ArticleInternational wound journal2017
Keloid progression: a stiffness gap hypothesis.
Article in International wound journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
20 citing papers in PubMed, 39 citations in OpenAlex.
- Arthrofibrosis After Total Knee Arthroplasty: Biological Mechanisms, Diagnosis, and Treatment: An International Consensus Symposium.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2026Article
- Deciphering the cellular landscape of pathological scars.Burns & trauma · 2026Article
- Fibroblast Dynamics in Keloid Pathogenesis: Unraveling Cellular Crosstalk and Novel Therapeutic Targets.Dermatology research and practice · 2026Review
- Ideal Surgical Incision Lines Minimizing Tension: A Proposal Based on Observations of Hypertrophic Scars and Keloids.Plastic and reconstructive surgery. Global open · 2025Article
- Leveraging Microneedles for Raised Scar Management.Polymers · 2025Review
- Increased Susceptibility to Mechanical Stretch Drives the Persistence of Keloid Fibroblasts: An Investigation Using a Stretchable PDMS Platform.Biomedicines · 2024Article
- Targeting Nuclear Mechanics Mitigates the Fibroblast Invasiveness in Pathological Dermal Scars Induced by Matrix Stiffening.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2024Article
- Laparoscopic procedures-induced keloids: A retrospective case series study.International wound journal · 2023Article
- Double enhancement effect of a surface dose with tungsten rubber bolus in photon radiotherapy for keloids and superficial tumors.Physical and engineering sciences in medicine · 2023Article
- Mechanical regulation of chromatin and transcription.Nature reviews. Genetics · 2022Review
- Role of Inflammasomes in Keloids and Hypertrophic Scars-Lessons Learned from Chronic Diabetic Wounds and Skin Fibrosis.International journal of molecular sciences · 2022Review
- Plastic Surgery Fellowship at Nippon Medical School Hospital: An Integrative Approach to Modern Plastic Surgery Education.Plastic and reconstructive surgery. Global open · 2021Article
- Tomotherapy as an Alternative Irradiative Treatment for Complicated Keloids.Journal of clinical medicine · 2020Article
- The Keloid Disorder: Heterogeneity, Histopathology, Mechanisms and Models.Frontiers in cell and developmental biology · 2020Review
- The Spectrum of Scarring in Craniofacial Wound Repair.Frontiers in physiology · 2019Review
- Structure and Distribution of an Unrecognized Interstitium in Human Tissues.Scientific reports · 2018Article
- Keloid and Hypertrophic Scars Are the Result of Chronic Inflammation in the Reticular Dermis.International journal of molecular sciences · 2017Review
- Keloid research: current status and future directions.Scars, burns & healingReview
- Keloidal pathophysiology: Current notions.Scars, burns & healingReview
- A Different Keloid in More Ways than One.Indian dermatology online journalArticle
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Keloids are fibroproliferative skin disorders characterised clinically by continuous horizontal progression and post-surgical recurrence and histologically by the accumulation of collagen and fibroblast ingredients. Till now, their aetiology remains clear, which may cover genetic, environmental and metabolic factors. Evidence in the involvement of local mechanics (e.g. predilection site and typical shape) and the progress in mechanobiology have incubated our stiffness gap hypotheses in illustrating the chronic but constant development in keloid. We put forward that the enlarged gap between extracellular matrix (ECM) stiffness and cellular stiffness potentiates keloid progression. Matrix stiffness itself provides organisational guidance cues to regulate the mechanosensitive resident cells (e.g. proliferation, migration and apoptosis). During this dynamic process, the ECM stiffness and cell stiffness are not well balanced, and the continuously enlarged stiffness gap between them potentiates keloid progression. The cushion factors, such as prestress for cell stiffness and topology for ECM stiffness, serve as compensations, the decompensation of which aggravates keloid development. It can well explain the typical shape of keloids, their progression in a horizontal but not vertical direction and the post-surgical recurrence, which were evidenced by our clinical cases. Such a stiffness gap hypothesis might be bridged to mechanotherapeutic approaches for keloid progression.
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Registered trials
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