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Wang H, Hamblin MR, Zhang Y, Xu Y, Wen X. Histological evaluation of monopolar and bipolar radiofrequency microneedling treatment in a porcine model. Lasers Surg Med 2024; 56:288-297. [PMID: 38334177 DOI: 10.1002/lsm.23768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND AND OBJECTIVE Fractional radiofrequency microneedling (FRM) is widely used as an option for skin rejuvenation, however there is a lack of histological evidence for the various energy delivery systems available. The objective was to assess thermal denaturation of tissue and the wound healing response in monopolar mode versus bipolar mode. Histological analysis was performed to demonstrate the efficacy of automatic impedance feedback system in monopolar mode. STUDY DESIGN AND METHODS In this study, the acute thermal effects caused by monopolar FRM treatment to the dorsal skin of pigs were assessed histologically by hematoxylin & eosin (H&E) staining. Then, one session of either monopolar or bipolar FRM was used to treat one or the other side of the pig using varying power levels and pulse widths. The acute and chronic tissue reactions were assessed using H&E, immunofluorescence, and western blot analysis at 0, 14, 30, and 90 days after treatment. The efficacy of the impedance feedback system was also monitored histologically. RESULTS High-energy FRM treatment produced tissue loss and necrosis. The power level and pulse duration significantly affected the coagulation amount. Histopathology at 0, 14, 30, and 90 days showed that the skin tissue reaction was more pronounced for bipolar compared to monopolar FRM. Immunofluorescence showed the expression of TGF-β, Ki67, MMP3, and elastin increased dramatically with both modes, but were higher in the bipolar FRM treated side. The automatic impedance feedback system could effectively adjust the output energy. CONCLUSIONS We found that bipolar FRM produced greater thermal effects, more collagen coagulation, and more pronounced molecular changes compared with monopolar mode in a porcine animal model.
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Affiliation(s)
- Hao Wang
- Laboratory of Dermatology, Frontiers Science Center for Disease-related Molecular Network, Clinical Institute of Inflammation and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Michael R Hamblin
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein, South Africa
| | - Yi Zhang
- Research Core Facility of West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yidan Xu
- Laboratory of Dermatology, Frontiers Science Center for Disease-related Molecular Network, Clinical Institute of Inflammation and Immunology, West China Hospital, Sichuan University, Chengdu, China
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiang Wen
- Laboratory of Dermatology, Frontiers Science Center for Disease-related Molecular Network, Clinical Institute of Inflammation and Immunology, West China Hospital, Sichuan University, Chengdu, China
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
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Guo Q, Cen J, He M, Huang D, Tang Z, Xiong H. Fractional erbium:yttrium aluminum garnet laser in the treatment of morphea mouse model. J Cosmet Dermatol 2023; 22:3282-3290. [PMID: 37326004 DOI: 10.1111/jocd.15855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 05/11/2023] [Accepted: 05/24/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To assess the efficiency and the mechanism of fractional erbium:yttrium aluminum garnet (Er:YAG) laser for the treatment of morphea in mouse model. BACKGROUND Morphea is a rare autoimmune disease characterized by excessive collagen deposition in skin. Fractional Er:YAG laser treatment is a promising treatment to improve morphea, despite limited studies about the therapeutic effect and underlying mechanism. METHODS The mouse model of morphea was established by subcutaneously injecting with bleomycin (BLM). A total of 24 mice received fractional Er:YAG laser treatment once a week for 4 weeks. Objective measurement employed was ultrasonic imaging to measure dermal thickness. Subjective measures included scoring according to the adjusted Localized morphea Cutaneous Assessment Tool (LoSCAT); hematoxylin and eosin (H&E) staining to evaluate the histological grade of fibrosis; and quantitative morphometric studies to determine the expression of transforming growth factor-β1 (TGF-β1) and matrix metalloproteinase-1 (MMP1) by immunohistochemistry. RESULTS In this self-controlled study, fractional Er:YAG laser treatment significantly ameliorate the severity of morphea, including lower clinical score (p < 0.01), decreased dermal thickness (p < 0.001), declined histological grade of fibrosis (p < 0.001), increased MMP1 (p < 0.001), and reduced TGF-β1 (p < 0.01) expression. CONCLUSIONS We found that fractional Er:YAG laser treatment of morphea has good clinical, ultrasonic, and histopathologic efficacy, which may be a promising treatment in the future.
