Immune cells in keloids: mechanisms and potential treatments

BACKGROUND: Keloids are a prevalent pathological fibrotic and proliferative disorder characterized by persistent inflammation and immune dysregulation. In recent years, the critical role of immune cells in keloid development and progression has attracted increasing attention. OBJECTIVE: To summarize the immunoregulatory mechanisms and immune dysfunction involved in keloids and to discuss therapeutic strategies targeting these pathways. METHODS: T cells, and natural killer cells. RESULTS: T cells and natural killer cells. These alterations collectively support an anti-inflammatory yet pro-fibrotic microenvironment that favors keloid persistence and progression. CONCLUSION: Immunoregulatory mechanisms and cytotoxic immune dysfunction are central to keloid pathogenesis. Targeting these pathways may provide a basis for the development of novel immunomodulatory strategies to improve keloid outcomes.