Therapeutic potential of silicone gel sheet treatment and alteration in transforming growth factor beta gene expression in hypertrophic scars

Abstract

Background: The management and prevention of hypertrophic scars is a challenging problem. Various efforts are made by the researchers to understand the mechanism of the abnormal healing and also to offer better therapy to control these unusual scars. Silicone gel sheet is widely used as the first-line therapy for hypertrophic scars. Objective: The present study has been designed to find out the efficacy of silicone gel sheet treatment on transforming growth factor beta gene(s) expression. Subjects and Methods: The total RNA was isolated from forty hypertrophic scar cases with median age of 42 years before starting the treatment and at 6 months after the silicone gel sheet therapy using Trizol. The cDNA was synthesized for the quantitative gene expression analysis of transforming growth factor beta gene (1, 2, and 3) by real-time polymerase chain reaction. Results: The observations showed that the mRNA expression of transforming growth factor beta (TGF β)-1 and -2 gene in hypertrophic scars was much higher, i.e., 2.6- and 3.8-fold, respectively, when evaluated and compared with controls. The present study also evaluated the efficiency of silicone gel sheet treatment therapy in hypertrophic scars in relation to altered expression of TGF-beta genes. After 6 months of therapy, the mRNA expression of TGF β-2 gene was significantly downregulated (P = 0.01) and β-3 insignificantly upregulated. Patients' assessment scale showed complete cure in 12.5% of cases, and major improvement was observed in 45% of cases. Conclusion: The silicone gel sheet therapy is useful for treating the hypertrophic scars by downregulating expression of profibrotic TGF β-1 and -2 genes.