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Affiliation(s)
- Qing Guo
- Department of Dermatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Junjie Cen
- Department of Dermatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Mingjie He
- Department of Dermatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Danqi Huang
- Department of Chemical Pathology, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Zengqi Tang
- Department of Dermatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hui Xiong
- Department of Dermatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetic and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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Lewis CJ, Douglas H, Martin L, Deng Z, Melton P, Fear MW, Wood FM, Rea S. Carbon dioxide laser treatment of burn-related scarring: Results of the ELIPSE (Early Laser Intervention Promotes Scar Evolution) prospective randomized controlled trial. J Plast Reconstr Aesthet Surg 2023; 84:368-376. [PMID: 37393760 DOI: 10.1016/j.bjps.2023.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/30/2023] [Accepted: 06/06/2023] [Indexed: 07/04/2023]
Abstract
AIM To investigate the impact of ablative fractional carbon dioxide laser (AFCO2L) on patient-reported outcomes measures, subjective scar appearance, dermal architecture, and gene transcription in early burn scars. METHODS Fifteen adult patients with a burn-related scar were recruited. Inclusion criteria were two non-contiguous scar areas of 1% total body surface area, similar baseline Vancouver scar scale (VSS) score and 3months since the time of injury. All participants acted as their own control. Scars were randomized to treatment or control. Treatment scars received three AFCO2L treatments at 6-week intervals. Outcome measures were recorded at baseline, 3, 6, and 12-months post-treatment. Measures included blinded VSS, Patient Observer Scar Assessment Scale (POSAS), Brisbane Burn Scar Impact Profile (BBSIP), blinded scar photo assessment, histological tissue analysis, and RNA sequencing analysis. RESULTS No significant difference was found in VSS, scar erythema, or pigmentation. Patient POSAS improved in scar thickness and texture following AFCO2L. All elements of BBSIP improved in control and laser groups. AFCO2L-treated scars were scored better than control scars by blinded raters. RNA sequencing illustrated that AFCO2L induced sustained changes in fibroblast gene expression. CONCLUSIONS AFCO2L treated scars had significantly altered scar thickness and texture 6 months post-laser and were rated better than controls on blinded photo analysis after 3 treatments. RNASeq results suggest laser treatment alters the transcriptome of treated fibroblasts for at least 3 months after treatment. Expansion of this research to study in more depth fibroblast changes in response to laser, as well as assessing the impact on daily activity and quality of life, will be beneficial.
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Affiliation(s)
- Christopher J Lewis
- Burn Service of Western Australia, Fiona Stanley Hospital, WA Department of Health, Perth, WA, Australia.
| | - Helen Douglas
- Burn Service of Western Australia, Fiona Stanley Hospital, WA Department of Health, Perth, WA, Australia
| | - Lisa Martin
- Burn Injury Research Unit, School of Biomedical Sciences, University of Western Australia, Perth, WA, Australia
| | - Zhenjun Deng
- Burn Injury Research Unit, School of Biomedical Sciences, University of Western Australia, Perth, WA, Australia
| | - Phillip Melton
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; School of Global and Population Health, University of Western Australia, Crawley, WA, Australia
| | - Mark W Fear
- Burn Injury Research Unit, School of Biomedical Sciences, University of Western Australia, Perth, WA, Australia
| | - Fiona M Wood
- Burn Service of Western Australia, Fiona Stanley Hospital, WA Department of Health, Perth, WA, Australia; Burn Injury Research Unit, School of Biomedical Sciences, University of Western Australia, Perth, WA, Australia
| | - Suzanne Rea
- Burn Service of Western Australia, Fiona Stanley Hospital, WA Department of Health, Perth, WA, Australia; Burn Injury Research Unit, School of Biomedical Sciences, University of Western Australia, Perth, WA, Australia
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Hafidh B, Baradwan S, Latifah HM, Gari A, Sabban H, Abduljabbar HH, Tawfiq A, Hakeem GF, Alkaff A, Alzawawi N, Iskandarani R, Khurshid K, Syed KA, Alkhiary AY, Bukhari IA, Baalharith MA, Abu-Zaid A. CO 2 laser therapy for management of stress urinary incontinence in women: a systematic review and meta-analysis. Ther Adv Urol 2023; 15:17562872231210216. [PMID: 37953973 PMCID: PMC10638870 DOI: 10.1177/17562872231210216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 10/06/2023] [Indexed: 11/14/2023] Open
Abstract
Background Carbon dioxide (CO2) laser therapy is an emerging treatment for women with stress urinary incontinence (SUI). Objectives To examine the efficacy of CO2 laser therapy for management of SUI-related symptoms in women. Design A systematic review and meta-analysis of randomized controlled trials and cohort studies. Data sources and methods Four databases were screened until January 2023. All efficacy continuous endpoints were assessed via subtraction of the posttreatment from pretreatment values. The data were summarized as mean difference (MD) with 95% confidence interval (CI) using the random-effects model. Results A total of 15 studies with 700 patients were analyzed. CO2 laser therapy significantly decreased the 1-h pad weights at 3 months [n = 5 studies, MD = -3.656 g, 95% CI (-5.198, -2.113), p < 0.001], 6 months [n = 6 studies, MD = -6.583 g, 95% CI (-11.158, -2.008), p = 0.005], and 12 months [n = 6 studies, MD = -3.726 g, 95% CI (-6.347, -1.106), p = 0.005]. Moreover, CO2 laser therapy significantly decreased the International Consultation of Incontinence Questionnaire-Urinary Incontinence Short Form Scores at 3 months [n = 10 studies, MD = -4.805, 95% CI (-5.985, -3.626), p < 0.001] and 12-months [n = 6 studies, MD = -3.726, 95% CI (-6.347, -1.106), p = 0.005]. Additionally, CO2 laser therapy significantly decreased the Pelvic Floor Impact Questionnaire scores at 6 months [n = 2 studies, MD = -11.268, 95% CI (-18.671, -3.865), p = 0.002] and 12 months [n = 2 studies, MD = -10.624, 95% CI (-18.145, -3.103), p = 0.006]. Besides, CO2 laser therapy significantly decreased the Urogenital Distress Inventory-6 scores at 3 months [n = 2 studies, MD = -21.997, 95% CI (-32.294, -11.699), p < 0.001], but not at 6 months [n = 3 studies, MD = -3.034, 95% CI (-7.357, 1.259), p = 0.169]. Lastly, CO2 laser therapy significantly increased the Vaginal Health Index Score at 6 months [n = 2 studies, MD = 2.826, 95% CI (0.013, 5.638), p = 0.047] and 12 months [MD = 1.553, 95% CI (0.173, 2.934), p = 0.027]. Conclusion CO2 laser therapy improved the SUI-related symptoms in women. To obtain solid conclusions, future studies should be well-designed with standardized settings, consistent therapeutic protocols, and long-term follow-up periods.
