elastin and Cicatrix

Laser therapy is a continuously evolving treatment option for scars, and the underlying therapeutic mechanisms continue to be elucidated.. To comprehensively review the literature to summarize the role of elastin in the formation scars, as well as treatment via therapeutic lasers.. Review of the PubMED/MEDLINE database for available studies pertaining to the role of elastic fibers in scar formation and after laser-based therapy.. The loss and disorganization of elastic fiber components plays a role in the development of atrophic, hypertrophic, and keloid scars. While the majority of histologic studies focus on the underlying changes in collagen, neoelastogenesis and reorganization of elastic fibers have also been demonstrated in studies using ablative, nonablative, and fractional laser devices for the treatment of scars.. Production of novel elastin and normalization of elastic fiber organization occur after a variety of resurfacing procedures to treat scarring. As the treatment modalities to manage scars continue to evolve, further characterization of the role of elastin in the skin and in scar formation is merited.

Topics: Cicatrix; Elastic Tissue; Elastin; Humans; Laser Therapy

Skin is an important organ to the human body as it functions as an interface between the body and environment. Cutaneous injury elicits a complex wound healing process, which is an orchestration of cells, matrix components, and signaling factors that re-establishes the barrier function of skin. In adults, an unavoidable consequence of wound healing is scar formation. However, in early fetal development, wound healing is scarless. This phenomenon is characterized by an attenuated inflammatory response, differential expression of signaling factors, and regeneration of normal skin architecture. Elastin endows a range of mechanical and cell interactive properties to skin. In adult wound healing, elastin is severely lacking and only a disorganized elastic fiber network is present after scar formation. The inherent properties of elastin make it a desirable inclusion to adult wound healing. Elastin imparts recoil and resistance and induces a range of cell activities, including cell migration and proliferation, matrix synthesis, and protease production. The effects of elastin align with the hallmarks of fetal scarless wound healing. Elastin synthesis is substantial in late stage in utero and drops to a trickle in adults. The physical and cell signaling advantages of elastin in a wound healing context creates a parallel with the innate features of fetal skin that can allow for scarless healing.

Topics: Adult; Age Factors; Cicatrix; Elastin; Fetus; Humans; Models, Biological; Signal Transduction; Skin Physiological Phenomena; Wound Healing

The therapeutic management of the sequelae of deep burns always relies in principle on dermal-epidermal grafts. The latter, the price of which to pay is heavy scarring, cannot always be performed because the surface of skin available may not be sufficient. Research pathways have turned towards the creation of skin substitutes to minimise the scarring and improve the cosmetic quality of the grafts. We review the technical characteristics of collagen matrixes (Intégra(®) - Matriderm(®)) and their method of use.

Topics: Burns; Chondroitin Sulfates; Cicatrix; Collagen; Elastin; Humans; Skin, Artificial; Treatment Outcome; Wound Healing

Vocal fold scarring is the greatest cause of poor voice after vocal fold injury. Scarring causes a disruption of the viscoelastic layered structure of the lamina propria, an increase in stiffness of the vibratory structure, and glottic incompetence. Current treatments for this complex condition are inconsistent and often produce suboptimal results. Research investigating this condition has dramatically increased over the last several years. The literature has been directed toward understanding vocal fold scarring at the biological level and translating this to the clinical forum. We present an up-to-date, thorough, and scholarly review of the literature in vocal fold scarring since 1996.

Topics: Adjuvants, Immunologic; Animals; Cicatrix; Collagen; Elastin; Extracellular Matrix Proteins; Growth Substances; Humans; Hyaluronic Acid; Treatment Outcome; Vocal Cords; Voice Disorders; Voice Quality; Wound Healing

Topics: Aging; Animals; Cell Differentiation; Cicatrix; Collagen; Elastin; Fibroblasts; Glycoproteins; Glycosaminoglycans; Humans; Lipoproteins, LDL; Mice; Microscopy, Electron; Muscles; Organoids; Platelet-Derived Growth Factor; Protein Precursors; Rats; Skin; Swine; Wound Healing

Topics: Animals; Basement Membrane; Cicatrix; Collagen; Elastin; Epithelial Cells; Epithelium; Fibroblasts; Granulation Tissue; Hair; Humans; Lymphatic System; Methods; Regional Blood Flow; Sebaceous Glands; Skin; Skin Transplantation; Sweat Glands; Transplantation, Autologous; Transplantation, Homologous; Wound Healing

Striae, or stretch marks, are very common skin disorders that do not impair bodily function, but are of considerable cosmetic concern to many patients. Traditionally, treatment options have been very limited. This study examines the results of treating striae using the 585-nm pulsed dye laser. Stimulation of a variety of wound healing processes has been attributed to low energy laser therapy. Clinically, improvement of hypertrophic and erythematous scars with the 585-nm pulsed dye laser at energy densities of 6-7 J/cm2 is well established. Since striae are dermal scars, evaluation of this same therapy to treat striae was undertaken.. To evaluate the effectiveness of the 585-nm flashlamp-pumped pulse dye laser in treating cutaneous striae.. Thirty-nine striae were treated with four treatment protocols. These treated striae were compared with untreated striae controls in the same patient. The patients ages ranged from 23 to 52 years, with an average age of 36 years. The average age of the treated striae prior to initial treatment was 14 years (range, 8 months to 32 years). Treatment parameters included spot sizes of 7 and 10 mm and fluences of 2.0, 2.5, 3.0, and 4.0 J/cm2. Response to therapy was evaluated through clinical grading, sequential photography, and optical profilometry at a blinded laboratory. Skin biopsies were also examined with light microscopy from two of the 39 striae that were treated.. Subjectively, striae appeared to return toward the appearance of normal skin with all protocols. However, the protocol with 10-mm spot size using 3.0 J/cm2 fluence improved the appearance of striae better than the other treatment protocols. Objectively, shadow profilometry revealed that all treatment protocols reduced skin shadowing in striae. This result corresponds with surface patterns of striae returning to that closely resembling adjacent normal skin surface patterns. Histologically, using hematoxylin and eosin stains as well as elastin strains, striae treated with a low fluence pulsed dye laser treatment protocol regained normal appearing elastin content when compared with normal (non-striae) skin adjacent to the treated striae.. Treatment with the 585-nm pulsed dye laser at low energy densities was shown to improve the appearance of striae. Apparent increased dermal elastin was also observed 8 weeks posttherapy and possibly contributed to the improvement seen in the study patients.

Topics: Adult; Biopsy; Cicatrix; Elastin; Female; Humans; Laser Therapy; Male; Middle Aged; Skin

Myocardial infarction (MI) is among the leading causes of death worldwide. Following MI, necrotic cardiomyocytes are replaced by a stiff collagen-rich scar. Compared to collagen, the extracellular matrix protein elastin has high elasticity and may have more favorable properties within the cardiac scar. We sought to improve post-MI healing by introducing tropoelastin, the soluble subunit of elastin, to alter scar mechanics early after MI.. We developed an ultrasound-guided direct intramyocardial injection method to administer tropoelastin directly into the left ventricular anterior wall of rats subjected to induced MI. Experimental groups included shams and infarcted rats injected with either PBS vehicle control or tropoelastin. Compared to vehicle treated controls, echocardiography assessments showed tropoelastin significantly improved left ventricular ejection fraction (64.7±4.4% versus 46.0±3.1% control) and reduced left ventricular dyssynchrony (11.4±3.5 ms versus 31.1±5.8 ms control) 28 days post-MI. Additionally, tropoelastin reduced post-MI scar size (8.9±1.5% versus 20.9±2.7% control) and increased scar elastin (22±5.8% versus 6.2±1.5% control) as determined by histological assessments. RNA sequencing (RNAseq) analyses of rat infarcts showed that tropoelastin injection increased genes associated with elastic fiber formation 7 days post-MI and reduced genes associated with immune response 11 days post-MI. To show translational relevance, we performed immunohistochemical analyses on human ischemic heart disease cardiac samples and showed an increase in tropoelastin within fibrotic areas. Using RNA-seq we also demonstrated the tropoelastin gene. We demonstrate for the first time that purified human tropoelastin can significantly repair the infarcted heart in a rodent model of MI and that human cardiac fibroblast synthesize elastin. Since human cardiac fibroblasts are primarily responsible for post-MI scar synthesis, our findings suggest exciting future clinical translation options designed to therapeutically manipulate this synthesis.

Topics: Animals; Cicatrix; Collagen; Elastin; Humans; Myocardial Infarction; Myocardium; Myocytes, Cardiac; Rats; Stroke Volume; Tropoelastin; Ventricular Function, Left; Ventricular Remodeling

Dermal substitutes are well established in the reconstructive ladder. MatriDerm® (Dr. Otto Suwelack Skin & Health Care AG, Billerbeck, Germany) is a single-layer dermal substitute composed of a bovine collagen (type I, III, and V) and elastin hydrolysate, that allows for immediate split-thickness skin grafting (SSG). The aim of this study was to histologically characterize the integration of MatriDerm® when used during burns surgery reconstruction. Eight subjects with nine burn scars and one acute burn wound underwent reconstruction with MatriDerm® and an immediate SSG. MatriDerm® integration and skin graft take were assessed with serial biopsies performed at weeks 1, 2, 3, and 4 and months 2, 3, 6, 9, and 12. Biopsies were assessed with standard special stains and immunohistochemistry, and representative slides were imaged with a transmission electron microscope. Patient satisfaction and clinical scar outcome were assessed with the Vancouver Scar Scale and a patient questionnaire. Histological analysis showed similar stages of wound healing as shown in other dermal templates but on a different timescale. There is early evidence of vascularization and an inflammatory infiltrate in the first 2 weeks. MatriDerm® is resorbed earlier than other dermal substitutes, with evidence of resorption at week 3, to be completely replaced by a neodermis at 2 months. The use of MatriDerm® in reconstruction with immediate skin grafting is supported histologically with early evidence of vascularization to support an epidermal autograft. Future histological studies may help further characterize the ideal dermal substitute.

