| BACKGROUNDKeloid is scar tissue due to excessive hyperplasia after aberrant wound healing process.It is often considered as a benign proliferative disease,occurring more often in colored people.The most common clinical manifestations were robust growth of collagen fibers beyond primary wound boundary,sometimes accompanied with itchiness,pain and pigmentation.Multiple etiologies can lead to keloid lesion formation.However,due to partially understood underlying mechanisms,this frustrating clinical problem still lacks warranted solutions.One important theory about keloid formation is repeatedly chronic inflammation leading to keloid formation.Meanwhile,gut microbiota is considered to be linked to multiple systemic diseases including cancer,hypertension and autoimmune disease.Given the facts that gut flora is also associated with systemic chronic inflammation response,we here to present the study of correlation between gut flora and susceptibility to keloids formation.This study is aimed to study this relationship through multidimensional data from gut flora and chest skin flora,which might provide us some evidence for probiotics treatment or topical antibiotics as adjuvant therapy in keloid treatment.OBJECTIVE1)For the very first time globally,we explore the relationship between chest keloids and gut microbiota,to validate the possibility of probiotics as adjuvant treatment for comprehensive chest keloid treatment.2)To establish the gut microbiota spectrum for chest keloid patients for the very first time globally3)To verify the potential role IL-6 might play in this relationship4)To explore the relationship between acne keloidalis nuchae susceptibility and chest skin microbiota5)To identify the differences between chest acne keloid microbiota and as of surrounding normal chest skinMETHODSThe main purpose of this study was to investigate the difference between chest keloid patients in and normal patients,by using multi-dimensional data such as 16S rRNA sequencing,bacterial culture,scar scoring,and serum IL-6 sequencing to find the dominant flora in the intestinal flora of keloid patients.The proportion of probiotics also varied significantly between 2 groups.To explore the differences between the keloids in the chest area and the surrounding normal skin flora,the sequencing of gut microbiome and dermatological microbiota in patients with keloids in the chest area were obtained.RESTULTSAs for gut microbiota,Bacteroides is the dominant genus shared by both the keloid group(K group)and the control group(C group),which accounted for>60%of the overall abundance.The relative abundance of bifidobacterium was significantly lower than that of the normal control group(p<0.05).Although there was difference in lactobacillus comparation,the difference was not significant(p>0.14).Bifidobacteria and lactobacilli both accounted for little proportion of gut microbiota for both group patients(each<0.1%),suggesting the possibility of application of probiotics therapy in a comprehensive treatment of chest keloids.The serum IL-6 concentration in the keloid group was 2.35g±0.07g/L,slightly higher than that in the normal control group 2.08±0.04g/L,both were all negative and not significantly different.In the subgroup analysis,patients with multiple keloids and familial keloids had a higher Vancouver Scar Scale of 13.44±0.24 vs 12.78±0.31)and serum IL-6 concentrations(2.46±0.16 g/L vs 2.29±0.08 g/L).There was no significant difference in the subgroup analysis of probiotics.In terms of skin microbiota,14 samples were selected for acne keloid patients,but with unqualified DNA samples extracted.Only 27%of the samples(7/26)met the DNA requirements for sequencing.Compared with the patients' own control,Propionibacterium and Staphylococcus bacteria on keloids accounted for higher abundance than the surrounding normal skin,which might provide evidence for the use of topical antibiotics in the future.In bacterial culture test,only one patient(3.8%)showed positive results,which showed shallow ulceration over the lesion.CONCLUSIONS We have established gut microbiota spectrum in chest keloid patients,which demonstrates that there are certain differences between the probiotics and the normal control population,but further experiments still required.Serum IL-6 inflammatory factors were elevated in chest keloid scarring compared to surrounding normal skin,but not significantly.Propionibacterium acnes and Staphylococcus were significantly higher in the acne keloidalis nuchae group than as in the surrounding skin.This study provides some moderate evidence for the utilization of probiotics and topical antibiotics in future comprehensive chest keloid treatment.Moreover,further detailed in-depth studies are still needed in the future. |
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