title: Immunohistochemical analysis of neuropeptides (protein gene product 9.5, substance P and calcitonin gene-related peptide) in hypertrophic burn scar with pain and itching.
abstract: BACKGROUND
  Neuropeptides have been recently reported as having an important role in wound repair, and relief from pain and itching sensation. The aim of this study was to evaluate the effect of neuropeptides on the wound healing process in hypertrophic scar formation that accompanies severe pain and itching sensation.
  
  
  METHODS
  We collected forty-three hypertrophic scar specimens from hypertrophic scar release and skin graft under general anesthesia. Immunohistochemical stains for protein gene product (PGP) 9.5, substance P (SP), and calcitonin gene-related peptide (CGRP) were performed. Pain and itching over the scar were recorded using verbal numerical rating scale (VNRS).
  
  
  RESULTS
  In the epidermis, PGP 9.5, SP, and CGRP were significantly increased in hypertrophic scars compared with matched unburned skin. In the reticular dermis, SP and CGRP were significantly increased in hypertrophic scars compared with control. The pain and itching verbal numerical rating scale in scar group were significantly higher compared to control. In the papillary dermis, the PGP represented significant correlation with Itching P (correlation coefficient 0.698) and the SP represented significant correlation with pain N (correlation coefficient -0.671). In the reticular dermis, the SP represented significant correlation with pain N (correlation coefficient -0.614) and CGRP represented significant correlation with pain P/Itching P (correlation coefficient 0.801/0.611).
  
  
  CONCLUSIONS
  Neuropeptides such as PGP 9.5, SP, and CGRP seem to affect scarring via sensory neurotransmission, it have a regulatory role for pain and itching sensation in hypertrophic scars.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
authors.forename: In Suk
authors.initials: IS
authors.lastname: Kwak
authors.affiliation: Department of Pathology, Dongtan Sacred Heart Hospital, College of Medicine, Hallym University, Hwaseong, Korea.
authors.forename: Young Hee
authors.initials: YH
authors.lastname: Choi
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Young Chul
authors.initials: YC
authors.lastname: Jang
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea. Electronic address: ykleeanes@gmail.com.
authors.forename: Yoon Kyung
authors.initials: YK
authors.lastname: Lee
mesh_terms: D000328:Adult; D002056:Burns / Q000150:complications*; D015740:Calcitonin Gene-Related Peptide / Q000378:metabolism*; D016022:Case-Control Studies; D017439:Cicatrix, Hypertrophic / Q000209:etiology / Q000378:metabolism*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000378:metabolism*; D011537:Pruritus / Q000209:etiology / Q000378:metabolism*; D012867:Skin / Q000378:metabolism*; D013373:Substance P / Q000378:metabolism*; D043222:Ubiquitin Thiolesterase / Q000378:metabolism*
chemical_list: C482860:UCHL1 protein, human; D013373:Substance P; D043222:Ubiquitin Thiolesterase; D015740:Calcitonin Gene-Related Peptide
keywords: Hypertrophic scar; Itching; Neuropeptide; Pain