瘢痕形成机制的研究：真皮“模板缺损”学说

Study on the mechanism of scar formation： Epidermis template defect theory

创面愈合过程由细胞、细胞因子、细胞外基质等共同参与完成，以往瘢痕形成机制的研究主要着眼于这些环节。随着研究的深入和范围的拓展，人们逐渐意识到：在创面愈合过程中，细胞、细胞因子、细胞外基质等扮演着“参与者”和“执行者”的角色，对瘢痕形成而言，其变化及相互调控等诸多环节可能属于后续的“连锁”或“瀑布”效应，是一种修复的“中间过程”，而非导致瘢痕超常增生的始动因素和根本原因。

Dermal defection and the degree of its loss determine the natural process of wound healing, which is the key reason leading to excess scar hypcrplasy. The function of tri-dimcnsional structure in dermis acts as a template to regulate the properties of reparative cells. The template structure induces the reparative cells to grow into the structure which changes the skin mechanic status on wound area. Also, the component of extracclluar matrix can affect bchaviours of fibroblasts negatively or positively, for the reason that the structure of dermal tissue has a permissive effect on the dermal components in regulating bchavlouts of reparative cells. Therefore, the behaviors of cells depend on the structure of the template. The suitable tri-dimcnsional structure of dermis facilitates normal cell cycling. The more the structure of dermis closed to its physiological status, the better the biological behaviors of cells act. Moreover, the integrity as well as the continuity of dermal tissue is the prerequisite for serving as a template. The damage to the integrity and the continuity of dermal tissue may be one of the key reasons to lead abnormal tissue repair and scar formation. Thus, we hypothesize that the loss of dermal template may be one of the mechanism of abnormal scar formation and propose the theory of cxtraccllular matrix framework deficiency or destruction.