[Relationship between keloid proliferation and apoptosis of epithelial cell with destruction of structure and function of skin appendages].
OBJECTIVE
To investigate the relationship between keloid proliferation and destruction of skin appendages (SAs).


METHODS
Pathological biopsies of keloids were derived from 17 patients who underwent scar resection. All samples were divided into 4 groups: infiltrating growth locus of keloids (K-I, n = 9), proliferative keloids (K-P, n = 17), atrophic keloids (K-A, n = 10), and edging normal skin (K-N, n = 6). Normal skin derived from thorax of patients was used as control (NS, n = 6). The density of SAs and the expressive characteristics of pan-cytokeratin (CKp), cytokeratin 19 (CK19), secretory component of glandular epithelium (SC), proliferating cell nuclear antigen (PCNA), and apoptosis related proteins (Bcl-2 and Bax) were observed with immunohistochemical method.


RESULTS
Compared with K-N and NS, the density of SAs expressing CKP and SC in keloids was apparently decreased, and remnant of CKp protein was observed after the disappearance of SAs structures. Protein expression of Bax was increased in epithelial cells of most SAs. SAs containing positive immunostaining signals of Bcl-2, PCNA and CK19 exhibited squamous epithelization and abnormal structure. The structure of SAs underwent 3 morphological stages: infiltrating, proliferating, and maturing. In correspondence to each stage, SAs underwent proliferation, structural destruction, and fibrosis which were caused by cellular migration, inflammatory reaction, and vascular occlusion respectively.


CONCLUSIONS
Abnormal proliferation of epithelial cells and their structural destruction of SAs may be associated with tissue fibrosis in keloid lesion.
Jiang
Duyin
D
Key Laboratory of Wound Repair of PLA, 304th Clinical Department, General Hospital of PLA, Beijing, 100037, P R China.
Fu
Xiaobing
X
Chen
Wei
W
Sun
Tongzhu
T
Sheng
Zhiyong
Z
D000293:Adolescent; D000328:Adult; D017209:Apoptosis; D049109:Cell Proliferation; D002675:Child, Preschool; D004847:Epithelial Cells / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007627:Keloid / Q000378:metabolism / Q000473:pathology*; D007633:Keratins / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D018809:Proliferating Cell Nuclear Antigen / Q000378:metabolism; D012867:Skin / Q000378:metabolism / Q000473:pathology*; D055815:Young Adult
D018809:Proliferating Cell Nuclear Antigen; D007633:Keratins