The various fibroproliferative disorders affecting humans have in common excess fibroblast activity and persistent overexpression or dysregulated activity of transforming growth factor beta (TGF- β ). Cancer has many similar characteristics. Antineoplastic drugs can downregulate fibroblast activity and cytokine growth factors. This study evaluates the effect of six antineoplastic drugs on keloid and Dupuytren’s disease fibroblasts. Keloid, normal scar, Dupuytren’s affected palmar fascia, and normal palmar fascia fibroblasts were grown and seeded into Fibroblast Populated Collagen Lattices (FPCLs). The FPCLs were treated with one of six antineoplastic drugs or left untreated as controls. At 7 days, supernatants were extracted from all FPCLs and assayed for expression of Transforming Growth Factor beta (TGF)- β 1 and TGF- β 2 . All six antineoplastic drugs significantly inhibited FPCL contraction in both fibroproliferative conditions compared with the untreated controls ( p < 0.05). Similarly, TGF- β 1 and TGF- β 2 expression was downregulated in the supernatants of all FPCLs by the drug exposure. Cytotoxicity did not occur in these studies and was not the reason for the results. Although antineoplastic drugs can have significant side effects when given systemically, these results may be minimized when given to small areas involved in fibroproliferative scarring or when given topically or intralesionally. These in vitro results suggest that antineoplastic drugs may have a utility for treating various fibroproliferative disorders and warrant further investigation.
Robson, M.C. and Payne, W.G. (2012) Using Laboratory Models to Develop Mechanistic Treatments for Dupuytren’s Disease. In: Eaton, C., Seegenschmiedt, M.H., Bayat, A., Gabbiani, G., Werker, P.M. and Wach, W., Eds., Dupuytren’s Disease and Related Hyperproliferative Disorders, Springer-Verlag, Berlin, 175-183. http://dx.doi.org/10.1007/978-3-642-22697-7_22
Robson, M.C. (2003) Proliferative Scarring. Surgical Clinics of North America, 83, 557-569. http://dx.doi.org/10.1016/S0039-6109(02)00197-4
Lee, T.Y., Chin, G.S., Kim, W.G.H., Chau, D., Gittes, G.K. and Longaker, M.T. (1999) Expression of Transforming Growth Factor Beta 1, 2, and 3 Proteins in Keloids. Annals of Plastic Surgery, 43, 179-184.
Pu, L.L.Q., Smith, P.D., Payne, W.G., et al. (2000) Overexpression of Transforming Growth Factor Beta-2 and Its Receptor in Rhinophyma: An Alternative Mechanism of Pathobiology. Annals of Plastic Surgery, 45, 515-519. http://dx.doi.org/10.1097/00000637-200045050-00008
Younai, S., Nichter, L.S., Wellisz, T., Reinisch, J., Nimni, M.E. and Tuan, T.L. (1994) Modulation of Collagen Synthesis by Transforming Growth Factor-Beta in Keloid and Hypertrophic SCAR fibroblasts. Annals of Plastic Surgery, 33, 148-151. http://dx.doi.org/10.1097/00000637-199408000-00005
Younai, S., Venter, G., Vu, S., Nichter, L., Nimni, M.E. and Tuan, T.L. (1996) Role of Growth Factors in Scar Contraction: An in Vitro Analysis. Annals of Plastic Surgery, 36, 495-501. http://dx.doi.org/10.1097/00000637-199605000-00011
Kuhn, A., Singh, S., Smith, P.D., et al. (2000) Periprosthetic Breast Capsules Contain the Fibrogenic Cytokines TGF-β1 and TGF-β2, Suggesting Possible New Treatment Approaches. Annals of Plastic Surgery, 44, 387-391. http://dx.doi.org/10.1097/00000637-200044040-00006
Kuhn, M.A., Payne, W.G., Kierney, P.C., et al. (2001) Cytokine Manipulation of Explanted Dupuytren’s Affected Human Palmar Fascia. International Journal of Surgical Investigation, 2, 443-456.
