Genetic risk factors for hypertrophic scar development.
Genetic risk factors for hypertrophic scar development.
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DOI：
10.1097/bcr.0b013e3182a2aa41
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发表时间：
2013-09
期刊：
影响因子：
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通讯作者：
Gibran NS
中科院分区：
文献类型：
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作者：
Thompson CM;Hocking AM;Honari S;Muffley LA;Ga M;Gibran NS
30-72%的患者在热损伤后出现增生性瘢痕（HTS）。风险因素包括皮肤颜色，女性性别，年轻，烧伤部位和烧伤严重程度。最近的遗传变异和临床条件之间的相关性表明，单核苷酸多态性（SNP）可能与HTS的形成。我们假设p27 kip 1基因（rs36228499）中的SNP先前与冠状动脉支架植入术后再狭窄减少相关，将与较低的温哥华瘢痕评分（VSS）测量值和瘙痒减少相关。从患有热烧伤的成人中收集患者和损伤特征。在伤后4-9个月计算VSS评分。采用真实的时间PCR进行基因分型。Logistic回归用于确定增生性瘢痕的危险因素，如VSS评分>7。300名受试者的中位年龄为39岁（范围18-91）; 69%为男性，中位烧伤面积为7% TBSA（范围0.25-80）。与文献一致，p27 kip 1变体SNP的等位基因频率为40%，但在任何遗传模型中与HTS形成减少或瘙痒评分降低无关。HTS的形成与美洲印第安人/阿拉斯加原住民种族（OR，12.2; P=0.02）、面部烧伤（OR，9.4; P=0.04）和烧伤面积≥20% TBSA（OR，1.99; P=0.03）相关。而p27 kip 1 SNP可以防止血管纤维增生，效果不能推广到皮肤疤痕。我们的研究表明，美洲印第安人/阿拉斯加原住民种族，面部烧伤，和较高的%TBSA是HTS的独立危险因素。美洲印第安人/阿拉斯加原住民协会表明，有潜在的尚未确定的遗传变异。
Hypertrophic scars (HTS) occur in 30–72% patients following thermal injury. Risk factors include skin color, female gender, young age, burn site, & burn severity. Recent correlations between genetic variations and clinical conditions suggest that single nucleotide polymorphisms (SNPs) may be associated with HTS formation. We hypothesized that a SNP in the p27kip1 gene (rs36228499) previously associated with decreased restenosis after coronary stenting would be associated with lower Vancouver scar scale (VSS) measurements and decreased itching. Patient & injury characteristics were collected from adults with thermal burns. VSS scores were calculated at 4–9 months following injury. Genotyping was performed using real time PCR. Logistic regression was used to determine risk factors for hypertrophic scar as measured by a VSS score >7. 300 subjects had a median age of 39 years (range 18–91); 69% were male & median burn size was 7% TBSA (range 0.25–80). Consistent with literature, the p27kip1 variant SNP had an allele frequency of 40%, but was not associated with reduced HTS formation or lower itch scores in any genetic model. HTS formation was associated with American Indian/Alaskan Native race (OR, 12.2; P=0.02), facial burns (OR, 9.4; P=0.04), and burn size ≥20% TBSA (OR, 1.99; P=0.03). Whereas the p27kip1 SNP may protect against vascular fibroproliferation, the effect cannot be generalized to cutaneous scars. Our study suggests that American Indian/Alaskan Native race, facial burns, and higher %TBSA are independent risk factors for HTS. The American Indian/Alaskan Native association suggests that there are potentially yet-to-be-identified genetic variants.