Topics: Animals; Burns; Cattle; Cicatrix; Collagen; Collagen Type I; Elastin; Humans; Skin Transplantation; Skin, Artificial

Extensive scar tissue formation after peripheral nerve injury or surgery is a common problem. To avoid perineural scarring, implanting a mechanical barrier protecting the nerve from inflammation processes in the perineural environment has shown promising results for functional recovery. This study investigates the potential of an acellular collagen-elastin matrix wrapped around a peripheral nerve after induction of scar tissue formation.. In the present study, 30 Lewis rats were separated into three groups and sciatic nerve scarring was induced with 2.5% glutaraldehyde (GA-CM) or 2.5% glutaraldehyde with a supplemental FDA-approved acellular collagen-elastin matrix application (GA+CM). Additionally, a sham group was included for control. Nerve regeneration was assessed by functional analysis using the Visual Statisc Sciatic Index (SSI) and MR neurography during the 12-week regeneration period. Histological and histomorphometry analysis were performed to evaluate the degree of postoperative scar tissue formation.. Histological analysis showed an extensive scar tissue formation for GA-CM. Connective tissue ratio was significantly (p < 0.009) reduced for GA+CM (1.347 ± 0.017) compared to GA-CM (1.518 ± 0.057). Similarly, compared to GA+CM, MR-Neurography revealed extensive scar tissue formation for GA-CM with a direct connection between nerve and paraneural environment. Distal to the injury site, quantitative analysis presented significantly higher axon density (p = 0.0145), thicker axon diameter (p = 0.0002) and thicker myelinated fiber thickness (p = 0.0008) for GA+CM compared to GA-CM. Evaluation of functional recovery revealed a significantly faster regeneration for GA+CM.. The supplemental application of an acellular collagen-elastin matrix showed beneficial effects in histological, radiological, and functional analysis. Therefore, applying a collagen-elastin matrix around the nerve after peripheral nerve injury or surgery may have beneficial effects on preventing scar tissue formation in the long run. This represents a feasible approach to avoid scar tissue formation in peripheral nerve surgery.

Topics: Animals; Cicatrix; Collagen; Elastin; Glutaral; Nerve Regeneration; Peripheral Nerve Injuries; Peripheral Nerves; Rats; Rats, Inbred Lew; Rats, Sprague-Dawley; Sciatic Nerve

A previous study has found an association between chronic inflammatory disorders e.g. psoriasis, rheumatoid arthritis, and inflammatory bowel disease and increased vascular stiffness(1). Psoriasis and hidradenitis suppurativa (HS) are believed to have shared comorbidities and pathophysiology despite their morphologically different manifestations in the skin. In order to evaluate a putative association between the chronic inflammatory skin disease HS and arterial stiffness, an observational cross-sectional retrospective study was carried out as part of the Danish General Suburban Population Study (GESUS) (1), in which 430 patients with HS from the general population (representing mild HS; Table 1), 32 patients with HS from a hospital-based out-patient clinic (representing severe HS, Table 1), and 20,780 controls underwent measurements of arterial vascular tone and stiffness using photoplethysmography (Pulse Trace PCA2®; Micro Medical Ltd, Kent, UK). The method of Pulse Trace has been validated by correlation with intra-arterial sensing techniques, and is a simple cost-effective screening method[2]. All analyses were performed using SAS 9.3. This study was accepted by the ethics committee of Region Zealand (project number SJ-191, SJ-113, SJ-114) in Denmark (2,3). RESULTS Reflection index (RI) is an expression of arterial vascular tone and stiffness of small arteries. The raw data showed a significantly lower RI for both HS groups groups, compared to controls. The results remained significant when adjusting for confounders (age, sex, smoking and metabolic syndrome) in the out-patient clinic HS group (-11.26 (-17.75- -4.76), P=0.0002*), but not in the population HS group (Table 2). Stiffness index (SI) expresses arterial stiffness in large arteries. Both HS groups showed no significant difference in either SI or vascular age in multivariate analysis, when compared with controls (Table 2). DISCUSSION This study suggests that decreased vascular tone and stiffness of small arteries may be associated with severe HS, and at the same time found no difference in arterial stiffness in large arteries. The significance for the out-patient clinic HS group, but not the population HS group may reflect a dose-response relationship. Vascular tone in vascular smooth muscle cells of small arteries depends on competing vasodilators and vasoconstrictors. We speculate that the inflammation of HS may induce a dysfunctional balance e.g. through increased TNF-alpha with subsequent

Topics: Arteries; Cicatrix; Cross-Sectional Studies; Elastin; Hidradenitis Suppurativa; Histamine; Humans; Hydrocortisone; Inflammation; Myocardial Infarction; Nitric Oxide; Psoriasis; Retrospective Studies; Stroke; Tumor Necrosis Factor-alpha; Vasoconstrictor Agents; Vasodilator Agents

The advent of dermal regeneration templates has fostered major advances in the treatment of acute burns and their sequelae, in the last three decades. Both data on morphological aspects of the newly-formed tissue, and clinical trials comparing different templates, are few. The goal of this study was to prospectively analyze the outcome of randomized patients treated with two of the existing templates, followed by thin skin autograft. They are both 2 mm-thick bovine collagen templates (Matriderm® and Integra®), the latter includes a superficial silicone layer. Surgery was performed on patients with impaired mobility resulting from burn sequelae (n = 12 per template) in a two-step procedure. Negative pressure therapy was applied after surgery; patients were monitored for 12 months. No intra or postoperative complications were observed. Data on scar skin quality (Vancouver scar scale), rate of mobility recovery, and graft contraction were recorded; as well as morphological analyses at light microscopical level. Improvement in mobility and skin quality were demonstrated along with graft contraction, in all patients. The double layer template showed the best performance in retraction rate, skin quality and mobility recovery. The subepidermal newly-formed connective tissue showed no histoarchitectural differences between the templates. The double layer template was not absorbed up to 12 months after placement.

Topics: Adolescent; Adult; Burns; Chondroitin Sulfates; Cicatrix; Collagen; Contracture; Elastin; Female; Guided Tissue Regeneration; Humans; Longitudinal Studies; Male; Middle Aged; Negative-Pressure Wound Therapy; Plastic Surgery Procedures; Postoperative Complications; Skin; Skin Transplantation; Transplantation, Autologous; Young Adult

Gel-based injectable biomaterials have significant potential for treating vocal fold defects such as scarring. An ideal injectable for vocal fold lamina propria restoration should mimic the microenvironment of the lamina propria to induce scarless wound healing and functional tissue regeneration. Most current synthetic or natural injectable biomaterials do not possess the same level of complex, tissue-specific constituents as the natural vocal fold lamina propria. In this study we present a newly-developed injectable gel fabricated from decellularized bovine vocal fold lamina propria. Blyscan assay and mass spectrometry indicated that the vocal fold-specific gel contained a large amount of sulfated glycosaminoglycans and over 250 proteins. Gene Ontology overrepresentation analysis revealed that the proteins in the gel dominantly promote antifibrotic biological process. In vivo study using a rabbit vocal fold injury model showed that the injectable gel significantly reduced collagen density and decreased tissue contraction of the lamina propria in vocal folds with chronic scarring. Furthermore, this acellular gel only elicited minimal humoral immune response after injection. Our findings suggested that the tissue-specific, injectable extracellular matrix gel could be a promising biomaterial for treating vocal fold scarring, even after the formation of mature scar. STATEMENT OF SIGNIFICANCE: Vocal fold lamina propria scarring remains among the foremost therapeutic challenges in the management of patients with voice disorders. Surgical excision of scar may cause secondary scarring and yield inconsistent results. The present study reports an extracellular matrix-derived biomaterial that demonstrated antifibrotic effect on chronic scarring in vocal fold lamina propria. Its injectability minimizes the invasiveness of the delivery procedure and the degree of mucosal violation. In this work we also describe a new methodology which can more accurately identify proteins from the complex mixture of an acellular extracellular matrix gel by excluding interfering peptides produced during the enzymatic digestion in gel fabrication.

Topics: Animals; Biocompatible Materials; Cattle; Cicatrix; Collagen; Elastin; Extracellular Matrix; Female; Gels; Glycosaminoglycans; Immunity, Humoral; Injections; Mucous Membrane; Rabbits; Regeneration; Regenerative Medicine; Tissue Engineering; Vocal Cords; Wound Healing

The use of split-thickness skin autografts (STSA) with dermal substitutes is the gold standard treatment for third-degree burn patients. In this article, we tested whether cryopreserved amniotic membranes could be beneficial to the current treatments for full-thickness burns. Swines were subjected to standardised full-thickness burn injuries, and then were randomly assigned to treatments: (a) STSA alone; (b) STSA associated with the dermal substitute, Matriderm; (c) STSA plus human amniotic membrane (HAM); and (d) STSA associated with Matriderm plus HAM. Clinical and histological assessments were performed over time. We also reported the clinical use of HAM in one patient. The addition of HAM to classic treatments reduced scar contraction. In the presence of HAM, skin wound healing displayed high elasticity and histological examination showed a dense network of long elastic fibres. The presence of HAM increased dermal neovascularization, but no effect was observed on the recruitment of inflammatory cells to the wound. Moreover, the use of HAM with classical treatments in one human patient revealed a clear benefit in terms of elasticity. These results give initial evidence to consider the clinical application of HAM to avoid post-burn contractures and therefore facilitate functional recovery after deep burn injury.

