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Botulinum toxin type a intralesional monotherapy for treating human hypertrophic scar in a dose-dependent manner: In an animal model

  • Yawei Li
    Affiliations
    Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, 100081, China
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  • Xiaofeng Shan
    Affiliations
    Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, 100081, China
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  • Qianying Mao
    Affiliations
    Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, 100081, China
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  • Ruolan Xiang
    Correspondence
    Corresponding authors.
    Affiliations
    Department of Physiology and Pathophysiology, Peking University School of Basic Medical Sciences, Beijing, 100191, China
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  • Zhigang Cai
    Correspondence
    Corresponding authors.
    Affiliations
    Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, 100081, China
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Published:April 23, 2021DOI:https://doi.org/10.1016/j.bjps.2021.03.062

      Summary

      Background

      The effect of Botulinum toxin type A (BTX-A) in treating or preventing a hypertrophic scar (HS) had been reported in clinical studies. However, the dose-effect relationship remains unclear.

      Objective

      To study the dose-effect relationship of BTX-A intralesional monotherapy treating human HS.

      Methods

      Six HS tissues were collected from six patients. Each tissue was segmented into 24 specimens and split into four groups: negative control (group A), 0.5U BTX-A (group B), 1U BTX-A (group C), and 2U BTX-A (group D). Six nude mice, each was prepared by implanting four specimens (one from each group) into the back for a total of 24 specimens. The process mentioned above were repeated six times. A re-entry operation was performed to obtain the specimens after 8 weeks. The weight of HS, the expression of decorin and TGF-β1, the proliferation, and migration ability of hypertrophic scar fibroblasts (HSFBs) were compared among groups.

      Results

      The weight of HS, the expression of decorin and TGF-β1, the proliferation, and migration ability of HSFBs showed significant differences in groups C and D as compared to group A; there has been no statistical significance in group B.

      Conclusion

      BTX-A showed significant therapeutic efficacy when compared with the negative control group in a dose-dependent manner. BTX-A can reduce the weight of HS, upregulate the expression of decorin, downregulate the expression of TGF-β1, and inhibit HSFBs proliferation and migration ability. This study indicates that BTX-A intralesional monotherapy treating HS should reach a threshold dose to achieve an effective treatment, and a high dose of BTX-A is more effective than a low dose.

      Keywords

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      Linked Article

      • Botulinum toxin type a intralesional monotherapy for treating human hypertrophic scar in a dose-dependent manner: In an animal model
        Journal of Plastic, Reconstructive & Aesthetic SurgeryVol. 74Issue 11
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          We read with great interest the article entitled “Botulinum Toxin Type A Intralesional Monotherapy for Treating Human Hypertrophic Scar in a Dose-dependent Manner: in an Animal Model”1 by Li YW et al. in Journal of Plastic, Reconstructive & Aesthetic Surgery. In this article, the authors conducted an in vivo experiment on the effect of different doses of botulinum toxin Type A (BTXA) for treating human hypertrophic scar. They concluded that BTXA reduced the severity of hypertrophic scar in a dose-dependent manner by inhibiting proliferation and migration of scar fibroblasts.
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