炎性反应在瘢痕疙瘩发生发展中的作用及机制研究

邓雨萌 雷霞

[摘要]瘢痕疙瘩即一种过度生长的异常瘢痕组织，一般是在伤口愈合后形成的，通常具有较高的复发性，其早期通常伴有炎性浸润区，这些炎性浸润区的炎症反应会在一定程度上促使成纤维细胞的过度增殖、成纤维细胞产物的增多及一些与炎性反应相关的细胞因子的高表达，故瘢痕疙瘩与炎症反应有着密不可分的关系。近年来研究瘢痕疙瘩的炎性反应成为瘢痕疙瘩发病及治疗研究的一大方向。本文从炎性反应所导致的成纤维细胞的增殖过度，以及与成纤维细胞增生和炎性反应相关细胞的因子，例如：PDGF、TGF-β、IGF-1、HIF-1和过度增殖的成纤维细胞所分泌的胶原蛋白导致的代谢异常这三大方面来阐述瘢痕疙瘩与炎性反应的相关性，从而进一步说明炎性反应在瘢痕疙瘩发展中的作用及机制。

[关键词]瘢痕疙瘩;炎症反应;成纤维细胞;细胞因子

Abstract： Keloid is an abnormally growing scar tissue that is usually formed after wound healing. It usually has a high recurrence.It is also usually accompanied by inflammatory infiltration areas in the early stage. The inflammatory response in these inflammatory infiltration areas will promote the excessive proliferation of fibroblasts， the increase of fibroblast products， and the high expression of some cytokines related to the inflammatory response to a certain extent. Therefore， keloids have an inseparable relationship with inflammation. In recent years， researches on the inflammatory response of keloids have become a major direction for the research on the pathogenesis and treatments of keloids. Through this hot spot， this article will focus on the excessive proliferation of fibroblasts caused by inflammatory reactions and factors related to fibroblast proliferation and inflammatory responses， such as： PDGF， TGF-β， IGF-1， HIF -1 and metabolic abnormalities caused by collagen secreted by overgrowthed fibroblasts to explain the correlation between keloid and inflammatory response， and further explain the role and mechanism of inflammatory response in keloid development.

Key words： keloid; inflammatory response; fibroblasts; cytokines

瘢痕疙瘩是成纖维细胞增生的瘢痕组织，有着“肿瘤样生长”的倾向，故而它也被称作为“瘢痕瘤”，通常伴有早期炎症性浸润区，这些炎症细胞浸润到周围的正常皮肤而且没有退行性改变，刺激成纤维细胞过度增殖。有的学者认为瘢痕疙瘩是一种慢性的炎症反应[1]。而炎症与多种因素相关，近年来的研究表明，最主要的是与成纤维细胞的过度增生有关，炎症可以刺激成纤维细胞的增生，促使创面愈合，当其过度增生时，则形成了所谓的病理性瘢痕或者瘢痕疙瘩。同时成纤维细胞的过度增生又与IGF-1、HIF-1、PDGF、TGF-β细胞因子有关，过度增生的成纤维细胞可以使得胶原蛋白代谢异常。……