Border, W.A. and Rouslahti, E. (1992) Transforming Growth Factor Beta in Disease: The Dark Side of Tissue Repair. Journal of Clinical Investigation, 90, 1-7. http://dx.doi.org/10.1172/JCI115821
Border, W.A. and Noble, N.A. (1994) Transforming Growth Factor Beta in Tissue Fibrosis. New England Journal of Medicine, 331, 1266-1292.
O’Kane, S. and Ferguson, M.W.J. (1997) Transforming Growth Factor Bs and Wound Healing. International Journal of Biochemistry & Cell Biology, 29, 63-78. http://dx.doi.org/10.1016/S1357-2725(96)00120-3
Owens, L.V., Cance, W.G. and Huth, J.F. (1995) Retroperitoneal Fibrosis Treated with Tamoxifen. Annals of Surgery, 61, 842-844.
Clark, C.P., Vanderpool, D. and Preskill, J.T. (1991) The Response of Retroperitoneal Fibrosis to Tamoxifen. Surgery, 109, 502-506.
Timmons, M.J. (1994) Fibromatosis, Desmoids, Fibroblasts, and Tamoxifen. British Journal of Plastic Surgery, 47, 378-380. http://dx.doi.org/10.1016/0007-1226(94)90100-7
Kuhn, M.A., Wang, X., Payne, W.G., Ko, F. and Robson, M.C. (2002) Tamoxifen Decreases Fibroblast Function and Downregulates TGF Beta-2 in Dupuytren’s Affected Palmar Fascia. Journal of Surgical Research, 103, 146-152. http://dx.doi.org/10.1006/jsre.2001.6350
Payne, W.G., Ko, F., Anspaugh, S., Wheeler, C.K., Wright, T.E. and Robson, M.C. (2006) Down-Regulating Causes of Fibrosis with Tamoxifen: A Possible Cellular/Molecular Approach to Treat Rhinophyma. Annals of Plastic Surgery, 56, 301-305. http://dx.doi.org/10.1097/01.sap.0000199155.73000.2f
Dickens, T.A. and Colletta, A.A. (1993) The Pharmacological Manipulation of Members of the Transforming Growth Factor-Beta Family in the Chemo-Prevention of Breast Cancer. BioEssays, 15, 71-74. http://dx.doi.org/10.1002/bies.950150111
Pollock, M., Constantino, J., Polychronakos, C., et al. (1990) Effect of Tamoxifen on Serum Insulin-Like Growth Factor-1 Levels in Stage 1 Breast Cancer Patients. Journal of the National Cancer Institute, 82, 1693-1697. http://dx.doi.org/10.1093/jnci/82.21.1693
Mancoll, J.S., Zhao, J., McCauley, R.L. and Phillips, L.G. (1996) The Inhibitory Effect of Tamoxifen on Keloid Fibroblasts. Surgical Forum, 47, 718-720.
