Limitations of studying keloid scars using the nude athymic mouse model

Abstract

French

Keloid scars are benign fibroproliferative growths that respond poorly to treatment. This study sought to determine the efficacy of three different glucocorticoids (triamcinolone, methylprednisolone and dexamethasone) in altering human keloid scar tissue implanted in athymic mice.

Keloid tissue obtained from three patients (one man and two women) who sought cosmetic removal of their scars was implanted into athymic mice for a duration of 15 or 30 days. The keloid tissue was examined histopathologically and evaluated by a dermatopathologist who was blinded to sample identity and who was using predetermined qualitative scoring criteria. The appearance of central calcification, granulation tissue, foreign body granulomatous reaction and acute inflammatory reaction complicated the comparison of the keloid tissue samples. However, on the basis of observations reported in the present paper, it appears that triamcinolone should remain the treatment of choice for keloid scars. The athymic mouse model that is used for studying keloid scars is the best available approach to in vivo studies; however, limitations identified in this study confound the interpretation of experimental data. Ideally, promising and novel therapies should be investigated clinically.

Keywords

Athymic mice Glucocorticoids Keloid scars

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References

Tredget

E.E.

. The molecular biology of fibroproliferative disorders of the skin: Potential cytokine therapeutics. Ann Plast Surg 1994; 33: 152–4.

Urioste

S.S.

, Arndt

K.A.

, Dover

J.S.

. Keloids and hypertrophic scars: Review and treatment strategies. Semin Cutan Med Surg 1999; 18: 159–71.

Murray

J.C.

. Scars and keloids. Dermatol Clin 1993; 11: 697–708.

Shons

. The treatment of earlobe keloids by surgical excision and postoperative triamcinolone injection. Ann Plast Surg 1983; 10: 480–2.

Kiil

. Keloids treated with topical injections of triamcinolone acetonide (kenalog): Immediate and long-term results. Scand J Plast Reconstr Surg 1977; 11: 169–72.

Shetlar

M.R.

, Shetlar

C.L.

, Hendricks

, Kischer

C.W.

. The use of athymic mice for the study of human keloids. Proc Soc Exp Biol Med 1985; 179: 549–52.

Shetlar

M.R.

, Shetlar

C.L.

, Kischer

C.W.

, Pindur

. Implants of keloid and hypertrophic scars into the athymic nude mouse: Changes in the glycosaminoglycans of the implants. Connect Tissue Res 1991; 26: 23–36.

Waki

E.Y.

, Crumley

R.L.

, Jakowatz

J.G.

. Effects of pharmacologic agents on human keloids implanted in athymic mice. A pilot study. Arch Otolaryngol Head Neck Surg 1991; 117: 1177–81.

Boyadjiev

, Popchristova

, Mazgalova

. Histomorphologic changes in keloids treated with Kenacort. J Trauma 1995; 38: 299–302.

10.

Cohen

K.I.

, Mast

B.A.

. Models of wound healing. J Trauma 1990; 30: S149–55.

11.

Kischer

C.W.

, Pindur

, Shetlar

M.R.

, Shetlar

C.L.

. Implants of hypertrophic scars and keloids into the nude (athymic) mouse: Viability and morphology. J Trauma 1989; 29: 672–7.

12.

Bazin

, Nicoletis

, Delbet

, Delaunay

. [Comparative study of water, collagen, and mucopolysaccharide contents in healthy human skin, in normal and the keloid cicatrix]. C R Acad Sci Hebd Seances Acad Sci D 1970; 270: 1532–4.

13.

Cotran

R.S.

, Kumar

, Collins

, eds. Pathologic Basis of Disease, 6th edn. Pennsylvania: WB Saunders Company, 1999.

14.

Clark

R.A.F.

. Wound repair: overview and general considerations. In: Clark

R.A.F.

, Henson

P.M.

, eds. The Molecular and Cellular Biology of Wound Repair. New York: Plenum Press, 1996: 3–50.

15.

Reth

. Immunodeficiency Trapping the nude mouse gene. Curr Biol 1995; 5: 18–20.

16.

Schimmer

B.P.

, Parker

K.L.

. Adrenocorticotropic hormone: Adrenocorticol steroids and their synthetic analogs; inhibitors of the synthesis and actions of adrenocortical hormones. In: Hardman

J.G.

, Limbird

L.E.

, Molinoff

P.B.

, Ruddon

R.W.

, eds. Goodman and Gillman, 9th edn. New York: McGraw Hill, 1996: 1459–85.

17.

Polo

, Kim

, Kucukcelebi

, Hayward

P.G.

, Ko

, Robson

M.C.

. An in vivo model of human proliferative scar. J Surg Res 1998; 74: 187–95.