A novel TGF-beta antagonist speeds reepithelialization and reduces scarring of partial thickness porcine burns

Abstract

Scar formation after thermal injury is common and results in significant aesthetic and functional impairment. Transforming growth factor beta (TGF-beta) plays a significant role in scar formation. We tested the hypothesis that a novel TGF-beta peptantagonist would reduce scar formation and wound contraction in partial thickness burns by using a randomized controlled experiment. The subjects include two domestic pigs (20-25 kg). Forty burns were created on the animal's dorsum using an aluminum bar preheated to 80 degrees C and applied for 20 seconds resulting in a partial thickness thermal burn extending half way down the dermis. Burns were treated every other day for 1 week, then twice weekly for 3 weeks with a topical TGF-beta antagonist or its vehicle. Full thickness biopsies were obtained from all burns at 7, 10, and 14 days after injury. The wounds were completely excised after 28 days for histological assessment. Wound sections were stained with H&&E and evaluated by a dermatopathologist masked to treatment assignment for reepithelialization and depth of scar formation. We also determined the number of wounds at 28 days that healed with contracted, hour-glass shaped scars. Data were compared with chi and t-tests. Twenty burns were treated with TGF-beta antagonist and 20 with control vehicle. TGF-beta antagonist increased the percentage of completely reepithelialized wounds at 14 days (90 vs 45%, P = .002) and reduced the percentage of contracted wounds (35 vs 65%, P = .02) and full thickness scars (10 vs 60%, P = .002) at 28 days. Treatment of partial thickness porcine burns with the TGF-beta antagonist speeds reepithelialization and reduces scar formation and wound contraction in partial thickness porcine burns.