The Impact of Dye Laser Therapy on Molecules of the TGF-β Pathway in Keloid Tissue

染料雷射治療蟹足腫的臨床反應和分子生物上的影響

楊善淳(San-Tsun Yang) ； 馬旭(Hsu Ma)

《中華民國整形外科醫學會雜誌》 18卷4期 (2009/12) Pp. 301-310

https://doi.org/10.7096/JPSA.200912.0301

摘要

背景及目的：
Keloid組織除在臨床上造成外觀問題，也有痛或癢的困擾，但是及造成原因並不明確，很多研究指出和TGF-β路徑有相關性，臨床上治療方式有很多種，染料雷射是其中之一，在臨床治療提供顯著的改善，所以研究對於TGF-β路徑其中分子的影響，及其可能的機轉為何。
材料與方法：
在西元2005年至2006年間，10個有keloid的病人在簽署同意書之後，接受6次染料雷射的治療，在雷射治療前以及之後一個月，接受臨床表現的評估和部分keloid組織切除，執行TGF-β和Smad2蛋白的免疫染色分析，和Smad2的mRNA定量分析。
結果：
在染料雷射治療後，臨床上病灶的顏色,柔軟度,血管性有改善，Smad2的mRNA量也在治療後有明顯下降，但是TGF-β和Smad2蛋白的免疫染色分析並沒有看到顯著差異。
結論：
染料雷射對於TGF-β路徑上的分子有其影響，可能經由直接降低作用分子的生成量或是經由其他的分子影響，但是本實驗收集的標本已完全使用，目前無法作更近一步的探討研究，未來需要收集更多的病人和組織標本，來作更深入的分析。

並列摘要

Background and Objectives:
Keloid is benign hyperproliferative collagen formation in response to skin trauma. Although the pathoetiology of keloid formation remains unclear, over reaction of the TGF-β pathway is believed to be a mechanism. In this study, we survey the differences in clinical presentation and the change in molecules of the TGF-β pathway after pulsed dye laser therapy.
Materials and Methods:
From January 2005 to December 2006, patients diagnosed with keloid were selected to receive six doses of pulsed dye laser therapy. Clinical assessments were evaluated before and 1 month after the laser therapy. Keloid tissue samples were also collected before and 1 month after laser therapy. Laboratory analysis included immunohistochemical staining of TGF-β and phosphorylated Smad2, and real-time PCR of Smad2 mRNA.
Results:
Ten patients were included in the clinical assessment. Vascularity, pliability, height and colour difference were significantly different after dye laser therapy. Six patients were entered into laboratory analysis. Presentation of TGF-β and phosphorylated Smad2 in IHC staining was not significant in either control or test group. However, real-time PCR of Smad2 mRNA showed a significance reduction (P=0.018).
Conclusion:
Reduction of Smad2 mRNA after pulsed dye laser therapy was observed in our study. A larger patient population is required for further study.

並列關鍵字

keloid ； smad ； pulsed-dye laser