Expression And Clinical Significance Of TSG-6 And MMP-9 In The Border Of Keloids

Background: Keloid(KD) is the result of abnormal post-traumatic skin restoration and is in general considered to be secondary to skin injury, which results from the excessive collagen deposition caused by fibroblasts(FB) abnormal proliferation and massive collagen synthesis in extracellular matrix(ECM). KD is characterized with overgrowth and progressive enlargement, invasion of adjacent normal skin tissue, extension beyond the scope of the original wound, high recurrence after surgical resection. Given the enlarged wound if recurrence occurs, treatment with surgery alone is meaningless and, therefore, requires comprehensive treatment that combines other approaches. Discussion on the invasive growth mechanism of KD has always been an important subject that draws the attention of domestic and foreign scholars. Studies have shown that the differential expression of multiple cytokines and regulatory genes in different parts of KD may be closely associated with the invasive growth of KD.Objective: KD is featured by the invasive growth towards surrounding normal tissues. In order to better understand the uncontrollability and invasive growth mechanism of KD, this paper is supposed to study the TSG-6(tumor necrosis factor alpha stimulated gene-6), a protective inflammatory response gene, and MMP-9. Based on the difference and relationship of detected expression level of TSG-6 protein and MMP-9 in the invasive parts and surrouding skins of KD, the association of their overexpression or underexpression with the invasive growth of KD is explored. This paper also aims to provide new ideas and methods for the research and prevention of KD pathogenesis, thus offering a new direction for the clinical treatment of KD.Methods 1. 10 cases of keloid were obtained from the surgrey patients of the Department of Plastic Surgery,the First Hospital of Anhui Medical University,and were diagnosed by clinical and history. 2 According to the standard, the specimens were divided into the invasive group(Ke-I) as Group A, the control group as Group B(Ke-N) for the normal skin surrounding Keloid(0.5cm from the edge) and Group C for the normal skin(NS) collected from the patients who had no keloid undergoing skin grafting operation,or extra normal skin when we cleaned the wound. 3 All specimens were cut 4um thickness Immunohistochemisrty techniques were performed to detect the expression and distribution of TSG-6 and mmp9. And then data were statiscally analyzed.Results The expressions of TSG-6 in group A and B were higher than those in group C, and group A and B showed significant differences from group C(P<0.05). The expressions of mmp9 in group A and B were higher than those in group C, and group A and B showed significant differences from group C(P<0.05).Conclusion The differential expression of MMP-9 and TSG-6 in KD edge may be one of the mechanisms that contribute to the invasive growth and suppression of KD. Expression of MMP-9 may be associated with the invasive growth mechanism of KD, which may result in the imbalance of collagen synthesis and decomposition and promote invasion of Ke to normal tissues. TSG-6 may inhibit further formation of KD by inhibiting MMP-9 and the locally deteriorated inflammatory response. This offers a new therapeutic target for the prevention and treatment of KD.