Chau, D., Mancoll, J.S., Lee, S., et al. (1998) Tamoxifen Downregulates TGF-[Beta] Production in Keloid Fibroblasts. Annals of Plastic Surgery, 40, 490-493. http://dx.doi.org/10.1097/00000637-199805000-00008
Hu, D., Hughes, M.A. and Cherry, G.W. (1998) Topical Tamoxifen: A Potential Therapeutic Regimen in Treating Excessive Dermal Scarring? British Journal of Plastic Surgery, 51, 462-469. http://dx.doi.org/10.1054/bjps.1997.0100
Dvorak, H.F. (1986) Tumors: Wounds That Do Not Heal. The New England Journal of Medicine, 315, 1650-1659. http://dx.doi.org/10.1056/NEJM198612253152606
Bell, E., Ivarsson, B. and Merrill, C. (1979) Production of a Tissue-Like Structure by Contraction of Collagen Lattices by Human Fibroblasts of Different Proliferative Potential in Vitro. Proceedings of the National Academy of Sciences of the United States of America, 76, 1274-1278. http://dx.doi.org/10.1073/pnas.76.3.1274
Ehrlich, H.P., Buttle, D.J. and Bernanke, D.H. (1989) Physiological Variables Affecting Collagen Lattice Contraction by Human Dermal Fibroblasts. Experimental and Molecular Pathology, 50, 220-229. http://dx.doi.org/10.1016/0014-4800(89)90033-6
Germain, L., Jean, A., Auger, F.A. and Garrel, D.R. (1994) Human Wound Healing Fibroblasts Have Greater Contractile Properties than Dermal Fibroblasts. Journal of Surgical Research, 57, 268-273. http://dx.doi.org/10.1006/jsre.1994.1143
Ehrlich, H.P. and Rajaratnam, B.M. (1990) Cell Locomotion Forces versus Cell Contraction Forces for Collagen Lattice Contraction: An in Vitro Model of Wound Contraction. Tissue and Cell, 22, 407-417. http://dx.doi.org/10.1016/0040-8166(90)90070-P
Kuhn, M.A., Moffitt, M.R., Smith, P.D., Lyle, W.G., Ko, F., Meltzer, D.D. and Robson, M.C. (2000) Silicone Sheeting Decreases Fibroblast Activity and Downregulates TGF-β2 in Hypertrophic Scar Model. International Journal of Surgical Investigation, 2, 467-474.
Simman, R., Alani, H. and Williams, F. (2003) Effect of Mitomycin C on Keloid Fibroblasts: An in Vitro Study. Annals of Plastic Surgery, 50, 71-76. http://dx.doi.org/10.1097/00000637-200301000-00012
Bailey, J.N., Waite, A.E., Clayton, W.J. and Rustin, M.H. (2007) Application of Topical Mitomycin C to the Base of Shave-Removed Keloid Scars to Prevent Their Recurrence. British Journal of Dermatology, 156, 682-686. http://dx.doi.org/10.1111/j.1365-2133.2006.07714.x
Hendricks, T., Martens, M.F., Huyben, C.M. and Wobbes, T. (1993) Inhibition of Basal and TGF Beta-Induced Fibroblast Collagen Synthesis by Antineoplastic Agents. Implications for Wound Healing. British Journal of Cancer, 67, 545-550. http://dx.doi.org/10.1038/bjc.1993.100
Naeini, F.F., Najafian, J. and Ahmadpour, K. (2006) Bleomycin Tattooing as a Promising Therapeutic Modality in Large Keloids and Hypertrophic Scars. Dermatologic Surgery, 32, 1023-1029.
Espana, A., Solano, T. and Quintanilla, E. (2001) Bleomycin in the Treatment of Keloids and Hypertrophic Scars by Multiple Needle Punctures. Dermatologic Surgery, 27, 23-27.
Aggarwal, H., Saxena, A., Lubana, P.S., Mathur, R.K. and Jain, D.K. (2008) Treatment of Keloids and Hypertrophic Scars Using Bleomycin. Journal of Cosmetic Dermatology, 7, 43-49. http://dx.doi.org/10.1111/j.1473-2165.2008.00360.x
Choi, H.S., Savard, C.E., Choi, J.W., Kuver, R. and Lee, S.P. (2007) Paclitaxel Interrupts TGF-β1 Signaling between Gallbladder Epithelial Cells and Myofibroblasts. Journal of Surgical Research, 141, 183-191. http://dx.doi.org/10.1016/j.jss.2006.12.558
Liu, X., Zhu, S., Wang, T., et al. (2005) Paclitaxel Modulates TGFβ Signaling in Scleroderma Skin Grafts in Immunodeficient Mice. PLoS Medicine, 2, e354. http://dx.doi.org/10.1371/journal.pmed.0020354
Jemec, B., Linge, C., Grobbelaar, A.O., Smith, P.J., Sanders, R. and McGrouther, D.A. (2000) The Effect of 5-Fluorouracil on Dupuytren Fibroblast Proliferation and Differentiation. Chirurgie de la Main, 19, 15-22. http://dx.doi.org/10.1016/S1297-3203(00)73455-X
Uppal, R.S., Khan, U., Kakar, S., Talas, G., Chapman, P. and McGrouther, D.A. (2001) The Effect of a Single Dose of 5-Fluorouracil on Keloid Scars: A Clinical Trial of Timed Wound Irrigation after Extralesional Excision. Plastic & Reconstructive Surgery, 108, 1218-1224. http://dx.doi.org/10.1097/00006534-200110000-00018
Gupta, S. and Karlra, A. (2002) Efficacy and Safety of Intralesional 5-Fluorouracil in the Treatment of Keloids. Dermatology, 204, 130-132. http://dx.doi.org/10.1159/000051830
Occleston, N.L., Daniels, J.T., Tarnuzzer, R.W., et al. (1997) Single Exposures to Antiproliferatives: Long-Term Effects on Ocular Fibroblast Wound Healing Behavior. Investigative Ophthalmology & Visual Science, 38, 1998-2007.
