Abstract
Purpose: To determine the anti-scarring property of bacoside A (BA) in a rabbit model of post-burns hypertrophic scar (HS). Methods: A total of 16 healthy male rabbits were divided into four groups (4 rabbits/group). The rabbits were subjected to full-thickness burn wound by placing a 10-mm brass rod at 90 oC on their ears for 20s, and were untreated (HS group). The remaining rabbits also underwent HS process but were topically treated daily with 0.2, 0.4 or 0.6 % BA gel (HS + 0.2, 0.4, and 0.6 % BA groups) from day 8 to day 34. Results: The mean values of collagen (types I & III), hydroxyproline (precursor of collagen) and hexosamine, as well as scar index significantly (p < 0.001) decreased after 28 days of topical treatment with BA. Moreover, BA application resulted in improved histological changes with proper arrangement of collagen fibers. Significant (p < 0.001) upregulation or downregulation of transforming growth factor beta-1 (TGF-β1) and matrix metalloproteinase-1 (MMP-1) were observed in the BA-treated rabbits. Conclusion: Treatment with BA significantly lowers the scarring area of burn wounds by downregulation of TGF-β1. Thus, BA can potentially be developed into a drug for managing injury scars. Keywords: Hypertrophic scar, Bacoside A, Scar elevation index, Transforming growth factor beta-1, Collagen
Highlights
Hypertrophic scar (HS) reflects the dysfunctional response from the skin during injury especially burns and surgery, which leads to excessive deposition of fibroblast and collagen and thick elevated scar/fibrosis [1]
The effect of bacoside A (BA) on collagen types I and III, and glycosaminoglycans in the experimental rabbits are shown in Figure 1A and Figure 1B, respectively
The scar tissue section of HS rabbits revealed the presence of excessively scattered fibroblasts with an irregular arrangement of collagen fibers leading to thickened dermal layers
Summary
Hypertrophic scar (HS) reflects the dysfunctional response from the skin during injury especially burns and surgery, which leads to excessive deposition of fibroblast and collagen and thick elevated scar/fibrosis [1]. Post-burn HS presents an emotional and physical burden on the patient owing to excessive pain, pruritus, discomfort, disability (joint contracture) and disfigurements [2]. Epidemiological studies have indicated that about 40 – 70 % of thermal injury (burn wound) result in HS. There are no effective treatment procedures or protocols for managing post-burn HS. A few treatment strategies (sub-optimal treatments) are employed efficiently to manage HS. These include silicone gel sheeting, massage therapy, laser surgery, and peptide therapy with natural products (combination therapy) [4]
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