Taming the Scar: How a Cellular "Eraser" Fuels Keloid Growth

Groundbreaking research reveals how the USP37 enzyme acts as a molecular eraser that promotes keloid formation by regulating c-Myc expression in fibroblasts.

Molecular Biology Cell Research Dermatology

Introduction

We all have scars. A childhood fall, a kitchen mishap, a surgical procedure—they all leave their mark. For most, a scar is a temporary, fading reminder. But for some, the healing process goes haywire, leading to keloids: raised, thick, and often itchy growths that extend far beyond the original wound. They are a common yet frustrating medical mystery. Now, groundbreaking research is pinpointing the exact molecular culprits, and one in particular, an enzyme named USP37, is taking center stage.

The Uncontrolled Construction Site of a Keloid

Imagine your skin is a construction site after an injury. Normally, cells called fibroblasts arrive, lay down a framework of collagen (the body's scaffolding protein), and then the site is cleaned up, leaving a neat, flat repair. A keloid is what happens when the foreman loses control.

1
The Workers Go Rogue

Fibroblasts multiply out of control.

2
Too Much Scaffolding

They produce an excessive amount of collagen, far more than is needed.

3
No Off-Switch

The construction site never closes. The scar tissue keeps growing, invading healthy skin.

Enter USP37: The Molecular Eraser

This is where our key player, USP37, enters the story. Inside our cells, proteins are constantly being tagged for disposal with a small marker called ubiquitin. This is a crucial recycling system. When a protein like c-Myc is ubiquitinated, it's sent to the cellular shredder, and its "GO" signal is silenced.

USP37 is a deubiquitinating enzyme. Its job is to remove the ubiquitin tag. In essence, USP37 is an "eraser" that can save proteins from destruction. The new discovery is that in keloid cells, USP37 is overactive. It is constantly erasing the "destroy c-Myc" order, allowing this powerful growth signal to accumulate and run amok, fueling the uncontrolled scar tissue growth.

A Closer Look: The Experiment That Connected the Dots

To prove that USP37 was the key to keloid formation, researchers conducted a series of elegant experiments. Here's a step-by-step breakdown of their crucial investigation.

The Methodology: Silencing the Eraser

The researchers used keloid fibroblasts (KF cells) isolated from actual patient keloids and compared them to normal skin fibroblasts (NF cells).

  1. Observation: They first confirmed that both USP37 and c-Myc protein levels were significantly higher in KF cells than in NF cells.
  2. Intervention - "Knockdown": To test if USP37 was causing the high c-Myc levels, they used a powerful molecular tool called siRNA. This technology allows scientists to "silence" a specific gene, effectively reducing the production of its corresponding protein. They created a setup where they could turn off the USP37 gene in the keloid cells.
  3. Measuring the Effects: After silencing USP37, they measured three key outcomes:
    • c-Myc Levels: Did the "GO" signal protein decrease?
    • Cell Proliferation: Did the keloid cells stop multiplying so quickly?
    • Collagen Production: Did the cells slow down their excessive collagen manufacturing?
Results and Analysis: The Domino Effect

The results were clear and striking. Silencing USP37 set off a powerful chain reaction:

  • Result 1: With the USP37 "eraser" gone, the c-Myc protein was no longer protected. Its levels plummeted as it was correctly tagged for destruction.
  • Result 2: With the main "GO" signal (c-Myc) turned off, the keloid fibroblasts lost their hyper-proliferative edge. Their growth rate slowed dramatically.
  • Result 3: The excessive collagen production, the hallmark of a bulky keloid, was significantly reduced.

This experiment proved that USP37 isn't just a bystander; it is a direct driver of keloid formation by stabilizing c-Myc. It provided a clear causal link in the chain: High USP37 → High c-Myc → Out-of-control keloid growth.

The Data: A Clear Picture Emerges

The following tables and visualizations summarize the core findings from this critical experiment.

Table 1: Protein Levels in Keloid vs. Normal Cells

This initial observation confirmed the problem. Values are relative to normal fibroblast levels.

Cell Type USP37 Level c-Myc Level
Normal Fibroblasts (NF) 1.0 1.0
Keloid Fibroblasts (KF) 3.2 2.8

Keloid fibroblasts show dramatically elevated levels of both the "eraser" enzyme USP37 and the growth signal protein c-Myc compared to normal skin cells.

Table 2: Effects of Silencing USP37 in Keloid Cells

This table shows the powerful effect of turning off USP37.

Measured Outcome After USP37 Silencing (vs. Control)
USP37 Protein Decreased by ~70%
c-Myc Protein Decreased by ~65%
Cell Proliferation Decreased by ~60%
Collagen Production Decreased by ~55%

Reducing USP37 levels led to a corresponding drop in c-Myc, which in turn crippled the two main pathological features of keloids: rapid cell growth and excessive collagen production.

Protein Level Comparison: Normal vs. Keloid Fibroblasts
Table 3: Correlating c-Myc with Keloid Severity

This data strengthens the link between the molecular finding and the physical disease.

Experimental Condition Observed Keloid Cell Behavior
High USP37 / High c-Myc Aggressive growth and collagen overproduction
Low USP37 / Low c-Myc Growth and collagen production near normal levels
Artificially High c-Myc (even with low USP37) Keloid behavior is partially restored

The state of c-Myc is a decisive factor. Keeping c-Myc high, even when USP37 is low, can still drive keloid growth, confirming its central role.

The Scientist's Toolkit: Key Reagents in Keloid Research

Understanding a disease at the molecular level requires a precise set of tools. Here are some of the key reagents that made this discovery possible.

Keloid Fibroblasts (KFs)

The primary diseased cells studied, isolated from patient keloid tissue. They are the "model system" for the experiment.

Small Interfering RNA (siRNA)

A molecular tool used to "silence" or "knock down" a specific gene (like USP37). It's like a targeted off-switch.

Antibodies

Specialized proteins used to detect and measure specific targets (like USP37, c-Myc, or collagen) within a complex cellular mixture.

Cell Proliferation Assays

Chemical tests that measure how quickly cells are dividing. This is crucial for determining if a treatment can slow down keloid cell growth.

Collagen Staining & Assays

Techniques (like Sirius Red staining) to visually quantify and measure the amount of collagen produced by cells.

Conclusion: A New Target for a Stubborn Problem

The discovery of USP37's role is more than just an interesting biological story; it's a beacon of hope for new therapies. Current keloid treatments—like surgery, steroid injections, or laser therapy—are often invasive and have high recurrence rates.

This research points to USP37 as a promising new drug target. If a medication can be developed to safely inhibit the USP37 enzyme, it could, in theory, restore the natural cycle of c-Myc destruction, calming the overactive fibroblasts and preventing keloid growth from the inside out. By understanding the molecular eraser that won't quit, we are one step closer to finally helping the body close the construction site for good.

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