Author(s)

Runfang Chen ^1,2, Shuang Ding ^1,2, Pandeng Li ³

Affiliation(s)

¹ Department of Clinical Laboratory, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
² School of Medical Technology, Xuzhou Medical University, Xuzhou, China
³ Department of Burn and Plastic Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China

Corresponding Author

Shuang Ding

ABSTRACT

This study aimed to evaluate the expression of Survivin and Smac in sternal keloid tissue, analyze their correlation, and preliminarily elucidate how these two molecules participate in sternal keloid pathogenesis. Reverse transcription-polymerase chain reaction (RT-PCR) was used to quantify the mRNA levels of Survivin and Smac, and immunohistochemical (IHC) staining was applied to detect the protein expression levels of Survivin and Smac in 20 sternal keloid tissue samples and their matched adjacent normal skin tissue samples; Pearson correlation analysis was further performed to investigate the correlation between Survivin and Smac expressions in keloid tissues. The results revealed statistically significant differences in the mRNA and protein expressions of Survivin and Smac between sternal keloid tissues and adjacent normal skin tissues (p<0.05); specifically, the mRNA level and protein positive expression rate of Survivin in sternal keloid tissues were significantly higher than those in adjacent normal skin tissues (p<0.05), while the mRNA level and protein positive expression rate of Smac in sternal keloid tissues were obviously lower than those in adjacent normal skin tissues (p<0.05), and a significant negative correlation was found between Survivin and Smac protein expressions in sternal keloid tissues (r = -0.334, P<0.01). It is concluded that the overexpression of Survivin and downregulation of Smac may exert pivotal effects on the proliferation-apoptosis signal transduction pathway of keloids, and the two molecules are probably involved in the initiation and progression of sternal keloids.

KEYWORDS

Keloid; Survivin; Smac; Immunohistochemistry

CITE THIS PAPER

Runfang Chen,, Shuang Ding, Pandeng Li. Expression and Correlation of Survivin and Smac in Pectoral Keloid Tissues. MEDS Clinical Medicine (2026). Vol. 7, No. 3, 94-102. DOI: http://dx.doi.org/10.23977/medsc.2026.070313.

