Advances in the pathogenesis and clinical application prospects of tumor biomolecules in keloid

Abstract

Keloid scarring is a kind of pathological healing manifestation after skin injury and possesses various tumor properties, such as the Warburg effect, epithelial-mesenchymal transition (EMT), expression imbalances of apoptosis-related genes and the presence of stem cells. Abnormal expression of tumor signatures is critical to the initiation and operation of these effects. Although previous experimental studies have recognized the potential value of a single or several tumor biomolecules in keloids, a comprehensive evaluation system for multiple tumor signatures in keloid scarring is still lacking. This paper aims to summarize tumor biomolecules in keloids from the perspectives of liquid biopsy, genetics, proteomics and epigenetics and to investigate their mechanisms of action and feasibility from bench to bedside. Liquid biopsy is suitable for the early screening of people with keloids due to its noninvasive and accurate performance. Epigenetic biomarkers do not require changes in the gene sequence and their reversibility and tissue specificity make them ideal therapeutic targets. Nonetheless, given the ethnic specificity and genetic predisposition of keloids, more large-sample multicenter studies are indispensable for determining the prevalence of these signatures and for establishing diagnostic criteria and therapeutic efficacy estimations based on these molecules.

Keywords: Biomarkers; Epigenetics; Exosomes; Keloid; Proteome; Tumor biomolecules; Tumor signatures.

Figure 1.

Illustrations of tumor-associated molecules, giving examples of how these molecules may be involved in gene expression from chromosomes to proteins in keloids. Created with BioRender.com. TGF-β transforming growth factor beta, miRNAs microRNAs, MMP matrix metalloproteinase, ASPN asporin, HSP heat shock protein, HIF-1α hypoxia inducible factor 1 subunit alpha, IL interleukin, VEGF vascular endothelial growth factor

Figure 2.

Key pathological processes involved in the development of keloids by proteomic molecules. Created with BioRender.com. HIF-1α hypoxia inducible factor 1 subunit alpha, VEGF vascular endothelial growth factor