Topics: Adult; Amnion; Animals; Burns; Cicatrix; Collagen; Cryopreservation; Dermis; Elasticity; Elastin; Fibroblasts; Humans; Male; Models, Animal; Neovascularization, Physiologic; Skin, Artificial; Swine; Wound Healing

The effect of the "Patient and Observer Scar Assessment Scale" (POSAS) and "Vancouver Scar Scale" (VSS) on patients' quality of life and their correlation with objective scar assessment tools, such as the Cutometer®, is not fully elucidated. In addition, long-term results of the dermal substitute Matriderm® used in combination with split-thickness skin grafting (STSG) remain unclear. We evaluated burn scars of 45 patients at least 2 years postburn injury using the Cutometer® MPA 580, the VSS, and the POSAS with three additional questions regarding quality of life and correlated the results. Study groups were: 1) scars following conservative treatment, 2) scars following STSG, and 3) scars following STSG in combination with Matriderm®. Cutometer® measurements demonstrated better elastic qualities in the Matriderm® group compared with the STSG group. VSS and extended POSAS were rated best for the conservative group, followed by the STSG group and the Matriderm® group. There was a significant correlation between POSAS and VSS, quality of life and the objective Cutometer® measurements. Conservatively treated superficial dermal burns do not reach the elastic qualities of healthy skin, and the use of Matriderm® significantly improves the long-term elastic qualities of STSG in deep dermal and full-thickness burns 2 years post injury. Results from the VSS and the POSAS correlate with restrictions in the quality of life of patients and also with objective Cutometer® measurements and are therefore useful tools in scar evaluation following burn injury.

Topics: Adult; Aged; Aged, 80 and over; Burns; Cicatrix; Collagen; Elastin; Female; Humans; Male; Middle Aged; Quality of Life

The hands are involved in more than 80% of severe (grade IIb-III) burn accidents. Even if appropriate initial surgical care is provided in a timely manner, this does not necessarily guarantee a satisfactory outcome in terms of function and aesthetics if interdisciplinary postoperative care and patient compliance are inadequate. In the following case, a grade IIb-III burn, this led to unstable scars on the back of both hands and an intrinsic-minus hand position, bilaterally. Our case study demonstrates that even a delayed reconstruction with a collagen- elastin-based dermal substitute and split-skin graft combined with appropriate interdisciplinary postoperative care may lead to an excellent result comparable with the function and aesthetics of healthy hands, albeit with a significant effort.. Im Fall von schweren (IIb-III gradigen) Verbrennungen sind die Hände in über 80% mitbeteiligt. Auch die schnellstmögliche und richtige initiale chirurgische Versorgung sichert nicht zwingend ein funktionell und ästhetisch zufriedenstellendes Ergebnis, wenn die interdisziplinäre Nachsorge und Patientencompliance mangelhaft sind. In dem vorliegenden Fall führte dies bei einer IIb-III gradigen Verbrennung beider Hände zu instabilen Narbenverhältnisse im Bereich beider Handrücken sowie einer Intrinsic-minus-Handstellung beidseits. Wir zeigen, dass auch eine sekundäre Versorgung einer Verbrennungsnarbe im Bereich der Hände mit einem Collagen-Elastin-basierten Dermisersatz und nochmaliger Spalthauttransplantation mit dem richtigen interdisziplinären postoperativen Regime zu einem Ergebnis führen kann, das funktionell und ästhetisch einer gesunden Hand entspricht, jedoch mit einem deutlich erhöhtem Aufwand.

Topics: Cicatrix; Collagen; Elastin; Female; Follow-Up Studies; Hand Deformities, Acquired; Hand Injuries; Humans; Plastic Surgery Procedures; Postoperative Complications; Reoperation; Skin Transplantation; Wound Healing; Young Adult

Bombyx mori silk fibroin (BMSF) as biopolymer has been extensively explored in wound healing applications. However, limited study is available on the potential of silk fibroin (SF) from non-mulberry (Antheraea assama and Philosamia ricini) silk variety. Herein, we have developed non-mulberry SF (NMSF) based electrospun mats functionalized with epidermal growth factor (EGF) and ciprofloxacin HCl as potential wound dressing. The NMSF based mats exhibited essential properties of wound dressing like biocompatibility, high water retention capacity (440%), water vapor transmission rate (∼2330gm. A facile fabrication of a ready-to-use bioactive wound dressing capable of concomitantly accelerating the healing process as well as deposition of the extracellular matrix (ECM) to circumvent further scarring complicacies has become a focal point of research. In this backdrop, our present work is based on non-mulberry silk fibroin (NMSF) electrospun antibiotic loaded semi-occlusive mats, mimicking the ECM of skin in terms of morphology, topology, microporous structure and mechanical stiffness. Regulation of ECM deposition and isotropic orientation evinced the potential of the mat as an instructive platform for skin regeneration. The unique peptide motifs of NMSF assisted the augmented recruitment of fibroblast, keratinocytes and endothelial cells leading to accelerated wound healing. Early progression of mature granulation, faster re-epithelialization and angiogenesis in the wounds in in vivo rabbit model forwarded the blended nanofibrous mats of NMSF and PVA ferrying EGF, apt for scarless healing.

Topics: Animals; Anti-Bacterial Agents; Cell Proliferation; Cell Shape; Cell Survival; Cicatrix; Collagen; Drug Liberation; Elastin; Epidermal Growth Factor; Extracellular Matrix; Fibroblasts; Fibroins; Humans; Implants, Experimental; Mice; Microbial Sensitivity Tests; Microscopy, Atomic Force; Morus; Nanofibers; Rabbits; Steam; Subcutaneous Tissue; Wound Healing

This study investigated the recovery process during which grafted cultured epithelium generated skin elasticity and skin surface microarchitecture. The subjects were 18 patients whose burn scars were excised at a depth not exposing the fat layer and who subsequently received cultured epithelial autografts. A total of 24 samples were obtained from the grafted sites: 6 samples within 6 weeks (stage 1), 5 samples after 6 weeks and within 6 months (stage 2), 6 samples after 6 months and within 18 months (stage 3) and 7 samples beyond 18 months (stage 4) of transplantation. These samples were evaluated by taking replicas of skin surface, and histological changes of fibrillin-1 and elastin. The expression patterns were classified using a grading scale. The grade of skin surface texture was significantly higher at stage 3 and marginally significantly higher at stage 4 compared with stage 1. The grade of fibrillin-1 was marginally significantly higher at stage 3 and significantly higher at stage 4 compared with stage 1. The grade of elastin was marginally significantly higher at stage 4 compared with stage 1. These results showed that it is important for patients to have skin care and avoid external forces for at least 18 months after transplantation.

Topics: Adolescent; Adult; Aged; Burns; Cells, Cultured; Cicatrix; Elasticity; Elastin; Epithelium; Female; Fibrillin-1; Humans; Male; Middle Aged; Skin; Transplantation, Autologous; Treatment Outcome; Wound Healing; Young Adult

To prospectively evaluate an elastin-specific MR contrast agent (ESMA) for in vivo targeting of elastic fibers in myocardial infarction (MI) and postinfarction scar remodeling.. MI was induced in C57BL/6J mice (n=40) by permanent ligation of the left anterior descending coronary artery. MRI was performed at 7 and 21 days after MI. The merits of gadolinium-based ESMA (Gd-ESMA) were compared with gadopentetic acid (Gd-DTPA) for infarct size determination, contrast-to-noise ratio (CNR), and enhancement kinetics. Specific binding in vivo was evaluated by blocking the molecular target using nonparamagnetic lanthanum-ESMA. In vivo imaging results were confirmed by postmortem triphenyltetrazolium chloride staining, elastica van Gieson staining, and Western blotting. Delayed enhancement MRI revealed prolonged enhancement of Gd-ESMA in the postischemic scar compared with Gd-DTPA. Infarct size measurements showed good agreement between Gd-ESMA and Gd-DTPA and were confirmed by ex vivo triphenyltetrazolium chloride staining. Preinjection of the blocking lanthanum-ESMA resulted in significantly lower CNR of Gd-ESMA at the infarct site (P=0.0019). Although no significant differences in CNR were observed between delayed enhancement imaging and Gd-DTPA between days 7 and 21 (1.8± versus 3.8; P=ns), Gd-ESMA showed markedly higher CNR on day 21 after MI (14.1 versus 4.9; P=0.0032), which correlated with increased synthesis of tropoelastin detected by Western blot analysis and histology. Higher CNR values for Gd-ESMA further correlated with improved ejection fraction of the mice on day 21 after MI.. Gd-ESMA enables targeting of elastin within the infarct scar in a mouse model of MI. The imaging properties of Gd-ESMA allow quantification of intrascar elastin content in vivo and thereby provide potential for noninvasive characterization of postinfarction scar remodeling.

Topics: Animals; Cicatrix; Contrast Media; Coronary Vessels; Disease Models, Animal; Elastic Tissue; Elastin; Female; Follow-Up Studies; Gadolinium DTPA; Magnetic Resonance Imaging, Cine; Mice; Mice, Inbred C57BL; Myocardial Infarction; Myocardium; Predictive Value of Tests; Prospective Studies; Time Factors

Wounds of both the oral mucosa and early-to-mid gestation foetuses have a propensity to heal scarless. Repair of skin wounds in adults, however, regularly results in scar formation. The extracellular matrix (ECM) plays an important role in the process of healing. The fate of scarless or scar forming healing may already be defined by the ECM composition, prior to wounding. In this study, the presence of several ECM components in oral mucosa (palatum) and skin was investigated.. Immunohistochemical stainings of different ECM components were performed on skin, obtained from abdominal dermolipectomy surgery, and oral mucosa, derived after pharynx reconstruction.. Expression of fibronectin, its splice variant ED-A, and chondroitin sulphate was elevated in oral tissue, whereas elastin expression was higher in skin. Tenascin-C, hyaluronic acid, biglycan, decorin, and syndecan-1 were expressed at similar levels in both tissues. Oral mucosa contained more blood vessels than skin samples. Finally, oral keratinocytes proliferated more, while dermal keratinocytes demonstrated higher differentiation.. Comparing ECM components of the skin and oral mucosa coincides with differences earlier observed between foetal and adult skin, and this might indicate that some ECM components are involved in the mode of repair.

