Comparison of the biological effects of various radiation therapies for keloids by single-cell RNA sequencing reveals IRF1 as a novel target in keloid therapy.

Keloids are benign dermal tumors that arise from abnormal wound healing processes following skin lesions. Keloids are present in all human populations but occur most frequently in Africans. A significantly higher incidence is observed in female populations. Consequently, keloid patients not only endure physical burdens caused by symptoms such as pain, pruritus, and burning, but also suffer from psychological distress due to altered appearance, significantly compromising their quality of life. Surgical excision, as one of the various treatment options, demonstrates rapid efficacy but carries an unacceptably high recurrence rate of 40%-100% when used as a standalone therapy. Postoperative radiotherapy (PORT) is a clinically effective measure to reduce recurrence rates of keloid. Nevertheless, studies comparing the effectiveness and underlying mechanisms of distinct radiotherapy modalities for keloid remain absent in the literature. In our study, we performed single-cell RNA sequencing (scRNA-Seq) of primary keloid fibroblasts treated with three kinds of radiotherapy modalities, and unbiased clustering revealed the identification of seven distinct clusters. Among them, the cell proportions of Fib2-