Page last updated at 00:00 GMT, Sunday, 15 March 2009

How insulin could reduce scarring

By Jane Elliott
Health reporter, BBC News

Insulin molecule. Pic caption:Alfred Pasieka/SPL
Insulin is used to treat diabetes

Each year in the UK six million people undergo some sort of surgical procedure.

Many are left with scars. Some are hardly noticeable, but others can be deep and disfiguring.

Now a group of scientists think they have come up with a way of reducing all scarring, including those from burns and trauma, by the speedy use of an old drug.

The scientists have found that by injecting insulin within a short time of the injury they can have a real impact on reducing formation of scar tissue.

One-off treatment

Injected in small quantities, the drug can switch off the mechanism which encourages tissue to grow, and reduces the chances of an unsightly scar.

Researchers from the Middlesex-based Restoration of Appearance and Function Trust (Raft) Research Institute tested it out on 15 women who had had breast reduction surgery.

During the study, the women had the insulin injected into one of the breast scars, while having a placebo (dummy) injection on the other.

The results were promising, with the insulin treatment leading to significantly less scarring, and a patent for the treatment is pending.

Now the team is planning to test the technique on a larger group of patients across three hospitals over the next three months.

You will still have a scar, it is just that the scar will not be as prominent
Norbert Kang

"Basically what we found was a new use for the old drug insulin," said Dr Claire Linge, one of the study leaders.

Crucial timing

Insulin is well known for treating diabetes, but its ability to aid the wound-healing process has also been recognised.

But Dr Linge, whose work is backed by NHS Innovations East, said it was the timing of the treatment that they had found to be crucial.

"If you add insulin at a very specific time after wounding - within 24 hours - it does something very different and something that nobody has ever seen before.

"It reduces the amount of scar-tissue-producing cells at a stage during wound healing.

Dr Claire Linge and colleague
The drug only works if used within hours

"You need those cells there to help close the wound and fill it up with a bit of tissue.

"But to survive, we need to close that wound as soon as possible and it completely overruns and ends up producing too much tissue which results in a scar.

"What the insulin does is it allows the initial cells to be produced and shut the wound, but it shuts them off very quickly so it switches off the wound healing process before it can form a scar."

One-off treatment

Mr Norbert Kang, a consultant plastic surgeon at the Royal Free Hospital and member of the Raft team, said the treatment also has the benefit of being a one-off injection.

"You do not have to be given a treatment over and over again it is just given at the time the wound is generated," he said.

"It is radically different from other anti-scarring treatment because what it is doing fundamentally is changing the biology of the scar formation."

But Mr Kang said the results were sometimes hard to evaluate.

"You will still have a scar it is just that the scar will not be as prominent as the scar you would have had if you had not had the treatment," he said.

Therapy need

Dr David Becker of University College London, who has researched wound healing and scar prevention, said there was a huge demand for effective techniques.

"Most people would like to be able to reduce the size of scars, but as yet there are no approved therapeutics that are able to do this.

"The way that we have evolved is for our body to expect a wound to be badly infected and to mount a robust inflammatory response in order to prevent the wound becoming septic, which could kill us.

"Targeting early events in tissue repair, as Dr Linge is doing here, may stop the reaction being over the top."

The scars  - left treated; right untreated
One scar was treated with insulin



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