Topics: Adult; Biglycan; Biomarkers; Child; Chondroitin Sulfates; Cicatrix; Decorin; Elastin; Extracellular Matrix; Female; Fibronectins; Humans; Hyaluronic Acid; Immunoenzyme Techniques; Keratinocytes; Male; Mouth Mucosa; Skin; Syndecan-1; Tenascin; Wound Healing

Ablative fractional lasers can effectively treat acne scars and enlarged pores, but cause considerable pain and downtime for patients, as well as potentially causing postinflammatory hyperpigmentation (PIH), especially in Asian skin.. To evaluate the efficacy of a novel bipolar radiofrequency (RF)-based fractional device to treat acne scars and enlarged pores in Asians with objective measurements and histologic assessments.. Thirty-one Korean patients with acne scars and enlarged pores received 4 consecutive fractional RF treatments at 3-week intervals. Outcome assessments included photography, global evaluation by investigators in a blind manner, patient assessment, objective biophysical measurements of elasticity and color, and histological changes compared with untreated lesions.. Follow-up assessments by physicians 3 months after the last treatment revealed that patients showed clinical improvement. Patient self-assessments paralleled physicians' assessments. Objective biophysical measurements showed significant improvements in elasticity (R2, R5, and R7) and the melanin/erythema index, together with increases in the levels of procollagen Types I and III, as well as elastin. There were no cases of PIH, and adverse events were limited to mild ones.. Fractional bipolar RF provides clinical efficacy with safety in acne scars and enlarged pores through dermal matrix remodeling combined with tolerable epidermal ablation.

Topics: Acne Vulgaris; Adult; Asian People; Cicatrix; Collagen Type I; Collagen Type II; Dose Fractionation, Radiation; Elasticity; Elastin; Erythema; Face; Female; Humans; Male; Patient Satisfaction; Pigmentation; Radio Waves; Radiofrequency Therapy; Republic of Korea; Single-Blind Method; Skin; Young Adult

Skin grafts with an artificial dermis have been widely used as a part of the efforts to minimize contractures and reduce donor-site scars. We conducted a prospective randomized clinical trial to study the effect of a dermal substitute by measuring the size of the graft after surgery for months.. The artificial dermis (Matriderm, Dr. Suwelack Skin and Health Care AG, Billerbeck, Germany) was applied in combination with a split-thickness autograft in 40 patients with acute burn wounds or scar reconstruction. Demographic and medical data were collected on each patient. We directly measured the graft size by using a transparent two-ply film (Visitrak Grid, Smith & Nephew Wound Management, Inc, Largo, FL, USA) intraoperatively and 1, 2, 3, and 6 months postoperatively. For effective data comparison, the size of the graft at the time of surgery was taken to be "100%." Then, the size in each phase was estimated in percentage (%).. During the 1st month, the average size was 89%. The figure decreased to 86% and 82% in the 2nd and 3rd months, respectively. In the 6th month, it slightly rebounded to 85% but failed to return to the original state. The size of patients with acute burns was smaller than the size of scar patients as follows: 85-91% in the 2nd month, 81-87% in the 3rd month, and 85-96% in the 6th month.. This study examined the progress of skin grafts through the measurement of graft size in the human body. The grafted skin underwent contracture and remodeling for 3-6 months. In terms of skin contraction, an acute burn was more serious than scar reconstruction. The use of an artificial dermis that contains elastin is very effective from the functional and esthetic perspective by minimizing contractures and enhancing skin elasticity.

Topics: Adolescent; Adult; Burns; Child; Child, Preschool; Cicatrix; Collagen; Contracture; Elastin; Female; Humans; Infant; Male; Middle Aged; Organ Size; Postoperative Complications; Skin; Skin Transplantation; Skin, Artificial; Treatment Outcome; Young Adult

After a myocardial infarction, thinning and expansion of the fibrotic scar contribute to progressive heart failure. The loss of elastin is a major contributor to adverse extracellular matrix remodelling of the infarcted heart, and restoration of the elastic properties of the infarct region can prevent ventricular dysfunction. We implanted cells genetically modified to overexpress elastin to re-establish the elastic properties of the infarcted myocardium and prevent cardiac failure. A full-length human elastin cDNA was cloned, subcloned into an adenoviral vector and then transduced into rat bone marrow stromal cells (BMSCs). In vitro studies showed that BMSCs expressed the elastin protein, which was deposited into the extracellular matrix. Transduced BMSCs were injected into the infarcted myocardium of adult rats. Control groups received either BMSCs transduced with the green fluorescent protein gene or medium alone. Elastin deposition in the infarcted myocardium was associated with preservation of myocardial tissue structural integrity (by birefringence of polarized light; P < 0.05 versus controls). As a result, infarct scar thickness and diastolic compliance were maintained and infarct expansion was prevented (P < 0.05 versus controls). Over a 9-week period, rats implanted with BMSCs demonstrated better cardiac function than medium controls; however, rats receiving BMSCs overexpressing elastin showed the greatest functional improvement (P < 0.01). Overexpression of elastin in the infarcted heart preserved the elastic structure of the extracellular matrix, which, in turn, preserved diastolic function, prevented ventricular dilation and preserved cardiac function. This cell-based gene therapy provides a new approach to cardiac regeneration.

Topics: Adenoviridae; Animals; Cardiomegaly; Cicatrix; Cloning, Molecular; Diastole; Elastin; Extracellular Matrix; Female; Genetic Therapy; Genetic Vectors; Heart; Heart Failure; Mesenchymal Stem Cells; Myocardial Infarction; Organisms, Genetically Modified; Rats; Rats, Inbred Lew

Reconstruction of full-thickness defects may benefit from integration of dermal substitutes, which serve as a foundation for split-thickness skin grafts, thus enhancing short and long-term results. We present a series of 7 patients who were treated between 2010 and 2012 for complicated full-thickness defects by the second-generation collagen/elastin matrix Matriderm® covered by a split-thickness skin graft. The defects resulted from malignancy resection, trauma, and post-burn scar reconstruction. Overall graft take was excellent and no complications were noted regarding the dermal substitute. Graft quality was close to normal skin in terms of elasticity, pliability, texture, and color. Good contour and cushioning of defects in weight bearing areas was also achieved. Matriderm was found to be a useful adjunct to full-thickness defect reconstruction, especially in difficult areas where the desired result is a scar of the highest quality possible.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Animals; Burns; Cattle; Cicatrix; Collagen; Elasticity; Elastin; Face; Female; Follow-Up Studies; Humans; Male; Middle Aged; Neoplasms; Plastic Surgery Procedures; Skin Transplantation; Skin, Artificial; Treatment Outcome; Wounds and Injuries; Young Adult

Various modalities have been used to treat scars, but limited efficacy and problematic side effects have restricted their application.. To determine the effectiveness and safety of fractional photothermolysis treatment of various atrophic scars in Korean patients.. Fifty-nine patients with atrophic scars (caused by acne, trauma, herpes zoster, and burns) were treated with fractional photothermolysis using either Fraxel™ SR 750 or Fraxel™ SR 1500 instruments. Each patient underwent one to three treatment sessions 3-4 weeks apart. The assessment of treatment response was conducted by three dermatologists, who independently evaluated a series of photographs using a quartile grading scale. Skin biopsies were taken before treatment and 4 weeks after the final treatment, and were examined for procollagen-1, matrix metalloproteinase-1 (MMP-1), and elastin by immunofluorescence staining.. Four weeks after the final treatment, the mean overall improvement in objective grade was 2.0 when the Fraxel SR 750 was employed and 2.9 when the Fraxel SR 1500 was used. Confocal microscopy revealed an increase in procollagen-1 in dermis, with no difference or a slight increase in the levels of elastin and MMP-1. Side effects were minimal.. After short-term follow-up, fractional photothermolysis appeared to be a safe and effective option for atrophic scar treatment of Asian skin.

Topics: Adolescent; Adult; Asian People; Child; Child, Preschool; Cicatrix; Collagen Type I; Elastin; Female; Fluorescent Antibody Technique; Humans; Laser Therapy; Male; Matrix Metalloproteinase 1; Microscopy, Confocal; Middle Aged; Skin; Treatment Outcome; Young Adult

Scar margins dynamic with time were quantitatively characterized using multiphoton microscopy (MPM). 2D large-area and 3D focused images of elastin and collagen at scar margins were obtained to extract quantitative parameters. An obvious boundary was observed at the scar margin, showing altered morphological patterns of elastin and collagen on both sides. Content alteration of elastin and collagen between the two sides of boundary were defined to characterize scar margins from different individuals. The statistical results from 15 normal scar samples strongly demonstrated that content alteration degree of elastin and collagen had decreasing tendency with the increase of patient age or scar duration, consistent with the fact of normal scars regressing spontaneously over time. It indicated that alteration degree can potentially serve as quantitative indicators to examine wound healing and scar progression over time. With the advent of clinical portable multiphoton endoscopes, the MPM technique can be applied in tracking scar formation and progression in vivo by examination of scar margin.

