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Int. J. Mol. Sci. 2017, 18(12), 2536;

Could −79 °C Spray-Type Cryotherapy Be an Effective Monotherapy for the Treatment of Keloid?

Department of Plastic and Reconstructive Surgery, CHA Bundang Medical Center, CHA University, Seongnam 13496, Korea
Department of Biomedical Science, College of Life Science, CHA University, Seongnam 13488, Korea
Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea
These authors contributed equally to this work.
Authors to whom correspondence should be addressed.
Received: 15 September 2017 / Revised: 13 November 2017 / Accepted: 24 November 2017 / Published: 26 November 2017
(This article belongs to the Special Issue Recent Advances in Scar Biology)
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Cryotherapy has been regarded as an effective modality for the treatment of keloids, and the spray-type device is one of the novel cryotherapeutic units. However, the biological mechanisms and therapeutic effects of this technique are incompletely studied. We evaluated the clinical efficacy of our cryotherapy protocol with molecular and pathologic evidence for the treatment of keloids. We evenly split each of ten keloid lesions into a non-treated (C−) and treated (C+) area; the C+ area was subjected to two freeze-thaw cycles of spray-type cryotherapy using −79 °C spray-type CryoPen™. This treatment was repeated after an interval of two weeks. The proliferation and migration abilities of the fibroblasts isolated from the dermis under the cryotherapy-treated or untreated keloid tissues (at least 5 mm deep) were compared and pathologic findings of the full layer were evaluated. Molecular analysis revealed that the number of dermal fibroblasts was significantly higher in C+ group as compared with C− group. The dermal fibroblasts from C+ group showed more than two-fold increase in the migration ability as compared with the fibroblasts from C− group. The expression of matrix metallopeptidase 9 was increased by more than two-fold and a significant increase in transforming growth factor beta 1 expression and Smad2/3 phosphorylation level was observed in C+ group. C+ group showed more extensive lymphoplasmacytic infiltration with thicker fibrosis and occasional “proliferating core collagen” as compared with C− group. Thus, −79 °C spray-type cryotherapy is ineffective as a monotherapy and should be used in combination with intralesional corticosteroids or botulinum toxin A for favourable outcomes in the treatment of thick keloids. View Full-Text
Keywords: keloid; cryotherapy; fibrosis; matrix metallopeptidase 9; transforming growth factor β 1 keloid; cryotherapy; fibrosis; matrix metallopeptidase 9; transforming growth factor β 1

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Park, T.H.; Cho, H.-J.; Lee, J.W.; Kim, C.W.; Chong, Y.; Chang, C.H.; Park, K.-S. Could −79 °C Spray-Type Cryotherapy Be an Effective Monotherapy for the Treatment of Keloid? Int. J. Mol. Sci. 2017, 18, 2536.

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