FEATURES OF ENDOCRINE PROFILE IN HYPERTROPHIC AND KELOID SCARS OF SKIN
https://doi.org/10.57256/2949-0715-2023-1-25-32
Abstract
Background. Given the role of hormones in the regulation of scar formation and remodeling processes, it is advisable to study the features of the hormonal profile in conditions of pathological scars. This will improve the efficiency of diagnosing of scar type and form a pathogenetic basis for the treatment of hypertrophic and keloid scars.
Aim. To identify the features of the hormonal profile in conditions of hypertrophic and keloid scars.
Materials and methods. The clinical state of the scars and the hormonal profile (10 hormones) were studied in 90 women with hypertrophic, keloid and normotrophic scars (control). Blood was taken before treatment on the 5th–7th day of the menstrual cycle. The results were processed by non-parametric statistics (Me (Q25-Q75), U-test at p<0.05). Correlations between hormones were determined by the method of multiple regression at the coefficient of determination R2>0.7.
Results. All patients with pathological scars showed a decrease in cortisol levels. Hypertrophic scars are characterized by an increase in the concentration of follicle-stimulating hormone, a decrease in the concentration of estradiol and testosterone. In patients with keloids, the concentration of growth hormone is increased, the levels of prolactin, luteinizing hormone are reduced. Regression analysis showed that the interdependence of hormones is maximally expressed in conditions of normotrophic scars, while hormones had 1-2 correlations in conditions of pathological scars. At the same time, the qualitative composition and direction of interrelations have changed.
Conclusion. Pathological scarring is characterized by a decrease in the level of cortisol in the blood, which is expressed in patients with keloid scars in combination with reduced prolactin. A weakening of hormonal interactions and an imbalance in the system of sex hormones were revealed in conditions of hypertrophic scars. and the increased production of growth hormone in combination with a stable interaction between steroidogenesis and a weakened adaptive ability took place in conditions of keloid scars.
About the Author
Maxim Vladimirovich Kobets
Irkutsk Regional Clinical Hospital, Irkutsk, Russia
Russian Federation
Russian Federation
References
1. Huang C., Ogawa R. Systemic factors that shape cutaneous pathological scarring. FASEB J. 2020;34(10):13171-13184. https://doi.org/10.1096/fj.202001157R
2. Shafranov V.V., Borkhunova E.N., Taganov A.V. et al. Keloidnye rubcy: etiologiya, klinicheskaya, morfologicheskaya, fizikal'naya diagnostika i lechenie SVCH – kriogennym metodom. Moscow;2003:192 (In Russian)
3. Baryza M.J., Baryza G.A. The Vancouver Scar Scale: an administration tool and its interrater reliability. J Burn Care Rehabil. 1995;16(5):535-538. https://doi.org/10.1097/00004630-199509000-00013
4. Komisarenko V.P., Minchenko A.G., Tron'ko N.D. Molekulyarnye mekhanizmy dejstviya steroidnyh gormonov: Kiev: «Zdorov'e»;1986:192 (In Russian)
5. Reish R.G., Eriksson E. Scar treatments: preclinical and clinical studies. J Am Coll Surg. 2008;206(4):719-730. https://doi.org/10.1016/j.jamcollsurg.2007.11.022
6. Gilliver S.C., Ashworth J.J., Mills S.J. et al. Androgens modulate the inflammatory response during acute wound healing. J Cell Sci. 2006;119(Pt 4):722-732. https://doi.org/10.1242/jcs.02786
7. Horng H.C., Chang W.H., Yeh C.C. et al. Estrogen Effects on Wound Healing. Int J Mol Sci. 2017;18(11):2325. https://doi.org/10.3390/ijms18112325
8. Scacchi M., Valassi E., Pincelli A.I. et al. Increased lipid peroxidation in adult GH-deficient patients: effects of short-term GH administration. J Endocrinol Invest. 2006;29(10):899-904. https://doi.org/10.1007/BF03349194
9. Messias de Lima C.F., de Araújo Vieira L.F., de Carvalho Wanderley LA, de Souza Ferro JN, Smaniotto S. Topical Growth Hormone Accelerates Wound Healing in Mice. Wounds. 2017;29(12):387-392. URL: https://pubmed.ncbi.nlm.nih.gov/28976342/ [accessed: 05.12.2022]
10. Thorey I.S., Hinz B., Hoeflich A. et al. Transgenic mice reveal novel activities of growth hormone in wound repair, angiogenesis, and myofibroblast differentiation. J Biol Chem. 2004;279(25):26674-26684. https://doi.org/10.1074/jbc.M311467200
11. Lee Y.R., Oshita Y., Tsuboi R., Ogawa H. Combination of insulin-like growth factor (IGF)-I and IGF-binding protein-1 promotes fibroblast-embedded collagen gel contraction. Endocrinology. 1996;137(12):5278-5283. https://doi.org/10.1210/endo.137.12.8940346
12. Hu Z.C., Tang B., Guo D. et al. Expression of insulin-like growth factor-1 receptor in keloid and hypertrophic scar. Clin Exp Dermatol. 2014;39(7):822-828. https://doi.org/10.1111/ced.12407
13. Levine S., Muneyyirci-Delale O. Stress-Induced Hyperprolactinemia: Pathophysiology and Clinical Approach. Obstet Gynecol Int. 2018;2018:9253083. https://doi.org/10.1155/2018/9253083
14. Duffy D.M., Ko C., Jo M., Brannstrom M., Curry T.E. Ovulation: Parallels With Inflammatory Processes. Endocr Rev. 2019;40(2):369-416. https://doi.org/10.1210/er.2018-00075
15. Mazziotti G., Giustina A. Glucocorticoids and the regulation of growth hormone secretion. Nat Rev Endocrinol. 2013;9(5):265-276. https://doi.org/10.1038/nrendo.2013.5
16. Agha A., Monson J.P. Modulation of glucocorticoid metabolism by the growth hormone - IGF-1 axis. Clin Endocrinol (Oxf). 2007;66(4):459-465. https://doi.org/10.1111/j.1365-2265.2007.02763.x
17. Cook D.M. Growth hormone and estrogen: a clinician's approach. J Pediatr Endocrinol Metab. 2004;17 Suppl 4:1273-1276. URL: https://pubmed.ncbi.nlm.nih.gov/15506073/ [accessed: 05.12.2022]
18. Sun L., Gao Z., Luo L., Tan H., Zhang G. Estrogen affects cell growth and IGF-1 receptor expression in renal cell carcinoma. Onco Targets Ther. 2018;11:5873-5878. https://doi.org/10.2147/OTT.S172149
19. Brownlee K.K., Moore A.W., Hackney A.C. Relationship between circulating cortisol and testosterone: influence of physical exercise. J Sports Sci Med. 2005;4(1):76-83. URL: https://pubmed.ncbi.nlm.nih.gov/24431964/ [accessed: 05.12.2022]
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For citations:
Kobets M.V. FEATURES OF ENDOCRINE PROFILE IN HYPERTROPHIC AND KELOID SCARS OF SKIN. Baikal Medical Journal. 2023;2(1):25-32. (In Russ.) https://doi.org/10.57256/2949-0715-2023-1-25-32
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