothelial injury are critical drivers of keloid fibrosis.
• Mechanisms include endothelial-to-mesenchymal transition, inflammation, immune cell interactions, and hypoxia.
• Various treatments targeting vasculature and ED are discussed, including drugs, radiotherapy, HBOT, compression, and laser therapy.

Conclusions:

• Vascular dysregulation and ED are central to keloid pathogenesis.
• Understanding these vascular roles provides insights into keloid formation.
• Targeting vasculature and ED holds promise for future keloid therapies.