tretinoin and Burns

This study demonstrates that adipose-derived stem cells from debrided skin (dsASCs) of burn patients can be isolated in sufficient quantities and differentiated into cytokeratin-expressing cells by treating them with all-trans retinoic acid (ATRA) and the peroxisome proliferator-activated receptor-α (PPARα) specific activator fenofibrate. Differentiation of dsASCs with ATRA and a combination of growth factors induced expression of simple epithelial markers (KRT7, KRT8, KRT18, and KRT19), along with low levels of stratified epithelial markers (KRT5, KRT10, KRT13, and KRT14). We have optimized a condition to induce dsASCs differentiation to epithelial cells by treatment with ATRA and fenofibrate alone. Real-time polymerase chain reaction analysis showed a significant increase in transcript levels (>75-fold) for basal (KRT5 and KRT14), suprabasal (KRT10), and cornified envelope markers (involucrin [IVL] and Loricrin [LOR]) with this treatment. Expression of the proteins encoded by these transcripts was confirmed by immunocytochemical analysis. Further, we show that dsASCs differentiated to a skin epithelial cell phenotype through activation of nuclear hormone receptors PPARα and RXRγ. Collectively this study shows that dsASCs can be differentiated to skin epithelial cells, without the requirement for exogenous growth factors. This differentiation protocol using dsASCs in combination with an appropriate biocompatible scaffold can be adapted to develop epithelial skin substitute for burn wound treatment.

Topics: Adipose Tissue; Burns; Cell Differentiation; Cells, Cultured; Epithelial Cells; Humans; Immunohistochemistry; Keratin-18; Keratin-19; Keratin-7; Keratin-8; Keratins; PPAR alpha; Stem Cells; Tretinoin

An ointment containing retinoic acid deformable liposomes (TRA DLs) and epidermal growth factor cationic deformable liposomes (EGF CDLs) was prepared for the treatment of deep partial-thickness burns. The characterization tests confirmed both liposomes featured small particle sizes, high drug entrapment efficiencies and sustained drug release behavior. Compared with the free drug, TRA DLs and EGF CDLs exhibited superior skin permeation and remarkably increased drug deposition by 2.9 and 18.8 folds, respectively. Results on HaCaT cells indicated the combined application of two liposomes exerted a synergistic effect and prominently promoted cell proliferation and migration. Application of the dual liposomal ointment on a deep partial-thickness burn model stimulated wound closure (p < 0.001), promoted skin appendage formation and increased collagen production, thus improving healing quality. Finally, it was demonstrated that TRA significantly up-regulated the expression of EGFR and HB-EGF to enhance the therapeutic effect of EGF. Therefore, the dual liposomal ointment is a promising topical therapeutic for burn treatment.

Topics: Animals; Burns; Cell Line; Cell Movement; Cell Proliferation; Epidermal Growth Factor; Humans; Liposomes; Mechanical Phenomena; Permeability; Rats; Skin; Tretinoin; Wound Healing

Deep erythema and inflammation after re-epithelialization of superficial wounds is a sign of scar formation. Corticosteroids may prevent scarring by suppression of inflammation and fibroblast activity. Tretinoin may increase the efficacy of corticosteroids in this setting.. To evaluate the efficacy of corticosteroids plus tretinoin for prevention of scars after superficial wounds.. In a retrospective study of patients with superficial partial thickness thermal skin burn, we compared the patients who received clobetasol plus tretinoin after re-epithelialization with patients who did not receive any medication. Clobetasol propionate 0.05% ointment was used twice daily with overnight occlusive dressing in conjunction with twice weekly topical tretinoin 0.05% cream.. Among 43 patients who had light pink or no erythema after re-epithelialization and consequently did not receive clobetasol + tretinoin, no scar was developed. Among patients who had deep erythema after re-epithelialization, rate of scar formation was significantly higher in 14 patients who did not receive clobetasol + tretinoin than in 21 patients who received clobetasol + tretinoin (64% and 19%, respectively; p = 0.01).. Clobetasol + tretinoin can significantly decrease the incidence of scar formation in patients with inflammation after re-epithelialization of superficial wounds.

Topics: Adolescent; Adult; Aged; Burns; Child; Child, Preschool; Cicatrix; Clobetasol; Dermatologic Agents; Erythema; Female; Glucocorticoids; Humans; Male; Middle Aged; Occlusive Dressings; Re-Epithelialization; Retrospective Studies; Skin; Tretinoin; Ulcer; Young Adult

After burn injuries, scarred skin lacks elasticity, especially in hypertrophic scars. Topical treatment with tretinoin can improve the appearance and quality of the skin (i.e., texture, distensibility, color, and hydration). The objective of this prospective study was to examine the effects of treatment with 0.05% tretinoin for one year on the biomechanical behavior and histological changes undergone by facial skin with post-burn scarring.. Tertiary, Institutional.. Fifteen female patients who had suffered partial thickness burns with more than two years of evolution were selected. Skin biopsies were obtained initially and after one year of treatment. The resistance and elastance of these skin biopsies were measured using a mechanical oscillation analysis system. The density of collagen fibers, elastic fibers, and versican were determined using immunohistochemical analysis.. Tretinoin treatment significantly lowered skin resistance and elastance, which is a result that indicates higher distensibility of the skin. However, tretinoin treatment did not significantly affect the density of collagen fibers, elastic fibers, or versican.. Topical tretinoin treatment alters the mechanical behavior of post-burn scarred skin by improving its distensibility and thus leads to improved quality of life for patients.

Topics: Administration, Topical; Adolescent; Adult; Biomechanical Phenomena; Burns; Cicatrix, Hypertrophic; Elasticity; Facial Injuries; Female; Humans; Keratolytic Agents; Prospective Studies; Skin; Treatment Outcome; Tretinoin; Young Adult

Topics: Acne Vulgaris; Burns; Cicatrix; Female; Humans; Self-Injurious Behavior; Tretinoin

This study was designed to determine the effect of polyprenoic acid on wound healing in rats after thermal injury and to compare the effect with healing in vitamin A deficient controls and in retinol-fed vitamin A deficient rats. Both polyprenoic acid and retinol visibly accelerated wound healing after thermal injury. Both enhanced the induction of platelets in the peripheral blood but neutrophils were not affected by polyprenoic acid. Histologically, in the hypo-vitamin A rat, polyprenoic acid administration increased both capillary formation and also the production of fibroblasts and collagen deposition in the wound by comparison with control vitamin A deficient animals; similar effects were produced by retinol feeding. These results indicate that both polyprenoic acid and retinol can facilitate wound healing. 3H-thymidine incorporation into dermal tissues showed that in polyprenoid-fed rats capillaries multiplied 1.3 times, epithelial cells 2.1 times, and fibroblasts 2.0 times faster than those in vitamin A-deficient animals; 3H-thymidine incorporation was greater after polyprenoid feeding than after retinol feeding. Polyprenoid thus stimulates both collagen deposition and neo-vascularization within burns, and so accelerates healing.

Topics: Animals; Burns; Capillaries; Collagen; Fibroblasts; Leukocyte Count; Mitosis; Neutrophils; Platelet Count; Rats; Rats, Inbred Strains; Skin; Thymidine; Tretinoin; Vitamin A; Vitamin A Deficiency; Wound Healing