Contribution of epidermal stem cells to hypertrophic scars pathogenesis.

Hypertrophic scars are fibroproliferative disorders of excessive wound healing due to an imbalance between synthesis and degradation and the mechanism leading to hypertrophic scars formation is poorly understood and currently no successful treatment modality exists. We hypothesize epidermal stem cells (ESCs), which could inhibit epidermal fibrosis, plays a substantial contributory role in the pathogenesis of hypertrophic scars. Accepting the hypothesis to be correct, a therapy that inhibits cell and extracellular matrix proliferation can be used to prevent the hypertrophic scars formation. Current therapies are only partially effective and safe because they couldn't inhibit the cell and extracellular matrix proliferation and eliminate other relative factors of hypertrophic scars formation at all, such as: absence of epidermal-mesenchymal interaction, and at the same time inducing death (apoptosis and necrosis) of other normal cells. A more efficient prevention of hypertrophic scars could be achieved using tissue engineering skin enriched with ESCs and introduced recombinant genes into ESCs which could inhibit hypertrophic scars formation.