Health and Fitness Related Articles

In human beings and domestic animals, scarring in the skin after trauma, surgery, burns or a sports injury is an important health problem, often resulting in unsightly aesthetics, loss of function, restriction of tissue movement and/or growth and negative psychological effects.

Current treatments are strictly empirical, troublesome and unpredictable. There are no prescription medicines for the prevention or treatment of dermal scarring. Skin wounds on early mammalian embryos cure perfectly with no scars, whereas wounds to adult mammals are prone to scarring.

In scar treatment research, specialists are exploring the cellular and molecular differences between scar-free healing in embryonic wounds and scar-forming healing in adult wounds. Important differences include the inflammatory response, which in embryonic wounds consists of fewer quantities of less differentiated inflammatory cells. This occurrence, along with augmented levels of morphogenetic molecules involved in skin growth and morphogenesis, implies that the growth factor profile of an embryonic wound is very different from that of an adult wound.

These experiments resulted in scar-less healing in the adult subject and have lead to the recognition of appropriate therapeutic targets. It has been found that effective skin care markedly improves or completely prevents scarring during adult wound healing in experimental animals. Some of these new medications have successfully completed safety and other tests, such that they have entered human clinical trials with approval from the appropriate regulatory authorities. Based on auspicious results from such volunteer experiments, the leading medications have now entered human patient-based trials e.g. in skin graft donor sites.

Proposing Solutions

The hypothesis is that evolutionary factors have been exerted on intermediate sized, widespread, dirty wounds with considerable tissue destruction e.g. bites, bruises and contusions. Modern wounds (e.g. resulting from trauma or surgery) caused by sharp objects, are new situations not previously found in nature, in which the evolutionary selected wound healing reactions are somewhat useless. It has been shown that both repair with scarring and regeneration can occur within the same animal, including man, and indeed within the same tissue, thereby implying that they share similar mechanisms and regulators.

Consequently, by subtly altering the ratio of growth factors present in adult wound healing, we can induce adult wounds to heal perfectly with no scars, with accelerated healing and without negative consequences, e.g. on wound strength or wound infection rates. This implies that scarring may no longer be an inevitable consequence of modem injury or surgery, and that a fully new pharmaceutical approach to the prevention of human scarring is now possible. Scarring after injury occurs in many tissues in addition to the skin.

Thus scar-improving drugs could have widespread benefits and prevent complications in several tissues, e.g. the prevention of blindness after scarring due to eye damage, facilitation of neuronal reconnections in the peripheral and central nervous system by the elimination of glial scarring, restitution of normal gut and reproductive function by avoiding strictures and adhesions after damage to the gastrointestinal or reproductive systems, and the restoration of locomotor function by avoiding scarring in tendons and ligaments.