Botulinum Toxin Type A For Prevention And Therapy Of Hypertrophic Scars

There are various ways to cure Hypertrophic Scars(HTS),among which injection of drugs is one of the most important clinical treatments.In recent years,Botulinum Toxin Type A(BTXA)is the hot issue of research and application.As a kind of neurotoxin,the clinical appliable range of BTXA unceasingly expands.As is reported,the treatment of BTXA on pain disorders,benign prostate hyperplasia and the elements to restrain substance P hints that BTXA might have effect of prevention,restraining hyperplasia, relief of symptom on HTS.This subject explored the prevention and treatment of BTXA on inchoate HTS on base of previous study in order to expand the space of HTS treatment and the vista of BTXA application.The study can be divided into two parts.1.Clinical study is to inject BTXA in the area around HTS and in the tissue of HTS.Observe changes of the tissue form and the symptom and behavior of the patient.Using HE staining observe changes of pathology of HTS tissue slide.Meanwhile after surgically exscind strip-scar,oversew the incision and inject BTXA under hypoderma to study its long-term effect in a year.2.Study in the lab is to cultivate fibroblasts from the body in order to search the elements of BTXA on HTS.Observe the effect of BTXA on the biological changes and cell growth in order to supervise clinical treatment.After grouping fibroblasts of HTS,we treated with 50U/1ml BTXA,microscopically study changes of fibroblasts;then 72 hours later,inspect apoptosis of fibroblasts using flow cytometry(FCM),and checkout using statistics;as well as ultrastructure-changes of cells using transmission electron microscopy(TEM).The results show that partial injection of BTXA can alleviate pain and itch of the inchoate patients of HTS,and it causing them soft and atrophy. Tissue slide HE-stained shows that HTS structurally changes after treatment of BTXA.At the same time,injection of BTXA around cut after surgery can prevent occurs of HTS and improve healing.It can observe the biologically changes through microscope on fibroblast ultivated from HTS with the treatment of BTXA 50U/ml.It has statistical significance(p＜0.05)to study different periods of apoptosis of fibroblasts between control group and treatment group using FCM.The ultrastructural changes of apoptosis cell are also observed using TEM.We can draw the conclusion that BTXA can treat HTS to some extent.In addition,it may also prevent occurs of HTS of cut and improve healing after operation.It is possible that it achieves this effect through decreasing the movement and tensility around scar and cut,preventing the nerves transfer in HTS as well as substance P,and it can induce aopotosis of fibroblasts,reduce collagen secretion.The prospect of BTXA for HTS treatment is worth going deep into study.