Recent Articles of Interest

In human beings and domestic pets, scarring in the skin after trauma, surgery, burns or a sports injury is a major medical problem, usually resulting in unsightly aesthetics, loss of function, restriction of tissue elasticity and/or growth and negative psychological effects.

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

In scar treatment research, scientists are investigating the cellular and molecular differences between scar-free healing in embryonic wounds and scar-forming healing in adult wounds. Relevant differences include the inflammatory reaction, which in embryonic wounds consists of lower quantities of less differentiated inflammatory cells. This occurrence, together with augmented levels of morphogenetic molecules involved in skin growth and morphogenesis, implies that the growth factor profile of an embryonic wound is highly different from that of an adult wound.

These experiments proved the possibility of 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 highly improves or completely prevents scarring during adult wound healing in experimental animals. Some of these new medications have successfully passed safety and other tests, such that they have entered human medical trials with approval from the appropriate regulatory authorities. Based on auspicious results from such volunteer studies, the leading medications have now entered human patient-based tests e.g. in skin graft donor sites.

Proposing Solutions

The theory is that evolutionary pressures have been exerted on intermediate sized, widespread, dirty wounds with high tissue destruction e.g. bites, bruises and contusions. Modern wounds (e.g. produced by trauma or surgery) made by sharp instruments, are new occurrences not previously encountered in nature, in which the evolutionary selected wound healing responses are somewhat useless. It has been shown that both healing with scarring and regeneration can occur within the same animal, including man, and indeed within the same tissue, thereby suggesting that they share similar procedures and regulators.

Consequently, by subtly altering the proportion of growth factors present in adult wound healing, we can induce adult wounds to heal perfectly with no scars, with accelerated healing and with no negative effects, e.g. on wound strength or wound infection rates. This implies that scarring may no longer be an unavoidable consequence of modem injury or surgery, and that a fully new pharmaceutical concept to the avoidance of human scarring is now possible. Not only skin suffers from scarring; they can appear in many other tissues as well.

Thus scar-healing drugs could have extensive benefits and avoid complications in several tissues, e.g. the prevention of blindness after scarring due to eye damage, support of neuronal reconnections in the peripheral and central nervous system by the avoidance of glial scarring, recovery of normal gut and reproductive function by avoiding strictures and adhesions after damage to the gastrointestinal or reproductive tracts, and the recovery of locomotor function by avoiding scarring in tendons and ligaments.