Topics: Abdominal Wall; Adult; Cicatrix; Collagen; Elastin; Female; Humans; Microscopy, Fluorescence, Multiphoton; Middle Aged; Skin; Time Factors; Wound Healing

Congestive heart failure developing after acute myocardial infarction (AMI) is a major cause of morbidity and mortality. Clinical trials of cell-based therapy after AMI evidenced only a moderate benefit. We could show previously that suspensions of apoptotic peripheral blood mononuclear cells (PBMC) are able to reduce myocardial damage in a rat model of AMI. Here we experimentally examined the biochemical mechanisms involved in preventing ventricular remodelling and preserving cardiac function after AMI. Cell suspensions of apoptotic cells were injected intravenously or intramyocardially after experimental AMI induced by coronary artery ligation in rats. Administration of cell culture medium or viable PBMC served as controls. Immunohistological analysis was performed to analyse the cellular infiltrate in the ischaemic myocardium. Cardiac function was quantified by echocardiography. Planimetry of the infarcted hearts showed a significant reduction of infarction size and an improvement of post AMI remodelling in rats treated with suspensions of apoptotic PBMC (injected either intravenously or intramoycardially). Moreover, these hearts evidenced enhanced homing of macrophages and cells staining positive for c-kit, FLK-1, IGF-I and FGF-2 as compared to controls. A major finding in this study further was that the ratio of elastic and collagenous fibres within the scar tissue was altered in a favourable fashion in rats injected with apoptotic cells. Intravenous or intramyocardial injection of apoptotic cell suspensions results in attenuation of myocardial remodelling after experimental AMI, preserves left ventricular function, increases homing of regenerative cells and alters the composition of cardiac scar tissue. The higher expression of elastic fibres provides passive energy to the cardiac scar tissue and results in prevention of ventricular remodelling.

Topics: Animals; Apoptosis; Cells, Cultured; Cicatrix; Collagen; Echocardiography; Elastin; Humans; Leukocytes, Mononuclear; Male; Myocardial Infarction; Myocardium; Rats; Rats, Sprague-Dawley; Suspensions; Ventricular Remodeling

High-resolution, high-contrast, three-dimensional images of live cell and tissue architecture can be obtained using second harmonic generation (SHG), which comprises non-absorptive frequency changes in an excitation laser line. SHG does not require any exogenous antibody or fluorophore labeling, and can generate images from unstained sections of several key endogenous biomolecules, in a wide variety of species and from different types of processed tissue. Here, we examined normal control human skin sections and human burn scar tissues using SHG on a multi-photon microscope (MPM). Examination and comparison of normal human skin and burn scar tissue demonstrated a clear arrangement of fibers in the dermis, similar to dermal collagen fiber signals. Fluorescence-staining confirmed the MPM-SHG collagen colocalization with antibody staining for dermal collagen type-I but not fibronectin or elastin. Furthermore, we were able to detect collagen MPM-SHG signal in human frozen sections as well as in unstained paraffin embedded tissue sections that were then compared with hematoxylin and eosin staining in the identical sections. This same approach was also successful in localizing collagen in porcine and ovine skin samples, and may be particularly important when species-specific antibodies may not be available. Collectively, our results demonstrate that MPM SHG-detection is a useful tool for high resolution examination of collagen architecture in both normal and wounded human, porcine and ovine dermal tissue.

Topics: Animals; Burns; Child; Cicatrix; Collagen Type I; Elastin; Epidermis; Female; Fetus; Fibronectins; Humans; Microscopy, Fluorescence, Multiphoton; Sheep; Swine

This study aims to evaluate percutaneous collagen induction (PCI) in post-burn scarring.. Patients with scarring after burn frequently request help in improving the aesthetic appearance of their residual cicatricial deformity. Their scars are generally treated by tissue transfer, W- and Z-plasties, flaps, cortisone injections or ablative procedures that injure or destroy the epidermis and its basement membrane and subsequently lead to fibrosis of the papillary dermis. The ideal treatment would be to preserve the epidermis and promote normal collagen and elastin formation in the dermis.. A total of 16 consecutive patients (average age: 37+/-15.5 years, average body mass index (BMI): 25.7) in Germany with post-burn scarring.. PCI using the Medical Roll-CIT (Vivida, Cape Town, South Africa). This device was designed to multiply-puncture the skin to the level of the dermal scar to institute remodelling. Patients were prepared with topical vitamin A and C cosmetic creams for a minimum of 4 weeks preoperatively to maximise collagen stimulation.. The outcome was measured rating (visual analogue scale (VAS) and Vancouver Scar Scale (VSS)), histological specimen 12 months after intervention.. On average, patients rated their improvement as a mean of 80% better (+/-15.5) than before treatment. Histologic examination revealed considerable increase in collagen and elastin deposition 12 months postoperatively. The epidermis demonstrated 45% thickening of stratum spinosum and normal rete ridges as well as the normalisation of the collagen/elastin matrix in the reticular dermis at 1 year postoperatively.. This pilot study shows that PCI appears to be a safe method for treating post-burn scarring without destroying the epidermis. The procedure can be repeated safely and is also applicable in regions where laser treatments and deep peels are of limited use. However, it is necessary to initiate an efficacy trial to prove the data of this pilot study.

Topics: Administration, Topical; Adult; Ascorbic Acid; Burns; Cicatrix; Cohort Studies; Collagen; Elastin; Epidermis; Female; Humans; Male; Middle Aged; Pain Measurement; Patient Satisfaction; Pilot Projects; Preoperative Care; Punctures; Vitamin A

Mouse experimental models are commonly utilized tools in biomedical research but remain underrepresented in vocal fold biology, presumably due to the small size of the larynx and limited description of the anatomical, cellular and extracellular composition of the vocal folds. In this study, we provide a whole-mount serial section-based histological description of vocal fold morphology of wild-type FVB strain mice, alongside a histological and immunohistochemical (IHC)-based quantitative analysis of extracellular matrix (ECM) alteration 1, 7, 14, 28, 42 and 56 days following unilateral vocal fold injury. IHC was specific for procollagen type I, collagen type I, collagen type III, collagen type IV, elastin, decorin, fibronectin and hyaluronic acid binding protein 2. The histological description confirmed the presence of a laryngeal alar structural complex in the mouse, which appears to be a morphological feature unique to rodents. The lamina propria appeared uniform without evidence of a distinct layer structure as has been reported in larger animals and humans. Time-dependent alterations in vocal fold morphology, ECM organization and ECM protein/glycoconjugate abundance were observed in injured vocal folds compared to control. The presence of a mature scar was observed between 28 and 42 days postinjury. Morphological and ECM changes following vocal fold injury in the mouse were generally consistent with those reported in other animal models, particularly the rat, although wound repair in the mouse appears to occur at a faster rate.

Topics: Animals; Cicatrix; Collagen Type I; Collagen Type III; Collagen Type IV; Decorin; Disease Models, Animal; Elastin; Extracellular Matrix; Extracellular Matrix Proteins; Fibronectins; Immunohistochemistry; Mice; Rats; Rats, Sprague-Dawley; Serine Endopeptidases; Vocal Cords; Wound Healing

We have shown that the steroid hormone aldosterone, recognized for its action on the kidney and the cardiovascular system, also modulates deposition of extracellular matrix in human skin. We have shown that treatment of primary cultures of normal skin fibroblasts with aldosterone (10 n-1 μM), in addition to stimulation of collagen type I expression, induces elastin gene expression and elastic fiber deposition. We have further shown that the elastogenic effect of aldosterone, which can be enhanced in the presence of mineralocorticoid receptor (MR) antagonists spironolactone and eplerenone, is executed in a MR-independent manner via amplification of IGF-I receptor-mediated signaling. Because aldosterone applied alone stimulates both collagen and elastin deposition in cultures of fibroblasts and in cultures of skin explants derived from dermal stretch marks, we postulate that this steroid should be used in the treatment of damaged skin that loses its volume and elasticity. Moreover, aldosterone applied in conjunction with spironolactone or eplerenone induces matrix remodeling and exclusively enhances elastogenesis in cultures of fibroblasts and explants derived from dermal scars and keloids. We therefore propose that intra-lesional injection of these factors should be considered in therapy for disfiguring dermal lesions and especially in prevention of their recurrence after surgical excision.

Topics: Adult; Aldosterone; Biopsy; Cells, Cultured; Cicatrix; Collagen Type I; Elasticity; Elastin; Eplerenone; Extracellular Matrix; Female; Fibroblasts; Gene Expression; Humans; Keloid; Mineralocorticoid Receptor Antagonists; Organ Culture Techniques; Receptor, IGF Type 1; RNA, Messenger; Skin; Spironolactone; Up-Regulation

The goal of this study was to develop a surgical method for the creation of vocal fold injuries in mice, as a precursor to the use of genetically engineered mouse models in the study of vocal fold wound healing and scar formation.. Seven FVB strain mice were used in this study. A laryngoscope and 3 micro-instruments were designed and fabricated to facilitate endoscopic vocal fold visualization and the creation of vocal fold surgical injuries. The larynges were harvested 1 and 7 days after surgery, and the vocal fold injury sites were evaluated by routine hematoxylin and eosin staining. Additional immunohistochemical analysis of collagen type I and elastin distribution in the lamina propria was performed for an uninjured control larynx.. Endoscopic visualization and vocal fold stripping resulting in thyroarytenoid muscle exposure were successful in all animals. Histologic and immunohistochemical analyses revealed a simple lamina propria structure with relatively even collagen type I and elastin distribution in the control vocal fold, obliteration of vocal fold mucosa 1 day after surgery, and complete reepithelialization by 7 days.. These results demonstrate the feasibility of creating reproducible vocal fold injuries via an endoscopic approach in mice. The observation that the mouse lamina propria may have a relatively simple histologic structure indicates that additional characterization should be performed and caution used in translating findings between this and other model systems.

