Understanding the role of skin mechanical properties in the formation of scars.
Lead Research Organisation:
Imperial College London
Department Name: Bioengineering
Abstract
MRC : Magdalena Plotczyk : MR/N014103/1
Scarring is a common consequence of burn injuries and surgical procedures, placing an enormous burden on individuals and the society. An estimated 100 million people per year in the developed world alone suffer from excessive scarring. Patients suffer from long-term physical dysfunction in the form of painful contractures or psychological harm from social stigma. Multiple surgical techniques have been tried to minimize scarring, but so far there is no proven method to prevent scar formation. To address this clinical need, the present study aims to increase our understanding of the role of skin tension in dermal fibrosis and the heterogeneity between scars, which range from unpigmented fine lines to widespread pathological scars.
Despite differences between scar types, all of them are characterized by increased deposition of collagen fibres and changes in the mechanical properties of the skin. Increased tension on the healing wound is considered to promote scar formation. However, a laxity paradox in the field of hair transplantation describes a phenomenon opposing this view. After a surgery involving removal of tissue from the occipital scalp for harvesting hair follicles, patients with tight scalps heal with narrow 1-2 mm wide scars, while those characterised by loose scalp skin (approx. 5%) obtain 10-12 mm wide stretched scars. Despite the widespread recognition of the laxity paradox amongst hair transplant surgeons, its cellular mechanism remains unknown. In my PhD thesis, I hypothesise that the differences in clinical outcomes - developing a stretched or a neat scar, depend on the underlying mechanical properties of the skin. Despite previous references to stretched scars being formed in areas of extensive tension, in patients with loose skin, the tension of the healing skin may be insufficient to support a healthy level of skin contraction, and thus lead to skin 'stretching' and formation of a wide scar.
The results of my PhD thesis so far suggest that decreased presence of certain proteins can serve as a unique signature of stretched scars. In my future experiments, I will test if these changes can be caused by decreased tension applied to the healing wound in the loose skin. At the University of Toronto, I will use the expertise and facilities of the host lab to expose skin cells to different mechanical forces and record their response. Upon completion of these experiments, I will know whether the lower tension across a healing wound in loose skin has a role in decreased protein expression and stretched scar formation. In the long term, the study will validate targets for therapeutic intervention to reduce scar formation or revise established scars, leading to both economic and societal impact.
Scarring is a common consequence of burn injuries and surgical procedures, placing an enormous burden on individuals and the society. An estimated 100 million people per year in the developed world alone suffer from excessive scarring. Patients suffer from long-term physical dysfunction in the form of painful contractures or psychological harm from social stigma. Multiple surgical techniques have been tried to minimize scarring, but so far there is no proven method to prevent scar formation. To address this clinical need, the present study aims to increase our understanding of the role of skin tension in dermal fibrosis and the heterogeneity between scars, which range from unpigmented fine lines to widespread pathological scars.
Despite differences between scar types, all of them are characterized by increased deposition of collagen fibres and changes in the mechanical properties of the skin. Increased tension on the healing wound is considered to promote scar formation. However, a laxity paradox in the field of hair transplantation describes a phenomenon opposing this view. After a surgery involving removal of tissue from the occipital scalp for harvesting hair follicles, patients with tight scalps heal with narrow 1-2 mm wide scars, while those characterised by loose scalp skin (approx. 5%) obtain 10-12 mm wide stretched scars. Despite the widespread recognition of the laxity paradox amongst hair transplant surgeons, its cellular mechanism remains unknown. In my PhD thesis, I hypothesise that the differences in clinical outcomes - developing a stretched or a neat scar, depend on the underlying mechanical properties of the skin. Despite previous references to stretched scars being formed in areas of extensive tension, in patients with loose skin, the tension of the healing skin may be insufficient to support a healthy level of skin contraction, and thus lead to skin 'stretching' and formation of a wide scar.
The results of my PhD thesis so far suggest that decreased presence of certain proteins can serve as a unique signature of stretched scars. In my future experiments, I will test if these changes can be caused by decreased tension applied to the healing wound in the loose skin. At the University of Toronto, I will use the expertise and facilities of the host lab to expose skin cells to different mechanical forces and record their response. Upon completion of these experiments, I will know whether the lower tension across a healing wound in loose skin has a role in decreased protein expression and stretched scar formation. In the long term, the study will validate targets for therapeutic intervention to reduce scar formation or revise established scars, leading to both economic and societal impact.
People |
ORCID iD |
| Claire Higgins (Principal Investigator) |