[Comparison of the mechanisms of intralesional steroid, interferon or verapamil injection in the treatment of proliferative scars].
OBJECTIVE
To investigate the effects of intralesional steroid, interferon alpha-2b or verapamil injection on proliferation, apoptosis and TGF-beta1 expression in keloid and hypertrophic scar in vivo.


METHODS
6 patients with keloids and 6 patients with hypertrophic scar were treated with intralesional injection of triamcinolone acetonide (40 mg/ml) or IFN alpha-2b (15 x 10(5) U/ml) or verapamil (2.5 mg/ml). Samples were collected on the 7th day after intralesional injection. Samples of untreated keloid and hypertrophic scar and normal skin were used as control. Expression of PCNA and TGF-beta1 was detected in situ by immunohistochemical staining, and apoptosis was detected in situ by terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick end labeling (TUNEL).


RESULTS
1) Triamcinolone acetonide could prohibit proliferative scars through inhibiting cell proliferation and TGF-beta1 expression, as well as inducing apoptosis. 2) IFN alpha-2b could prohibit proliferative scars through inhibiting cell proliferation and TGF-beta1 expression, but not inducing apoptosis; 3) Verapamil could also prohibit proliferative scars through inhibiting proliferation and TGF-beta1 expression in fibroblasts, as well as inducing apoptosis. While the effect of inducing apoptosis was stronger than that of triamcinolone acetonide, the effect of inhibiting TGF-beta1 expression was weaker than those of triamcinolone acetonide and IFN alpha-2b.


CONCLUSIONS
Although intraleional injection of steroid, interferon alpha-2b or verapamil were all effective in the treatment of keloid and hypertrophic scar, their mechanisms are not similar.
Xu
Shao-jun
SJ
Department of Plastic Surgery of the Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.
Teng
Jian-ying
JY
Xie
Jing
J
Shen
Ming-qiang
MQ
Chen
Dong-ming
DM
D000293:Adolescent; D000328:Adult; D017209:Apoptosis; D002648:Child; D017439:Cicatrix, Hypertrophic / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D018809:Proliferating Cell Nuclear Antigen / Q000378:metabolism; D011994:Recombinant Proteins; D013256:Steroids / Q000627:therapeutic use*; D053773:Transforming Growth Factor beta1 / Q000378:metabolism; D014700:Verapamil / Q000627:therapeutic use*; D055815:Young Adult
D000077190:Interferon alpha-2; D016898:Interferon-alpha; D018809:Proliferating Cell Nuclear Antigen; D011994:Recombinant Proteins; D013256:Steroids; D053773:Transforming Growth Factor beta1; D014700:Verapamil