Topics: Animals; Cicatrix; Collagen Type I; Disease Models, Animal; Elastin; Follow-Up Studies; Immunohistochemistry; Laryngeal Diseases; Laryngoscopy; Male; Mice; Mice, Inbred Strains; Mucous Membrane; Vocal Cords; Wound Healing

Vocal fold scarring remains a significant problem. Although several animal models have been developed to improve our understanding of the histopathology, the histologic features of scarred human vocal folds have rarely been reported. The present case studies aimed to define the histologic changes of scarred human vocal folds caused by cordectomy or cordotomy. Ten patients with the scarred vocal folds were involved in this study. Nine patients with early glottic cancer underwent endoscopic cordectomy, and one patient underwent superficial cordotomy for idiopathic scar. The postcordectomy or cordotomy scar was biopsied or resected 3-13 months after the original procedure. After confirming absence of any tumor in cancer patients, the remaining specimens were used in the present study. Histologic examination investigated deposition of extracellular matrix (ECM) including collagen, elastin, hyaluronic acid (HA), fibronectin, and decorin in the lamina propria of the scarred vocal folds. There was a wide range of variation in the deposition of ECM in scarred vocal folds. Excessive and disorganized collagen deposition was observed in most cases that had undergone deep resection of the lamina propria, whereas deposition of collagen was mild and well organized after superficial resection. Decorin was retained in all cases after superficial cordectomy or cordotomy, but varied after deep resection. Deposition of elastin, HA, and fibronectin varied regardless of depth of injury. Histology of scarred vocal folds may vary with degree of injury and individual healing mechanism.

Topics: Adult; Aged; Arthritis, Rheumatoid; Cicatrix; Collagen; Decorin; Elastin; Extracellular Matrix; Extracellular Matrix Proteins; Female; Fibronectins; Humans; Hyaluronic Acid; Immunohistochemistry; Laryngeal Neoplasms; Male; Middle Aged; Proteoglycans; Vocal Cords

Adherent scars on the hand often lead to a major functional impairment and an aesthetic deformity. The rate of recurrence after scar correction is usually very high. A 57-year-old woman with an adherent scar on the back of her hand and major functional impairment was successfully treated with Matriderm. Using Matriderm as an additional layer between the atrophic skin and the tendons adherency of the scar could be prevented. One year after surgery the patient is free of pain. There is normal mobility between the skin and the underlying tissue. Complete wrist flexion and extension could be achieved. To the best of our knowledge this is the first case reported of using Matriderm for the correction of a scar that was caused by the paravasal injection of cytostatic drugs.

Topics: Absorbable Implants; Antineoplastic Agents; Breast Neoplasms; Cicatrix; Collagen; Dermatologic Surgical Procedures; Drug Eruptions; Elastin; Extravasation of Diagnostic and Therapeutic Materials; Female; Hand; Hand Deformities, Acquired; Humans; Infusions, Intravenous; Middle Aged; Postoperative Complications; Reoperation; Skin; Skin, Artificial; Suture Techniques; Tissue Adhesions

Vocal fold scarring is the major cause of voice disorders after voice surgery or laryngeal trauma. The role of inflammatory factors in vocal fold wound healing and fibrosis has not been adequately investigated. Scarless wound healing has been associated with decreased inflammatory responses. To understand scar formation and develop reliable treatments, it is necessary to control extracellular matrix production and inflammation. Thus, we examined the inflammation profile and extracellular matrix production in wounded vocal folds in the acute phase of wound healing.. Vocal fold stripping was performed on 30 Sprague-Dawley rats. Vocal fold tissue was collected at 5 time points (4, 8, 16, 24, and 72 hours). We examined the in vivo messenger RNA expression profile of inflammatory factors interleukin 1beta, interferon gamma, tumor necrosis factor alpha, nuclear factor kappa beta, transforming growth factor beta, and cyclooxygenase 2, as well as hyaluronic acid synthases 1 and 2, procollagen subtypes I and III, and elastin synthase in scarred vocal folds after injury, compared to normal vocal folds, using real-time reverse transcription-polymerase chain reaction.. The inflammatory factors showed a time-dependent sequence of expression peaks, starting with interleukin 1beta, nuclear factor kappa beta, tumor necrosis factor alpha (4 and 8 hours), and transforming growth factor beta (72 hours). Interferon gamma decreased at 24 hours. Correspondingly, hyaluronic acid synthase 1 expression peaked first (4 and 8 hours), whereas hyaluronic acid synthase 2 expression peaked at 16 hours and again at 72 hours. Procollagen I expression peaked at 72 hours, whereas procollagen III decreased from 8 to 16 hours but peaked at 72 hours. Cyclooxygenase 2 expression was elevated, whereas elastin expression remained constant.. The results show a clear profile of vocal fold inflammation with corresponding changes in extracellular matrix production.

Topics: Animals; Cicatrix; Collagen Type I; Collagen Type III; Cyclooxygenase 2; Cytokines; Elastin; Glucuronosyltransferase; Hyaluronan Synthases; Male; Rats; Rats, Sprague-Dawley; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger; Time Factors; Vocal Cords

Ventricular dilation after myocardial infarction can cause heart failure. Increasing strength and elasticity in the infarct region might prevent ventricular dilation. Because elastin provides strength, extensibility, and resilience to tissues and maintains tissue architecture, we studied the effect of elastin expression in the infarct on scar expansion and heart function. COS-7 cells transfected with a plasmid with an elastin gene fragment or a vector were seeded into a Gelfoam mesh and cultured. Mechanical stretch test (n = 5/group) showed that the elastin mesh was more elastic (P < 0.05) and tensile (P < 0.05) than the vector mesh. In an in vivo study in rats, 6 days after left anterior descending coronary artery ligation, COS-7 cells (Cell group, n = 7) or COS-7 cells with elastin gene (Elastin group, n = 9) or vector (Vector group, n = 9) were transplanted into the infarct; infarcted rats served as controls (n = 7). Over 8 wk the Cell group did not demonstrate effects on scar expansion and deterioration of heart function vs. controls. In contrast, infarct expansion was smaller and heart function was better maintained in the Elastin group vs. the Vector group (P < 0.05). At 8 wk after cell transplantation Langendorff data showed that the Elastin group had greater (P < 0.01) developed pressure and a smaller left ventricular volume than the Vector group. Western blot and histology showed accumulated elastin in the Elastin group infarct. Changing the extracellular matrix composition of a myocardial infarct by increasing elastin fragment content attenuated scar expansion, ventricular dilation, and onset of heart dysfunction.

Topics: Animals; Aorta; Base Sequence; Chlorocebus aethiops; Cicatrix; COS Cells; DNA Primers; Elastin; Extracellular Matrix; Genetic Vectors; Heart; Myocardial Infarction; Peptide Fragments; Rats; Recombinant Proteins; Reverse Transcriptase Polymerase Chain Reaction; Transfection

After a myocardial infarction, the injured region becomes fibrotic and the myocardial scar may expand if the ventricular wall lacks elasticity. Cardiac dilatation may precipitate the vicious cycle of progressive heart failure. The present study evaluated the functional benefits of increasing elastin within a myocardial scar using cell based gene therapy.. A myocardial infarction was generated by ligation of the left anterior descending artery in rats. Six days later, 2 x 10(6) syngeneic rat endothelial cells transfected with the rat elastin gene (elastin group, n=14) or an empty plasmid (control group, n=14) were transplanted into the infarct scar. Cardiac function, left ventricular (LV) volume, and infarct size were monitored over 3 months by echocardiography, Langendorff measurements, and planimetry. Elastin deposition was evaluated in the cells and in the infarct region by Western blot assay and by histological examination. Recombinant elastin was found in the scar in the elastin group but not the control group during the 3 months after cell transplantation. Histological assessment demonstrated organized elastic fibers within the infarct region. LV volume and infarct size were significantly smaller (P<0.05) in the elastin group than in the control group. Cardiac function evaluated by echocardiography and during Langendorff perfusion was significantly better (P<0.05) in the elastin group than in the control group.. Expressing recombinant elastin within the myocardial scar reduced scar expansion and prevented LV enlargement after a myocardial infarction. Altering matrix remodeling after an infarct preserved the LV function for at least 3 months.

Topics: Animals; Cells, Cultured; Cicatrix; Drug Evaluation, Preclinical; Elastin; Endothelial Cells; Extracellular Matrix; Genetic Therapy; Heart Failure; Hypertrophy, Left Ventricular; Male; Myocardial Infarction; Myocardium; Random Allocation; Rats; Rats, Inbred Lew; Recombinant Fusion Proteins; Single-Blind Method; Transfection; Ultrasonography; Ventricular Function, Left; Ventricular Remodeling

The purpose of the current study was to assess the histologic and rheologic properties of the scarred vocal fold lamina propria during a chronic phase of wound repair in a rabbit model. Eighteen rabbit larynges were scarred using a procedure that involved stripping the vocal fold lamina propria down to the thyroarytenoid muscle, using 3-mm microforceps. The approximate dimension of injury to the vocal fold was 3 x 1.5 x 0.5 mm [length x width x depth]. At 6 months postoperatively, histologic analysis of the scarred and control lamina propria in eight of these rabbits was completed for collagen, procollagen, elastin, and hyaluronic acid. Compared with control samples, scarred tissue samples revealed fragmented and disorganized elastin fibers. Additionally, collagen was significantly increased, organized, and formed thick bundles in the scarred vocal fold lamina propria. Measurements of the viscoelastic shear properties of the scarred and control lamina propria in the remaining 10 rabbits revealed increased elastic shear modulus (G') in 8 of 10 scarred samples and increased dynamic viscosity (eta') in 9 of 10 scarred samples. Although rheologic differences were not statistically significant, they revealed that on average, scarred samples were stiffer and more viscous than the normal controls. Histologic data are interpreted as indicating that by 6 months postinjury, the scarred rabbit vocal fold has reached a mature phase of wound repair, characterized by an increased, organized, and thick bundle collagen matrix. Rheologic data are interpreted as providing support for the potential role of increased, thick bundle collagen, and a disorganized elastin network on shear stiffness and dynamic viscosity in the chronic vocal fold scar. Based on these results, a 6-month postoperative time frame is proposed for future studies of chronic vocal fold scarring using the rabbit animal model.

