The role of the TGF-β family in wound healing, burns and scarring: a review.

摘要: It is estimated worldwide that over 6 million people per annum experience a burn injury. Despite advances in management and improved survival rates, the incidence of hypertrophic scarring remains high. These scars are particularly common after burns often raised, red, hard may cause abnormal sensations. Such pathological can lead to severe functional impairment, psychological morbidity, costly long term healthcare. Wound healing an inherent process which restores integrity skin injury although frequent by-product, scarless wound observed early human gestational fetuses suggests it not essential component response. This has large body research attempting understand mechanisms behind turn prevent it. One main focuses recent been role played by growth factor TGF-β both scar formation. The three isoforms (TGF-β1, TGF-β2 TGF-β3) appear have overlapping functions predominantly mediate their effects through intracellular SMAD pathway. Initial suggested TGF-β1 was responsible for fibrotic response whereas seen fetal wounds due increased levels TGF-β3. However, reality appears be far more complex unlikely simply altering ratio will healing. Other aspects system promising include downstream mediator CTGF, proteoglycan decorin binding protein p311. putative underlie pathogenesis excessive inflammation, angiogenesis, altered matrix metalloproteinases, factors, delayed apoptosis myofibroblasts either p53 genetic alterations or tensile forces across wound. If effective treatment following developed then further work must carried out basic scarring.