Flashlamp pulsed dye laser (PDL) suppression of keloid proliferation through down-regulation of TGF-beta1 expression and extracellular matrix expression.

Abstract

BACKGROUND AND OBJECTIVES:

Keloids have been treated with flashlamp pulsed dye lasers (PDLs) with good results. We investigated whether PDL treatments induced keloid regression by decreasing growth factor-beta(1) (TGF-beta(1)) induction, thereby reducing fibroblast proliferation and collagen deposition.

STUDY DESIGN/MATERIALS AND METHODS:

Clinical evaluation and photography documented keloid height/texture, erythema, and pliability before and after PDL treatments scheduled at 2-month intervals in 30 patients. Fluence per pulse was 10-18 J/cm(2) (mean 14.0 J/cm(2)). Immunohistochemical (IHC) staining of TGF-beta(1), proliferating cell nuclear antigen (PCNA), and collagen (types I and III) in extra-cellular matrix was performed on 10 intra-lesional or punch biopsies obtained before and 7 days after PDL treatments.

RESULTS:

Twelve months after final PDL treatments, keloid regression ( >/= 50%) had occurred in 26/30 patients in whom erythema and surface irregularities had been reduced and pliability had been increased. In 4/30 patients, no changes in keloids had occurred after 12 months. Multiple treatments ( > 6) yielded better results than fewer treatments: 79% versus 50%, respectively. Marked keloid regression ( >/= 90%) occurred in two patients who had received more than 10 treatments. IHC staining indicated that expression of TGF-beta(1), PCNA and collagen type III, but not type I, was significantly reduced in keloid fibroblasts after PDL irradiation.

CONCLUSIONS:

Keloids regressed following PDL-induced reduction in TGF-beta(1) expression, fibroblast proliferation, and collagen type III deposition. More than six PDL treatments at 2-month intervals provided the best results.

• Authors: Yur-Ren Kuo, Seng-Feng Jeng, Feng-Sheng Wang, Tien-Hsing Chen, Hui-Chen Huang, Pei-Rong Chang, Kuender D Yang
• Journal: Lasers in surgery and medicine (Lasers Surg Med) Vol. 34 Issue 2 Pg. 104-8 ( 2004) ISSN: 0196-8092 [Print] United States
• PMID: 15004820 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright 2004 Wiley-Liss, Inc.

Chemical References

• Collagen Type III
• Proliferating Cell Nuclear Antigen
• Transforming Growth Factor beta

Topics

• Adolescent
• Adult
• Child
• Collagen Type III (metabolism)
• Down-Regulation
• Extracellular Matrix (metabolism)
• Female
• Fibroblasts (metabolism)
• Humans
• Keloid (metabolism, radiotherapy)
• Laser Therapy
• Male
• Middle Aged
• Proliferating Cell Nuclear Antigen (metabolism)
• Transforming Growth Factor beta (metabolism)
• Treatment Outcome