• Peter O Kwan, Jie Ding, and Edward E Tredget.
• From the *Division of Plastic Surgery, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada; †Wound Healing Research Group, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada; and ‡Critical Care, Department of Surgery, University of Alberta Hospital, Edmonton, Canada.
• J Burn Care Res. 2016 Nov 1; 37 (6): 356-366.

AbstractHypertrophic scar after burn injury is a significant problem. Previous studies have examined the roles for decorin, interleukin-1β, and transforming growth factor-β1 in hypertrophic scar formation locally, but few have considered their systemic influence. The authors conducted a pilot study to examine whether serum levels of these molecules could predict hypertrophic scar formation. Serum levels were measured using enzyme-linked immunosorbent assay, and hypertrophic scar formation determined from chart reviews. Peripheral blood mononuclear cells and fibroblasts were stimulated with decorin, interleukin-1β, and transforming growth factor-β1, and expression of profibrotic molecules examined using flow cytometry, immunofluorescence microscopy, quantitative polymerase chain reaction, and mass spectrometry. Multiple linear regression analysis suggested early serum levels of decorin and interleukin-1β, and late serum levels of transforming growth factor-β1 were predictive of hypertrophic scar formation. Decorin up-regulated the expression of toll-like receptor 4 and C-X-C receptor 4 in peripheral blood mononuclear cells, and interleukin-1β up-regulated fibroblast production of C-X-C ligand 12. Transforming growth factor-β1 up-regulated, and interleukin-1β down-regulated, the production of profibrotic cytokines, collagen, and myofibroblast differentiation. The model predicting hypertrophic scar formation is supported by clinical results and limited in vitro experiments.

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