Table 3.
Emerging therapeutics for hypertrophic scarring.
| Treatment | Proposed Mechanism |
|---|---|
| Corticosteroids + 5-Fluorouracil [163,164,177,178] | Anti-inflammatory, local vasoconstriction, inhibit fibroblasts proliferation, decrease collagen synthesis |
| Laser + Verapamil + 5-Fluorouracil or corticosteroids [180] | Destroy microvascularization resulting in hypoperfusion and hypoxia, inhibit fibroblast proliferation, decrease collagen synthesis, anti-inflammatory |
| CO2 * Laser + Intense Pulse Light [176] | Destroy microvascularization resulting in hypoperfusion and hypoxia, promote new dermal collagen formation and rapid differentiation of keratinocytes |
| Losartan [181] | Fibroblasts with decreased contractile activity, migration, and adhesion |
| Oxandolone + hyaluronic acid gel [182] | Decrease inflammation, collagen and fibroblast cellularity, vascularization, and myofibroblast activity |
| Dipeptidyl peptidase-4 inhibitors [183] | Attenuate collagen synthesis and deposition |
| 1,4-Diaminobutane [184] | Inhibits collagen cross-linking |
| Autologous fat grafting [185] | Decreases the expression of the myofibroblast marker α-SMA * and ECM * components |
| Stem cells [186,187] | Reduce inflammation, cellularity, and collagen filaments |
| Platelet-rich plasma [61,188,189] | Reduces expression of TGF-β1 * and CTGF mRNA |
| CD206 * + Macrophages and Fibroblasts [190] | Increase MMP-1 * and decrease expression of pro-fibrotic factors, COL1A1 *, COL2A1 *, α-SMA *, CTGF *, and TGF-β1 * |
| IL-6 * [190] | Increases expression of anti-fibrotic genes |
| IFN-γ * [191] | Increases expression of COL1A1 * and COL3A1 * mRNA and decreases expression of MMP-2 * (gelatinase) |
* Abbreviations: CO2 (carbon dioxide); CD206 (cluster of differentiation 206); IL-6 (interleukin 6); IFN-γ (Interferon gamma); α-SMA (alpha smooth muscle actin); ECM (extracellular matrix); TGF-β1 (transforming growth factor beta-1); COL1A1 (collagen type I alpha 1 chain); COL2A1 (collagen type II alpha 1 chain); COL3A1 (collagen type III alpha 1 chain), CTGF (connective tissue growth factor); TGF-β1 (transforming growth factor beta 1); MMP-2 (matrix metalloproteinase 2).