Topics: Animals; Chronic Disease; Cicatrix; Collagen; Disease Models, Animal; Elastin; Hyaluronic Acid; Image Processing, Computer-Assisted; Immunohistochemistry; Male; Procollagen; Rabbits; Rheology; Viscosity; Vocal Cords; Wound Healing

The objective was to assess the histological and viscoelastic shear tissue properties of the scarred vocal fold lamina propria at 2 and 6 months postoperatively in a canine model.. Experimental, nonrandomized prospective study.. Six canine larynges were injured using a vocal fold stripping procedure. At 2 and 6 months postoperatively, histological analyses of the scarred and control lamina propria samples were completed for collagen, procollagen, elastin, and hyaluronic acid.. In canines killed at 2 months, scarred tissue samples contained increased procollagen and decreased elastin. Elastin fibers in the scarred lamina propria were characteristically tangled and disorganized. In canines killed at 6 months, scarred tissue samples showed decreased elastin and increased collagen. Collagen fibers formed thick, disorganized bundles, and elastin fibers were disorganized throughout the entire scarred vocal fold lamina propria. Viscoelastic shear tissue measurements revealed increased stiffness and viscosity in one of three cases at 2 months and in all three cases at 6 months, indicating increased stiffness and resistance to shear flow during oscillatory shear deformation for scarred tissue samples. No differences were observed between the two postoperative times.. Results indicated that viscoelastic tissue changes may take place before scar maturation in the scarred vocal fold lamina propria and that, although abundant collagen deposition may influence viscoelastic shear tissue properties, disorganization of collagen and elastin fibers, thick bundle collagen formation, or the interplay of several of these factors might also play a contributing role.

Topics: Animals; Cicatrix; Collagen; Dogs; Elastin; Hyaluronic Acid; Male; Procollagen; Prospective Studies; Rheology; Vocal Cords

Solidity and elasticity are the two main biomechanical properties of pelvic tissues involved in surgical cure of genital prolapse-prevertebral, pectinate, and sacrospinal ligaments, tendinous arcs of the pelvic fascia, vaginal tissue. We report data in the literature and personal studies concerning these autologous biological tissues.. The resistance of pelvic tissues was tested on 29 cadavers. Measurements were also made on two 2-cm samples of vaginal tissue obtained during vaginal route surgery for prolapse cure in 20 menopaused women. Stress tests were conducted to determine resistance and level of rupture.. There was a wide variability in ligament resistance, ranging from a minimum of 22 Newtons to a maximum to the order of 200 Newtons. Results varied greatly from one woman to another and also between the two sides in the same woman. The prevertebral ligament exhibited the greatest resistance. The pectinate ligament was significantly more resistant than the sacrospinal ligaments and the tendinous arcs of the pelvic fascia. There was a significant relationship between the subjective assessment of ligament quality and objective measurements of resistance. For vaginal tissues, resistance varied greatly from 12 Newtons to a maximum to the order of 76 Newtons. Flexion values ranged from 14 to 130 Newtons.. Our findings illustrate pelvic tissue failure observed in patients with genital prolapse. Individual maximal resistance of the pelvic ligaments is vary variable, between ligaments and between subjects, and even between sides in a given subject. Pelvic ligaments used for cure of genital prolapse are moderately resistant with wide interindividual variability. The mechanical properties of vaginal tissue are also very variable, illustrating why these tissues may exhibit a certain resistance against dissociation when exposed to loading but much less resistance when exposed to traction by a surgical suture. These findings suggest a revision of classical surgical procedures.

Topics: Age Factors; Aged; Biomechanical Phenomena; Cadaver; Cicatrix; Collagen; Elasticity; Elastin; Fascia; Female; Humans; Ligaments; Middle Aged; Patient Selection; Prostheses and Implants; Stress, Mechanical; Sutures; Uterine Prolapse; Vagina

Autologous cell transplantation may restore viable muscle after a myocardial infarction. We compared the effect of three cell types or an angiotensin-converting enzyme (ACE) inhibitor on preservation of ventricular function after cardiac injury.. A uniform transmural myocardial scar was created in adult rats by cryoinjury. Three weeks later the rats were randomly assigned to one of four blinded treatments: transplantation with 5 x 10(6) aortic smooth muscle cells (SMC, n = 12), ventricular heart cells (VHC, n = 13), skeletal muscle cells (SKC, n = 13) or culture medium alone (control, n = 11). The ACE inhibitor group (n = 8) received enalapril (1.0 mg/kg per day), also beginning 3 weeks after cryoinjury. Five and 12 weeks after transplantation, left ventricle (LV) function was assessed in a Langendorff apparatus, and histologic and immunohistological evaluation of the LV scars was performed.. At 5 weeks, greater scar elastin content and better LV function was noted with cell transplantation or ACE inhibitor therapy compared with control rats (p < 0.05). Twelve weeks after transplantation, cell-transplanted rats still had greater elastin content and better LV function than control rats, although elastin content and LV function had declined in ACE inhibitor-treated animals to levels below those observed in control rats (p < 0.05).. Transplantation of SMC, VHC, and SKC preserved ventricular function equivalent to the effects of an ACE inhibitor. Muscle cell transplantation, but not ACE inhibitor therapy, continues to be effective later after cryoinjury. No differences were detected between the muscle cells.

Topics: Angiotensin-Converting Enzyme Inhibitors; Animals; Aorta; Cardiac Output, Low; Cell Transplantation; Cells, Cultured; Cicatrix; Cryopreservation; Elastin; Enalapril; Heart Injuries; Heart Ventricles; Immunohistochemistry; Muscle, Skeletal; Muscle, Smooth, Vascular; Myocardial Infarction; Myocardium; Rats; Rats, Inbred Lew; Ventricular Function, Left

Scars are commonly encountered by dermatopathologists and usually do not present a diagnostic challenge. However, in some cases, the pathologist may need to consider a broad differential diagnosis including fibrohistiocytic tumors, smooth muscle tumors, myofibroblastic proliferations and desmoplastic malignant melanoma. Although specific histologic aspects of scars have been well studied, a complete histochemical profile of scars, especially at various stages of evolution, has not been described.. Twenty-five cases of scars including 8 normal scars, 5 hypertrophic scars and 12 keloids were studied. Sections were examined with Verhoeff van Giesson, colloidal iron, Giemsa, smooth muscle actin (SMA), CD34, Factor XIIIa and S-100.. All scars were negative for CD34 expression. Factor XIIIa immunostaining identified only rare dermal dendrocytes. S-100 was absent in 23 of 25 cases and stained scattered cells (less than 10%) in the other 2 cases. SMA was positive in 14 of 25 cases with 6 of these showing staining of up to 50% of spindled cells. Elastic fibers were markedly reduced or absent in all cases, mucin showed moderate or marked staining in three-fourths of the cases and dermal mast cells showed a moderate increase in 5 cases.. These findings confirm prior reports that negative staining with CD34, Factor XIIIa and S-100 can help differentiate scars from dermatofibrosarcoma protuberans, dermatofibroma and desmoplastic malignant melanoma, respectively. SMA staining is much more variable and requires careful interpretation.

Topics: Actins; Adolescent; Adult; Aged; Aged, 80 and over; Biomarkers; Cicatrix; Elastin; Female; Humans; Hypertrophy; Immunoenzyme Techniques; Keloid; Male; Mast Cells; Middle Aged; Mucins

Scarring of the vocal fold causes considerable dysphonia and presents significant treatment challenges. A rabbit model was developed to investigate the histologic ultrastructure and rheologic properties of the scarred vocal fold lamina propria. Eleven rabbit larynges were scarred by means of forcep biopsy. Sixty days postoperatively, the rabbits were sacrificed and their vocal folds were harvested. Histological analysis of the scarred and normal lamina propria was completed for collagen, procollagen, elastin, and hyaluronic acid. Linear viscoelastic shear properties of the tissues were also measured, including elastic shear modulus and dynamic viscosity. Compared to normal vocal fold lamina propria, scarred tissues demonstrated significantly less collagen, an increase in procollagen, and a decrease in elastin. Rheologically, both elastic shear modulus and dynamic viscosity were significantly higher for the scarred tissues. Increased stiffness and viscosity do not appear to result from an increase in collagen, but rather appear to be related to the presence of new, disorganized collagen scaffolding. Results are interpreted in terms of the possible role of interstitial proteins in the etiology of increased stiffness and viscosity, which requires further investigation. This animal model should allow for systematic future investigations of vocal fold scarring and its treatment.

Topics: Animals; Cicatrix; Collagen; Elastin; Hyaluronic Acid; Procollagen; Rabbits; Rheology; Vocal Cords; Wound Healing

Lesions of the anterior cruciate ligament are extremely common and frequently demand surgical treatment in order to avoid disabling sequels. The use of a central one-third of the patellar tendon as an autograft for surgical reconstruction of a damaged cruciate ligament is common. Although several investigations in human and animal models have demonstrated long-term graft viability, there have been cases of loosening and rupture of the graft. In these occasions, a new substitute for the torn structure must be found. Owing to its inherent accessibility, the patellar tendon has been elected one of the choices of donor tissue. In order to evaluate the characteristics of the remaining scar, we performed a histochemical and ultrastructural study using biopsy material obtained from the central one-third of the donor tendon of 8 patients. This material was analyzed by comparing the ultrastructural picture with the results obtained using the specific method for collagen-containing fibers (Picrosirius-polarization) by light microscopy; four normal patellar tendons were used as controls. Despite the resemblance with the normal tissue, our results show that the healed tissue does not restore the tendon ad integrum, neither at the light microscopic nor at the electron microscopic levels. Structural differences can be responsible for biomechanical alterations. Impaired biomechanical properties can, at least partly, explain some of the clinical complications observed in patients submitted to this surgical technique. However, without performing biomechanical studies in this kind of tendons, we are neither allowed to encourage nor to reject the use of scars as donor tissue for a second surgery.

