新型治療策略有望消除唇顎裂修復手術後的過度疤痕

https://forsyth.org/novel-therapeutic-approach-could-eliminate-excessive-scarring-following-orofacial-cleft-repair/

Somerville, Mass., 05/07/2025 – Cleft lip and/or cleft palate are among the most common craniofacial birth defects in the United States. These conditions, collectively referred to as orofacial clefts, occur when a baby’s lip or mouth do not form properly during pregnancy. 

當口顏裂透過手術進行修復時，常會產生一種隆起且增厚的疤痕，稱為 肥厚性疤痕（hypertrophic scar）。此類疤痕可能造成外觀變形並影響功能，對患者帶來重大的社會與經濟影響。 

近期由 ADA Forsyth Institute（AFI） 與 加州大學洛杉磯分校（UCLA） 科學家合作進行的一項研究指出，一種前沿的新型治療方法可能能夠減輕甚至預防過度疤痕形成，為傷口癒合與再生醫學領域帶來重要突破 

Scars are an important part of the body’s natural response to injury to wall off the injured site from normal tissues. During healing, scars are replaced gradually with healthy tissues. However, in abnormal healing, excessive myofibroblasts – cells that produce and organize collagen and play a key role in wound healing – and other abnormal activities can lead to excess scarring that does not heal normally. 

研究團隊成員包括 AFI 兼任教師 Eric Kang Ting, D.M.D., D.Med.Sc.，以及 UCLA 研究人員 Chia Soo, M.D., Pin Ha, D.D.S., M.D.以及 Zhong Zheng, Ph.D. identified a molecule – fibromodulin (FMOD) protein – which works to maintain a balanced level of myofibroblasts, resulting in minimal scarring at the surgical site. The scientists detail this mechanism in a new paper published in Nature Communications. 

丁醫師表示： 「我們的研究團隊一直在探索如何改善唇裂修復手術後的疤痕問題。我們已發現一種源自 fibromodulin 的新型胜肽藥物，可能有助於減少疤痕形成。本研究進一步證明 fibromodulin 在調控與疤痕形成相關的關鍵細胞——肌成纖維細胞——方面具有更廣泛的重要作用。」 

　
在如唇裂縫合等組織閉合手術中加入 FMOD（fibromodulin），可防止過度疤痕形成。此方法亦可能成功預防蟹足腫（keloid scars）的產生。蟹足腫是一種疤痕類型，其特徵為疤痕組織過度生長，並超出原始傷口邊界。 

“By targeting the biology of scarring at the molecular level, this breakthrough has the potential to transform outcomes for patients undergoing cleft repair and other surgical procedures,” said AFI chief science officer and chief operating officer .. “This powerful translational science brings fundamental biological insights to clinical care and would not have been possible without critical funding support by NIH.” 

蘇醫師表示： 「丁醫師與我在過去二十年一直致力於研究如何減少皮膚疤痕。這項最新突破說明 fibromodulin 可透過受控制的細胞死亡（controlled cell death）來減少過度疤痕形成，顯示在治療過度疤痕患者方面具有重大潛力。」  

這項研究為皮膚傷口修復（cutaneous wound repair）領域提供了新的觀點，朝向減少疤痕形成並改善臨床治療結果的方向發展。 鄭博士目前正主持一項FDA 核准的臨床研究（Phase 1/2A），評估 fibromodulin 衍生胜肽（fibromodulin-derived peptide） 的治療效果。 

鄭博士表示：「在本研究中，我們證明 fibromodulin（屬於一種 matricellular proteoglycan）可在不干擾初期傷口修復的情況下，加速肌成纖維細胞（myofibroblasts）的清除，從而提供一種新的減少疤痕形成機制。」 

研究經費 
This work was funded by NIH NIDCR R44DE024692 (to C.S. and Z.Z.) and SB1DE026972 (to K.T., C.S., and Z.Z.); NIH NIAMS R44AR064126 (to C.S. and Z.Z.), UCLA CTSI grant UL1TR000124 (to C.S.), UCLA Operation Mend (to C.S.), UCLA Orthopaedic Hospital (to C.S.), UCLA Orthopaedic Hospital Research Center (to C.S.), and the International Orthodontics Foundation. 

論文引用  
“Fibromodulin selectively accelerates myofibroblast apoptosis in cutaneous wounds by enhancing interleukin 1β signaling,” Nature Communications. DOI#1038/s41467-025-58906-z 

關於 ADA Forsyth Institute 
The ADA Forsyth Institute was founded in 1910 as the Forsyth Dental Infirmary for Children (later, the Forsyth Institute), to provide dental care to the disadvantaged children of Boston. While continuing to serve children in need, yet recognizing the ultimate goal is to prevent dental disease, the Institute in 1915 began to focus on scientific research and is today the world’s leader in oral health research. In October of 2023, the Institute joined with the American Dental Association to form the ADA Forsyth Institute, a 501(c)(3) entity dedicated to improving people’s oral and overall health and powering the profession of dentistry through cutting-edge basic research, creative translational science, innovative clinical technologies, and global public health outreach. Consistent with the Institute’s founding mission, the ADA ForsythKids mobile dental program continues to serve children in need.

圖片來源：RCSB 蛋白質資料庫（RCSB PDB，RCSB.org），PDB 編號 1BNA。