title: Downregulation of apoptosis-related genes in keloid tissues.
abstract: BACKGROUND
  Physiologically programmed cell death or apoptosis occurs during the natural balance between cellular proliferation and demise.
  
  
  METHODS
  We compared the expression of 64 apoptosis-related genes in keloids and normal scars to investigate the potential role of apoptosis in keloid formation. Two sets of mRNA were isolated from keloids excised from four previously untreated patients and four normal scar patients separately. Human cDNA arrayed hybridization was performed to compare the apoptosis-related gene expression between these two groups. In addition, TUNEL assays were performed to evaluate the percentage of apoptotic cells in keloids (center and periphery) versus normal scars.
  
  
  RESULTS
  Eight of the sixty-four apoptosis-related genes studied were significantly underexpressed in keloid tissue. The underexpressed genes and their relative expression compared with normal scar were defender against cell death 1 (DAD-1) (34.1% of normal scar); nucleoside diphosphate kinase B (c-myc transcription factor) (24.7%); glutathione S-transferase (17.9%); glutathione S-transferase microsomal (28.1%); glutathione peroxidase (47.2%); tumor necrosis factor receptor 1-associated protein (TRADD) (51.0%); 19-kDa interacting protein 3 (NIP3) (36.0%); and cytoplasmic dynein light chain 1 (HDLC1) (47.7%). Spatial analysis of apoptosis using TUNEL assays revealed apoptosis indices of 0.83 for keloid periphery and 0.63 for keloid center.
  
  
  CONCLUSIONS
  In this study we demonstrated underexpression of apoptosis-related genes in human keloid tissue and decreased apoptotic activity in fibroblasts derived from keloids versus normal scars. We hypothesized that keloid fibroblasts fail to undergo physiologically programmed cell death and, thus, continue to produce and secrete connective tissue beyond the period expected in normal scar formation, accounting for the progressive and hypertrophic nature of keloids. This mechanism leads to new possibilities for treatment of keloids through induction of apoptosis.
authors.affiliation: Institute of Reconstructive Plastic Surgery, New York University, New York, New York 10016, USA.
authors.forename: D N
authors.initials: DN
authors.lastname: Sayah
authors.forename: C
authors.initials: C
authors.lastname: Soo
authors.forename: W W
authors.initials: WW
authors.lastname: Shaw
authors.forename: J
authors.initials: J
authors.lastname: Watson
authors.forename: D
authors.initials: D
authors.lastname: Messadi
authors.forename: M T
authors.initials: MT
authors.lastname: Longaker
authors.forename: X
authors.initials: X
authors.lastname: Zhang
authors.forename: K
authors.initials: K
authors.lastname: Ting
mesh_terms: D000293:Adolescent; D000328:Adult; D017209:Apoptosis / Q000235:genetics*; D051017:Apoptosis Regulatory Proteins; D029742:Caenorhabditis elegans Proteins; D015536:Down-Regulation; D004398:Dyneins / Q000235:genetics; D005260:Female; D005786:Gene Expression Regulation; D016259:Genes, myc; D005982:Glutathione Transferase / Q000235:genetics; D006801:Humans; D020287:In Situ Nick-End Labeling; D007627:Keloid / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011506:Proteins / Q000235:genetics; D012097:Repressor Proteins / Q000235:genetics; D047990:TNF Receptor-Associated Factor 1
chemical_list: D051017:Apoptosis Regulatory Proteins; D029742:Caenorhabditis elegans Proteins; C096021:Dad-1 protein, C elegans; D011506:Proteins; D012097:Repressor Proteins; D047990:TNF Receptor-Associated Factor 1; D005982:Glutathione Transferase; D004398:Dyneins