Study IDs possible genetic link to keloid scarring

New research has led to the discovery of previously unidentified genes that may be responsible for keloid scarring. The findings could lead to more effective treatment methods.

The research team, led by Lamont R. Jones, M.D., vice chairman, department of otolaryngology-head and neck Surgery at Henry Ford Hospital, Detroit, used six fresh keloid samples and six fresh normal skin samples in which genome-wide profiling had already been done. The researchers identified 190 statistically significant regions of DNA that were mapped to 152 keloid-specific genes.

The 152 genes were uploaded into analysis software that integrates genes and molecules that are part of the same biological functions or regulatory networks interacting. Among 152 unique genes, the researchers identified 10 that demonstrated an increase of the cellular components and regulatory pathways that are keys to keloid development.

Thus, the researchers were able to show that certain keloid genomes are present in known bionetwork pathways involved in critical biological functioning and signaling events in the cell.

“The study results demonstrate how the optimization of gene selection can be used for biological significance in hopes of better understanding keloid pathogenesis and for targeted therapy for keloid disease in the near future,” Dr. Jones tells Dermatology Times.

Next: What does this mean for clinicians?

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A brief survey of three dermatologists revealed views ranging from uncertainty about the study’s findings to high praise.

“It seems to be a bit of a stretch to see where it will eventually help,” says Omaha, Neb., dermatologist Joel Schlessinger, M.D. “Given that this is a cosmetic issue, I am not sure we would have a huge reason to avoid surgery that is necessary. And even if someone wanted cosmetic surgery, such as a breast augmentation, I am not sure they would not have the procedure due to a potential genetic risk. While this (study) is interesting, I just don’t see a huge clinical benefit at this point until the time that some concrete treatment - based on the genetic information - is available. This is the holy grail.”

Patti Farris, M.D., a New Orleans dermatologist, tells Dermatology Times, “The findings are interesting but not surprising. Will it lead to a cure for keloids? I don’t know, but the more we know about a disease process, the better.”

Helen Torok, M.D., a dermatologist in Medina, Ohio, was enthused.

“What exciting and hopeful times we live in,” she says. “To be able to do a small punch biopsy and accurately predict who will form post-procedure keloids is a major step in medicine. Patients often ask if they will get a scar post-procedure, and we cannot, today, with certainty and confidence predict the outcome. This new technology allows the clinicians to accurately assess and perhaps not perform piercings or other surgical invasive procedures to the detriment of the patient.”

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