机械力对增生性瘢痕的影响及TGFβ1/Smad通路在其作用机制中的研究进展

Effect of mechanical force on hypertrophic scar and research progress of TGFβ1/Smad pathway in its mechanism

增生性瘢痕(HPs)常发生在伤口异常愈合后,是皮肤组织损伤后胶原过度合成和异常增生导致的病理性瘢痕,是一种皮肤纤维增生性疾病。目前,HPs的治疗方法主要包括注射治疗、药物治疗、激光治疗、放射治疗、冷冻疗法、压力治疗、机械减张及手术等多种方法。然而,在手术治疗之前,通常人们更愿意接受非手术治疗方法来抑制和减轻瘢痕的形成;且对于大面积的烧伤或创伤患者,手术治疗方法往往存在较多的局限性。因此,非手术治疗和预防瘢痕形成的方法是目前研究的重点。据大量文献报道,持续的机械张力可诱导HPs的形成,而机械压力是目前治疗HPs最有效的方法之一。TGFβ1/Smad信号通路在调节胶原合成及瘢痕形成的过程中起着重要作用。诸多研究也表明,通过调控TGFβ1/Smad信号通路在治疗和预防病理性瘢痕的形成中同样起着至关重要的作用。HPs的治疗和预防是临床医生面临的世界性难题之一,尽管有大量学者对HPs的治疗和预防进行了诸多研究,但人类对于这一临床难题的确切有效的治疗和预防的方法尚未完全阐明。因此,机械力对HPs的影响及TGFβ1/Smad通路在其作用机制中的研究进展的文献综述分析显得非常有必要。

Hypertrophic scars(HPs),which often occur after abnormal wound healing,are pathological scars caused by excessive collagen synthesis and abnormal hyperplasia after skin tissue damage.It is a kind of skin fibroproliferative disease.At present,the treatment methods of HPs mainly include injection therapy,drug therapy,laser therapy,radiotherapy,cryotherapy,pressure therapy,mechanical tension reduction and surgery.However,before surgical treatment,people often prefer non-surgical treatments to inhibit and reduce scar formation.In addition,for patients with large-area burns or trauma,surgical treatment often has many limitations.Therefore,non-surgical treatments and prevention of scar formation are the focus of current research.According to a large number of literature reports,continuous mechanical tension can induce the formation of HPs and mechanical pressure is currently one of the most effective methods for the treatment of HPs.TGFβ1/Smad signaling pathway plays an important role in regulating collagen synthesis and scar formation.Many studies have also shown that regulating the TGFβ1/Smad signaling pathway also plays a crucial role in the treatment and prevention of pathological scar formation.The treatment and prevention of HPs is one of the worldwide problems faced by clinicians.Although a large number of scholars have conducted many studies on the treatment and prevention of HPs,the exact and effective treatment and prevention methods for this clinical problem have not been fully elucidated.Therefore,it is very necessary to review and analyze the effect of mechanical force on HPs and the research progress of TGFβ1/Smad pathway in its mechanism.