Topics: Cicatrix; Collagen; Elastin; Extracellular Matrix; Humans; Knee Injuries; Patella; Tendons

In full-thickness skin wounds dermal regeneration usually fails, resulting in scar formation and wound contraction. We studied dermal regeneration by implantation of collagenous matrices in a human punch biopsy wound model. Matrices were made of native bovine collagen I fibres, and either hyaluronic acid, fibronectin, or elastin was added. Matrices were placed in 6-mm punch biopsy holes in seven patients (biopsies were used for the grafting of leg ulcers), and covered with a protective semi-permeable polyether urethane membrane. Histology, wound contraction and dermal architecture were studied. Dermal architecture was evaluated using a recently developed laser scatter technique. All collagen matrices showed a tendency to reduce wound contraction, compared with control wounds; elastin- and fibronectin-treated matrices showed significantly less contraction than control wounds. Only the addition of elastin had a clear beneficial effect on dermal architecture; collagen bundles were more randomly organized, compared with control wounds, and wounds treated with collagen matrices coated with fibronectin or hyaluronic acid, or without coating. We conclude that the punch biopsy wound model provides important information on dermal regeneration in humans. Native collagen matrices with elastin contributed to dermal regeneration and reduced wound contraction, in contrast with matrices coated with fibronectin or hyaluronic acid, or without coating. Future clinical studies of large-area, full-thickness wounds will be required to establish their clinical relevance for leg ulcer and burn treatment.

Topics: Aged; Aged, 80 and over; Biopsy; Cicatrix; Collagen; Elastin; Fibronectins; Humans; Hyaluronic Acid; Immunohistochemistry; Lasers; Scattering, Radiation; Skin; Wound Healing

Elastosis perforans serpiginosa (EPS) is an uncommon skin disease characterized by transepidermal elimination of abnormal elastic fibers. The disease is frequently associated with congenital connective tissue disorders or Down's syndrome. The pathogenesis of EPS is still unclear. There are a few reports in the literature about a familial occurrence of EPS in which different modes of inheritance are suggested. To support the hypothesis of a congenital origin of the disease, we have studied another family with EPS.. In this study, we describe a family in which two sisters and a brother were affected by EPS. The father and three paternal uncles were most probably affected by the same disease. There were no signs of other congenital connective tissue disease in the family members.. An autosomal dominant mode of inheritance with variable expression of EPS is suggested.

Topics: Adult; Aged; Atrophy; Cicatrix; Connective Tissue Diseases; Elastic Tissue; Elastin; Female; Humans; Keratins; Keratosis; Male; Middle Aged; Neck; Skin Diseases

The histopathology of striae distensae is disputed; different authorities give contradictory accounts of the microscopic changes, especially in elastic fibres. We re-evaluated the problem by taking eight elliptical biopsies across striae. Six were examined by light microscopy with appropriate stains for elastin and collagen. Two were prepared for scanning electronmicroscopy (s.e.m.), using a procedure which removes collagen, enabling the elastic network to be seen in its native form. By light microscopy, striae were sharply demarcated from normal skin, consisting mainly of fine, straight bundles of collagen arranged parallel to the surface. Fine elastic fibres were disposed similarly without fragmentation, fraying or curling. By s.e.m., the elastic network was found to be extraordinarily dense and well developed with many fine, curled fibres in random array. It was evident that the routine stains for elastin greatly underestimated the abundance of elastic fibres, probably because immature fibres contain insufficient protein matrix. The horizontal packing of collagen bundles was confirmed by s.e.m. These findings support the view that striae distensae are scars. There is no evidence that they form by stress-induced rupture of the connective tissue.

Topics: Adult; Cicatrix; Collagen; Elastic Tissue; Elastin; Epidermis; Female; Humans; Microscopy, Electron, Scanning; Middle Aged; Skin

Early reperfusion after a coronary occlusion may reduce myocardial infarct size, but late reperfusion into necrotic myocardium may alter post-infarction healing. In rabbits, we compared 1- or 3-week-old scars resulting from permanent coronary occlusion to those resulting from a 1- or 3-hour occlusion followed by reperfusion. Reperfusion at 1 hour post-occlusion did not affect scar mechanical properties assessed at 1 week post-infarction, but at 3 weeks post-infarction, these scars had a tensile strength significantly lower than those not reperfused (78 +/- 11 vs. 158 +/- 15 g/mm2, P less than 0.001). They also were composed of a mixture of fibrous tissue (58 +/- 8%) and myocytes (43 +/- 8%) with a hydroxyproline content of 23 +/- 2.5 mg/g dry weight. The nonreperfused scars had a higher proportion of fibrous tissue (73 +/- 3%) by histological evaluation and a 35% higher hydroxyproline content (31 +/- 2 mg/g dry weight, P less than 0.001) than the scars reperfused after 1 hour. In contrast, 3-week-old scars resulting from "late" reperfusion at 3 hours post-occlusion were similar to nonreperfused scars in fibrous tissue composition and hydroxyproline content. Nonetheless, the tensile strength of these scars reperfused 3 hours post-occlusion was significantly less than that of the nonreperfused scars (72 +/- 5 vs. 158 +/- 15 g/mm2, P less than 0.001). The lower tensile strength was associated with a lower collagen cross-link density in this reperfused group of scars. At physiological stress levels (approximately 3 g/mm2), all groups of reperfused and nonreperfused scars had similar mechanical properties in terms of natural strain, stiffness, creep, and stress relaxation. Thus, although the reperfused scars ruptured more easily at high stresses, when assessed at physiological stresses their mechanical properties were not significantly different from those of nonreperfused scars.

Topics: Animals; Arteries; Cicatrix; Collagen; Coronary Vessels; Desmosine; Elastin; Hydroxyproline; Ligation; Male; Myocardial Infarction; Norleucine; Perfusion; Rabbits; Stress, Mechanical; Tensile Strength

Heparin treated and aldehyde crosslinked rat aorta segments were implanted in infrarenal aorta of homologous rats. One year following aortic replacement, the subendothelial scar and the prosthetic remnants were excised. The scar and the host intima-media were incubated with 3H-valine for 4 h and extracted with 5 M guanidinium chloride--0.05 M dithiothreitol--0.1 M Tris--0.1% EDTANa2 at pH 7.5 prior (Extract 1) and following (Extract 2) hydrolysis of collagen. The radioactivity of extract 1 accounted for approximately 80% of the total label incorporated in the scar and host intima-media. The 3H-label of extract 1 adjusted for the tissue collagen content was about twenty times higher in the scar than in the host aorta. The major 3H protein peaks from Extract 1 of scar and host aorta were of 130 K, 100 K and 70 K apparent molecular weight, based on polyacrylamide gel electrophoresis in SDS. Hydrolysis with 2N KOH of the extraction residue from the host aorta and scar yielded 3H-val-pro dipeptides and hydrolysis with 6N HCl desmosines. The incorporation pattern of 3H-valine into proteins and the presence of elastin synthesized de novo in the scar replacing the prosthesis indicate macromolecular repair of the host aortic wall.

Topics: Animals; Aorta; Bioprosthesis; Blood Vessel Prosthesis; Cicatrix; Elastin; Endothelium; Hydrolysis; Proteins; Rats; Rats, Inbred Strains; Transplantation, Homologous; Valine

Scar tissue, obtained from humans, was stained for elastin fibers by a new staining method. Elastin fibers were noted at sites where they must have been formed de novo. The morphology and the distribution of elastin in various types of scars are described. Practically no elastin was found in keloids.

Topics: Adolescent; Adult; Child, Preschool; Cicatrix; Elastic Tissue; Elastin; Female; Humans; Keloid; Male; Middle Aged; Staining and Labeling

Full-thickness square wounds were made in the webs of fruit bats. Elastin was laid down in the healing scars of these wounds in two forms--as single fibers under the regenerated epidermis, and as bundles of fine fibers taking their origin and orientation from the cut ends of the web elastin bundles. This process continued over a period of 6 months, during which time other components of the scar became reduced in amount. The arrangement of the new elastin in the scar tissue was thus a replica of that seen in the normal web. There are indications in this study that elastin imparts elasticity to the scar.

Topics: Animals; Chiroptera; Cicatrix; Disease Models, Animal; Elastin; Regeneration; Skin; Skin Physiological Phenomena; Wound Healing; Wounds and Injuries

The collagen produced in response to an injury of human skin is initially stabilized by a cross-link derived from hydroxyallysine, and characteristic of embryonic skin. In normal healing there is a change over with time to the cross-link derived from allysine, which is typical of young skin collagen. In contrast, hypertrophic scars fail to follow the time-related changes of normal skin, but retain the characteristics of embryonic collagen, indicating a continued rapid turnover of the collagen. This is further supported by the high proportion of the embryonic Type III collagen present in hypertrophic scars.

Topics: Adolescent; Adult; Amino Acids; Child; Cicatrix; Collagen; Elastin; Humans; Hydroxylysine; Hypertrophy; Macromolecular Substances; Middle Aged; Protein Binding; Skin; Solubility; Time Factors; Water