THE MOLECULAR MECHANISM, TYPES AND TREATMENT OF SCAR FORMATION

Yıl 2024, Cilt: 7 Sayı: 3, 223 - 247

Enver Tekin

https://doi.org/10.52538/iduhes.1590063

Öz

Wound healing and scar formation is a complex biological process that occurs as a response to injury, characterized by the deposition of extracellular matrix components and the proliferation of fibroblasts. The mechanisms underlying wound healing and following scar formation can vary significantly depending on the type of scar, such as hypertrophic scars and keloids, and are influenced by various cellular and molecular factors. Myofibroblasts, a differentiated form of fibroblasts, play a pivotal role in wound healing and scar formation due to their contractile properties and ability to produce large amounts of collagen and other extracellular matrix components.
Scar formation process involves complex interactions among various cell types, including fibroblasts, macrophages, and endothelial cells, as well as the extracellular matrix components. Understanding these mechanisms is crucial for developing therapeutic strategies to minimize pathological scarring, such as hypertrophic scars and keloids.
The initial phase of scar formation is dominated by inflammation, which is essential for initiating the healing process. Inflammatory cells, particularly macrophages, play a pivotal role in orchestrating the wound healing response. Fibroblasts are the primary effector cells in scar formation, responsible for synthesizing extracellular matrix components, including collagen.
Scars can be classified into several types based on their characteristics, underlying mechanisms, and clinical presentations. The two most commonly discussed types of scars are hypertrophic scars and keloids, but there are also atrophic scars, contracture scars, and acne scars, each with distinct features and implications for treatment.
The aim of this study is to explain the molecular mechanism, types and treatment of scar formation.

Anahtar Kelimeler

Wound healing, Scar formation, Fibroblast, Inflammation, keloid, hypertrophic scar

SKAR OLUŞUMUNUN MOLEKÜLER MEKANİZMASİ, TÜRLERİ VE TEDAVİSİ

Öz

Yara iyileşmesi ve skar oluşumu, hasara yanıt olarak hücre dışı matris bileşenlerinin birikmesi ve fibroblastların çoğalmasıyla karakterize karmaşık bir biyolojik süreçtir. Yara iyileşmesinin ve sonrasında oluşan skar oluşumunun altında yatan mekanizmaları, hipertrofik skar ve keloid gibi skar tiplerine bağlı olarak önemli ölçüde değişebilmekte ve çeşitli hücresel ve moleküler faktörlerden etkilenmektedir. Fibroblastların farklılaşmış bir formu olan miyofibroblastlar, kasılma özellikleri ve büyük miktarda kolajen ve diğer hücre dışı matris bileşenleri üretme kabiliyetleri nedeniyle yara iyileşmesinde ve skar oluşumunda önemli bir rol oynarlar.
Skar oluşum süreci fibroblastlar, makrofajlar ve endotel hücreleri gibi çeşitli hücre tipleri ile hücre dışı matris bileşenleri arasındaki karmaşık etkileşimleri içerir. Bu mekanizmaların anlaşılması, hipertrofik skar ve keloid gibi patolojik skarları en aza indirmeye yönelik tedavi stratejileri geliştirmek için çok önemlidir.
Skar oluşumunun ilk evresinde, iyileşme sürecinin ilk aşaması olan inflamasyon mekanizması başlar. Özellikle makrofajlar olmak üzere inflamatuar hücreler, yara iyileşmesinin düzenlenmesinde önemli bir rol oynarlar. Fibroblastlar, kollajen de dahil olmak üzere ekstraselüler matriks bileşenlerinin sentezlenmesinden sorumlu olan, skar oluşumunda birincil etkili hücrelerdir.
Skarlar, özelliklerine, altta yatan mekanizmalarına ve klinik görünümlerine göre çeşitli türlere ayrılabilir. En sık tartışılan iki tür hipertrofik skar ve keloiddir, ancak atrofik skar, kontraktür skar ve akne skarı da görülebilir ve her biri tedavi için farklı özelliklere sahiptir.
Bu çalışmanın amacı skar oluşumunun moleküler mekanizmasını, tiplerini ve tedavisini açıklamaktır.

Anahtar Kelimeler

yara iyileşmesi, skar oluşumu, fibroblast, inflamasyon, keloid, hipertrofik skar

Kaynakça

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