Proliferative scarring.

Proliferative scarring in all organ systems is an enigma. Treatment has been difficult to impossible because the pathobiology of exuberant scarring and fibrosis was unclear. With the concept that proliferative scarring can be viewed on the healing trajectory and dissected into variations of the normal wound healing cellular processes mediated by soluble cytokine messengers, one can begin to understand how excessive scar formation occurs. Realizing that overexpression or dysregulated activity of the fibrogenic isoforms of TGF-beta and its attendant effect on apoptosis may be responsible for proliferative scarring opens the route to propose rational molecular manipulations that can be tested for the prevention or treatment of this enigmatic condition.