查看更多>>摘要:Bioactive compounds in plant extract provide a potential solution to improve the wound healing process and mitigate scar formation through their anti-inflammation, antioxidant, and antimicrobial activity. Although various studies presented the potential of plant compounds in improving the wound healing process and preventing scar formation, no systematic review has been performed to compare the anti-scarring effect and the underlying mechanisms of the plant compounds. Therefore, this study aims to explore the anti-scarring property of plant compounds and tries to answer the following research questions: 1) Which plants and phytochemicals have anti-scar effect? what is the mechanism of action? 2) Have human trials been conducted to confirm their anti-scar effect? 3) If not, which plant compounds are recommended for further human trials? The study was conducted by systematic reviewing of original in vitro and in vivo research following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow, dated from 2000 to 2021 throughout databases of Scopus, Web of Science, and PubMed. Screened plant/plant extracts/phytochemicals with scar inhibitory effects were classified based on the mechanisms of action. A total of 33 studies were selected through the PRISMA flow, in which 30 plant extracts and phytochemicals were found to have the potential of inhibiting excessive scar formation by accelerating wound healing process, regulating the pro-inflammatory cytokine level, collagen production, collagen type I:III composition, proliferation, and apoptosis through transforming growth factor beta/Smad (TGF-beta/Smad), Toll-like receptor-4/Nuclear factor-kappa B/Peroxisome proliferator-activated receptor gamma (TLR-4/NF-kappa B/PPAR gamma), AKT/Extracellular signal-regulated kinase (AKT/ERK), p38 mitogen-activated protein kinase (p38 MAPK) and c-Jun N-terminal kinases (JNK), and Phosphatidylinositol-3-kinase/AKT/mammalian target of rapamycin (PI-3 K/AKT/mTOR) signaling pathways. Amongst the selected studies, only one was performed on human tissue, which indicated that the oily extract of Hypericum perforatum could effectively reduce scar heights. The rest of the studies were all based on cell culture or animal study despite of the positive results, and further human trial is required to validate the results. Moreover, plant compounds namely tagitinin C, pseudolaric acid-B, osthole, shikonin, gallic acid, lapachol, aspidin PB, and essential oil extracts of Ligusticum chuanxiong, may induce apoptosis and have potential toxic risks to normal cells, and further assessments on their toxicity are required. This study identified plants/plant extracts/phytochemicals with anti-scarring property in vitro and in vivo and concluded that there was limited evidence to prove their anti-scarring property in human. Nevertheless, this study provides a valuable reference for future studies to select phytochemicals for human trial and the development of anti-scar formation cosmetics or health products.