It has been suggested that immunological factors play a major role in the pathogenesis of hypertrophic scars. Characteristically there is an onset of typical clinical features and, after a variable period of activity, there is a phase of remission. The factors which produce this progressive change in the scars are not clear, and it is not known if their manipulation could provide a therapeutic progress. In order to further investigate the pathophysiology, morphological studies have been performed. In active hypertrophic scars lymphocytic infiltrates are abundant. Among them activated T-cells represent 70% of infiltrates while in normotrophic scar activated T-cells make up 30% of lymphocytes, suggesting a role of these cells in the mechanisms leading to scar hypertrophy. Upon activation, the lesional T-cells release several cytokines which may induce anomalous expression of activation markers (HLA-DR, ICAM-1, CD36, IL-2R) on keratinocytes and fibroblasts of hypertrophic tissue. A wide range of cytokines has been examined: among those analyzed the only one that changes in the remission phase is IFNγ. In fact, IFNγ is highly expressed in lymphocytes in active hypertrophic scars while it is less expressed in the remission phase and in control samples.
European Journal of Plastic Surgery – Springer Journals
Published: Jan 1, 1998
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