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Am J Dermatopathol. 2019 Jan;41(1):16-28. doi: 10.1097/DAD.0000000000001254.

Extensive CD34-to-CD90 Fibroblast Transition Defines Regions of Cutaneous Reparative, Hypertrophic, and Keloidal Scarring.

Author information

1
Department of Dermatology, Boston University School of Medicine, Boston, MA.
2
Section of Dermatopathology, Boston University School of Medicine, Boston, MA.
3
Departments of Dermatology and Pathology, University of the West Indies, Kingston, Jamaica.
4
Department of Microbiology, Section of Rheumatology, Boston University School of Medicine, Boston, MA.

Abstract

BACKGROUND:

CD90 fibroblasts have been described arising from and replacing the homeostatic CD34 network in scleroderma, but have not been specifically examined in other forms of cutaneous fibrosis.

OBJECTIVES:

To address expression, timelines, and spatial relationships of CD90, CD34, and smooth muscle actin (SMA) expressing fibroblasts in scars and to examine for the presence of a CD34-to-CD90 transition.

METHODS:

One hundred and seventeen scars (reparative/hypertrophic/keloidal) were evaluated for CD90, CD34, and SMA expression. Double-staining immunohistochemistry for CD90/CD34 was performed to identify CD90/CD34 transitioning cells, confirmed by double-color immunofluorescence. In addition, some scars were double-stained with CD90/SMA, CD90/procollagen-1, or SMA/procollagen-1 to evaluate spatial relationships and active collagen synthesis. Expression was graded as diffuse, minority, and negative.

RESULTS:

Most scars demonstrate a CD90/CD34 pattern, and dual CD90/CD34 fibroblasts were observed in 91% of scars. In reparative scars, CD90 expression reverses to a CD34/CD90 state with maturation. Pathologic scars exhibit prolonged CD90 expression. Both CD90 and SMA fibroblasts collagenize scars, although CD90 fibroblasts are more prevalent.

CONCLUSIONS:

CD90 fibroblasts likely arise from the resting CD34 fibroblastic network. Actively collagenizing scar fibroblasts exhibit a CD90/CD34 phenotype, which is prolonged in pathologic scars. CD90 fibroblasts are likely important players in cutaneous scarring.

PMID:
30320623
DOI:
10.1097/DAD.0000000000001254
[Indexed for MEDLINE]

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