Ruffy, M.B., Kunnavatana, S.S. and Koch, R.J. (2006) Effects of Tamoxifen on Normal Human Dermal Fibroblasts. Archives of Facial Plastic Surgery, 8, 329-332. http://dx.doi.org/10.1001/archfaci.8.5.329
Mikulec, A.A., Hanasono, M.M., Lum, J., Kadleck, J.M., Kita, M. and Koch, R.J. (2001) Effect of Tamoxifen on Transforming Growth Factor Beta1 Production by Keloid and Fetal Fibroblasts. Archives of Facial Plastic Surgery, 3, 111-114. http://dx.doi.org/10.1001/archfaci.3.2.111
Daniels, J.T., Occleston, N.L., Crowston, J.G. and Khaw, P.T. (1999) Effects of Antimetabolite Induced Cellular Growth Arrest on Fibroblast-Fibroblast Interactions. Experimental Eye Research, 69, 117-127. http://dx.doi.org/10.1006/exer.1999.0684
Seo, S.H. and Sung, H.W. (2012) Treatment of Keloids and Hypertrophic Scars Using Topical and Intralesional Mitomycin C. Journal of the European Academy of Dermatology and Venereology, 26, 634-638. http://dx.doi.org/10.1111/j.1468-3083.2011.04140.x
Jones, C.D., Guiot, L., Samy, M. and Tehrani, H. (2015) The Use of Chemotherapeutics for the Treatment of Keloid Scars. Dermatology Reports, 7, 5880. http://dx.doi.org/10.4081/dr.2015.5880
Manca, G., Pandolfi, P., Gregorelli, C., Cadossi, M. and de Terlizzi, F. (2013) Treatment of Keloids and Hypertrophic Scars with Bleomycin and Electroporation. Plastic and Reconstructive Surgery, 132, 621-630e. http://dx.doi.org/10.1097/PRS.0b013e3182a053c8
Goldan, O., Weissman, O., Regev, E., Haik, J. and Winkler, E. (2008) Treatment of Postdermabrasion Facial Hypertrophic and Keloid Scars with Intralesional 5-Fluorouracil Injections. Aesthetic Plastic Surgery, 32, 389-392. http://dx.doi.org/10.1007/s00266-007-9109-3
Smith, P.D., Mosiello, G., Deluca, L., Ko, F., Maggi, S. and Robson, M.C. (1999) TGF-β2 Activates Proliferative Scar Fibroblasts. Journal of Surgical Research, 82, 319-323. http://dx.doi.org/10.1006/jsre.1999.5580
Kontochristopoulos, G., Stefanaki, C., Panagiotopoulos, A., Stefanaki, K., Argyrakos, T., Petridis, A. and Katsambas, A. (2005) Intralesional 5-Fluorouracil in the Treatment of Keloids: An Open Clinical and Histopathologic Study. Journal of the American Academy of Dermatology, 52, 474-479. http://dx.doi.org/10.1016/j.jaad.2004.09.018
Nanda, S. and Reddy, B.S. (2004) Intralesional 5-Fluorouracil as a Treatment Modality of Keloids. Dermatologic Surgery, 30, 54-57.