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The protein level of significantly increased p16 was confirmed in keloid lesions and fibroblasts based on western blot analysis ( p = 0.0007, p = 0.03

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Our results provide a possible mechanism in which upregulation of phosphorylated p53 and p16 maintain the cell cycle arrest of keloid fibroblasts, and FOXO4-DRI selectively induces apoptosis of keloid senescent fibroblasts by prompting p53-pS15 nuclear exclusion