殷旭峰 布文博 陈旭 周炳荣

[摘要]瘢痕疙瘩（Keloid）是一种发病机制不明的皮肤纤维增生性疾病，伴有极高的复发率。近年来，通过对干细胞特征表面抗原鉴定，发现瘢痕疙瘩中可能存在间充质干细胞（Mesenchymal-like stem cell）和造血干细胞（Hematopoietic stem cells）。后续的研究进一步发现各种刺激因素作用下，例如：炎症反应、外界张力作用下，发生上皮-间充质改变，这就影响了正常的干细胞所处的一个由间充质细胞、细胞外基质、血管和炎性细胞等共同构成的微环境（Niche），从而形成一种独特的病理微环境来促进瘢痕疙瘩干细胞的增殖。外源性干细胞用于瘢痕疙瘩的临床治疗尚处于实验阶段，对瘢痕疙瘩相关干细胞的深入研究，将为探索瘢痕疙瘩发病机制和临床治疗提供一个新方向。

[关键词]瘢痕疙瘩;干细胞;微环境;表型标志物;生物学特性

[中图分类号]R619+.6    [文献标志码]A    [文章编号]1008-6455（2021）03-0186-04

Research Progress of Keloid-related Stem Cells

YIN Xu-feng1，BU Wen-bo2，CHEN Xu2，ZHOU Bing-rong1

（1.Department of Dermatology， the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029，Jiangsu，China;

2.Dermatology Hospital， Chinese Academy of Medical Sciences，Nanjing 210042，Jiangsu，China）

Abstract： Keloid is a skin fibroproliferative disease of unknown pathogenesis， with an extremely high recurrence rate. In recent years， with antigen identification of surface of stem cell features， mesenchymal-like stem cells and hematopoietic stem cells that may be present in keloid have been discovered. Subsequent research further found： under the effects of various stimulating factors， for example the effects of inflammatory response and external tension， epithelial-mesenchymal will change. This effects the niche in which the normal stem cells are located， a niche composed of mesenchymal-like cells， extracellular matrix， blood vessels， inflammatory cells， etc.Thus forming a unique pathological niche to promote the proliferation of keloid stem cells. The clinical treatment of exogenous stem cells for keloid is still in experimental stage. Deep research on keloid-related stem cells will provide a new direction for exploring the pathogenesis and clinical treatment of keloid.

Key words：keloid;stem cells;niche;phenotypic markers;biological characteristics

瘢痕疙瘩是一種自发或继发于皮肤损伤后产生的异常纤维增生性疾病，主要特征是成纤维细胞过度增殖、细胞外基质的过度沉积，并且持续性侵入周围正常皮肤，具有一定的浸润性特征，伴有极高复发率[1-2]。有研究者从瘢痕疙瘩组织中分离并鉴定一组成体干细胞，称为瘢痕疙瘩源性干细胞，其表达明显的干细胞胚胎和间充质干细胞标志物[3]。经诱导后，具有向脂肪细胞、成骨细胞和软骨细胞方向分化的能力[4]。本文主要综述了瘢痕疙瘩中干细胞样成分及对其发病机制和治疗的潜在意义。

1  瘢痕疙瘩组织中存在干细胞样成分