Biochemistry
The biochemistry of keloid scars is marked by the following features:
- collagen metabolism:
- increased collagen turnover
- increased activity of the synthetic enzymes lysyl oxidase and prolyl-4-hydroxylase
- increased collagen mRNA expression
- active keloids synthesise collagen at a rate of 20 times that of normal skin and 3 times that of hypertrophic scars(1)
- type I and type III collagen synthesis is increased, but the former is increased to a relatively greater extent
- reduced breakdown of collagen as suggested by the accumulation of collagenase inhibitors alpha-1-antitrypsin and alpha-2-macroglobulin
- increased metabolic rate as suggested by a rise in the activity of enzymes of the glycolytic and TCA pathways
Ref:
(1) Craig RDP, Schofield JD, Jackson JS. Europ J Clin Invest (1975); 5: 69-72.
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