REFERENCES

[1] Zheng XF, He RL, Huang TY, et al. Efficacy of autologous keloid skin grafting combined with local drug injection in the treatment of giant pectoral keloids[J]. Chinese Journal of Dermatovenereology, 2021,35(7):820-824. (in Chinese)
[2] Wu ML, Wang R, Zheng XN, et al. Effect of metformin on proliferation and apoptosis of human keloid fibroblasts and its underlying mechanism[J]. Chinese Journal of Burns and Wound Repair, 2025,41(4):355-363.  (in Chinese)
[3] Zhang J, Wang D, Xu KY, et al. Expressions of Survivin and Smac in ovarian cancer tissues and their clinical significance[J]. Practical Journal of Cancer, 2025,40(7):1093-1095,1104. (in Chinese)
[4] Liu JY, Quan LL, Chen XX. Expressions of FBXW7, Smac and Survivin in ovarian cancer tissues and their correlation with clinicopathological features[J]. Chinese Journal of Practical Medicine, 2021,48(6):19-22. (in Chinese)
[5] Ogawa R. The most current algorithms for the treatment and prevention of hypertrophic scars and keloids: a 2020 update of the algorithms published 10 years ago[J]. Plastic and Reconstructive Surgery, 2022,149(1):79-94.
[6] Cohen AJ, Nikbakht N, Uitto J. Keloid disorder: genetic basis, gene expression profiles, and immunological modulation of the fibrotic processes in the skin[J]. Cold Spring Harbor Perspectives in Biology, 2023,15(7):a041245.
[7] Erlendsson AM, Rosenberg LK, Lerche CM, et al. A one-time pneumatic jet-injection of 5-fluorouracil and triamcinolone acetonide for the treatment of hypertrophic scars: A blinded randomized controlled trial[J]. Lasers in Surgery and Medicine, 2022,54(5):663-671.
[8] Frech FS, Hernandez L, Urbonas R, et al. Hypertrophic scars and keloids: advances in treatment and review of established therapies[J]. American Journal of Clinical Dermatology, 2023,24(2):225-245.
[9] Wang Q, Greene MI. Survivin as a therapeutic target for the treatment of human cancer[J]. Cancers (Basel), 2024,16(9):1705.
[10] Rohayem J, Diestlkoetter P, Weigle B, et al. Antibody response to the tumor-associated inhibitor of apoptosis protein survivin in cancer patients[J]. Cancer Research, 2000,60(7):1815-1817.
[11] Zhao ZS, Ding C, Huang PT, et al. Expressions of PLK1, MYH9 and Smac in keloid tissues and their clinical significance[J]. Chinese Journal of Health Care Medicine, 2025,27(1):131-135. (in Chinese)
[12] Li FK, Gu XY, Zhu YL, et al. Mechanism of Huoxue Jiedu Runzao Decoction on regulating the expression of Smac in submandibular gland cells of mice with Sjögren's syndrome[J]. Shaanxi Journal of Traditional Chinese Medicine, 2023,44(6):693-698. (in Chinese)
[13] Albadari N, Li W. Survivin small molecule inhibitors: recent advances and challenges[J]. Molecules, 2023,28(3):1376.
[14] Mai RH, Wei XM, Yang YW. Expression of Survivin in patients with lung adenocarcinoma and its prognostic significance[J]. Chinese Journal of Experimental Surgery, 2025,42(9):1850-1852. (in Chinese)
[15] Lu DF, Mu YM, Chen XL. Expression of serum pyroptosis-related factors Caspase-3, Survivin, Bax and Bcl-2 in cervical cancer and their involvement in invasion and metastasis[J]. Medical Research and War Trauma Treatment, 2025,38(10):1061-1066. (in Chinese)
[16] Liang HT, Zheng WP. Expressions of C-erbB-2, Ki67 and Survivin in breast cancer tissues and their correlation with clinicopathological features and prognosis[J]. Chinese Journal of Laboratory Diagnosis, 2025,29(6):621-625. (in Chinese)
[17] Mei SS, Tian SW, Duan YL, et al. Expressions of SIRT2, P65 and Survivin in breast cancer tissues and their clinical significance[J]. Journal of Guizhou Medical University, 2024,49(6):819-825. (in Chinese)
[18] Liu YH, Li J, Wang N, et al. Experimental design of Survivin gene silencing inducing apoptosis of cervical cancer cells by RNA interference[J]. Research and Exploration in Laboratory, 2023,42(9):146-150. (in Chinese)
[19] Albadari N, Li W. Survivin small molecule inhibitors: recent advances and challenges[J]. Molecules, 2023,28(3):1376.
[20] Miao QZ, Fan M, Yuan J, et al. Verification of the target role of Survivin (BIRC5) in targeted therapy of keloids by network pharmacology and experimental validation[J]. Chinese Journal of Aesthetic and Plastic Surgery, 2024,35(3):167-178. (in Chinese)
[21] Pandey SK, Paul A, Shteinfer-Kuzmine A, et al. SMAC/Diablo controls proliferation of cancer cells by regulating phosphatidylethanolamine synthesis[J]. Molecular Oncology, 2021,15(11):3037-3061.

Sponsors, Associates, and Links

---

• Journal of Neurobiology and Genetics
  
  
• Medical Imaging and Nuclear Medicine
  
  
• Bacterial Genetics and Ecology
  
  
• Transactions on Cancer
  
  
• Journal of Biophysics and Ecology
  
  
• Journal of Animal Science and Veterinary
  
  
• Academic Journal of Biochemistry and Molecular Biology
  
  
• Transactions on Cell and Developmental Biology
  
  
• Rehabilitation Engineering & Assistive Technology
  
  
• Orthopaedics and Sports Medicine
  
  
• Hematology and Stem Cell
  
  
• Journal of Intelligent Informatics and Biomedical Engineering
  
  
• MEDS Basic Medicine
  
  
• MEDS Stomatology
  
  
• MEDS Public Health and Preventive Medicine
  
  
• MEDS Chinese Medicine
  
  
• Journal of Enzyme Engineering
  
  
• Advances in Industrial Pharmacy and Pharmaceutical Sciences
  
  
• Bacteriology and Microbiology
  
  
• Advances in Physiology and Pathophysiology
  
  
• Journal of Vision and Ophthalmology
  
  
• Frontiers of Obstetrics and Gynecology
  
  
• Digestive Disease and Diabetes
  
  
• Advances in Immunology and Vaccines
  
  
• Nanomedicine and Drug Delivery
  
  
• Cardiology and Vascular System
  
  
• Pediatrics and Child Health
  
  
• Journal of Reproductive Medicine and Contraception
  
  
• Journal of Respiratory and Lung Disease
  
  
• Journal of Bioinformatics and Biomedicine