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Affiliation(s)
- Bandr Hafidh
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Saeed Baradwan
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Hassan M. Latifah
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Abdulrahim Gari
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
- Department of Obstetrics and Gynecology, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Hussein Sabban
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
- Department of Obstetrics and Gynecology, Faculty of Medicine at Rabigh, King Abdulaziz University, Rabigh, Saudi Arabia
| | - Hanin Hassan Abduljabbar
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Afaf Tawfiq
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Ghaidaa Farouk Hakeem
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Alya Alkaff
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Nabigah Alzawawi
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Radiah Iskandarani
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Kausar Khurshid
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Kausar Aisha Syed
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Ammar Y. Alkhiary
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Ibtihal Abdulaziz Bukhari
- Department of Obstetrics and Gynecology, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Maha Al Baalharith
- Department of Obstetrics and Gynecology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Ahmed Abu-Zaid
- College of Medicine, Alfaisal University, P.O. Box 50927 Riyadh 11533, Saudi Arabia
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Corrêa MEAB, Mendes C, Bittencourt JVS, Takejima A, de Souza IC, de Carvalho SCD, Orlandini IG, de Andrade TAM, Guarita-Souza LC, Silveira PCL. Effects of the Application of Decellularized Amniotic Membrane Solubilized with Hyaluronic Acid on Wound Healing. Ann Biomed Eng 2022; 50:1895-1910. [PMID: 35802205 DOI: 10.1007/s10439-022-03008-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 07/03/2022] [Indexed: 12/30/2022]
Abstract
A perfect graft for wound care must be readily available without affecting the immune response, covering and protecting the wound bed. Considering previous studies have already established the use of hyaluronic acid (HA) for the treatment of wounds but the data presented on the amniotic membrane (AM) and its promising effects on healing still requires further investigation, this study aimed to evaluate the effects of the application of a decellularized amniotic membrane solubilized with hyaluronic acid on the healing process of cutaneous wounds on the 7th and 14th day, to evaluate the evolution of the wound and the inflammatory phases in these two times. Cutaneous lesions were excised from the dorsal region and 96 Wistar rats were divided into four groups: I-Excisional wound (EW); II-EW + AM; III-EW + HA; IV-EW + AM + HA. The present study demonstrated that the proposed combined therapy favors the tissue repair process of the epithelial lesion. Results showed a reduction in pro-inflammatory cytokines, an increase in anti-inflammatory cytokines, an increase in TGF-β, and attenuation of oxidative stress, reducing the acute inflammatory response and promoting the beginning of tissue repair. We concluded that the proposed therapies accelerated the inflammatory process with anticipation of the repair phase.
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Affiliation(s)
- Maria Eduarda Anastácio Borges Corrêa
- Laboratory of Experimental Physiopathology, Program of Postgraduate in Science of Health, Universidade do Extremo Sul Catarinense, Criciúma, Santa Catarina state, 88806-000, Brazil
| | - Carolini Mendes
- Laboratory of Experimental Physiopathology, Program of Postgraduate in Science of Health, Universidade do Extremo Sul Catarinense, Criciúma, Santa Catarina state, 88806-000, Brazil
| | - João Vitor Silvano Bittencourt
- Laboratory of Experimental Physiopathology, Program of Postgraduate in Science of Health, Universidade do Extremo Sul Catarinense, Criciúma, Santa Catarina state, 88806-000, Brazil
| | - Aline Takejima
- Experimental Laboratory of Institute of Biological and Health Sciences of Pontifical Catholic University of Paraná (PUCPR), Street Imaculada Conceição, 1155, Curitiba, Paraná, 80215-901, Brazil
| | - Isio Carvalho de Souza
- Experimental Laboratory of Institute of Biological and Health Sciences of Pontifical Catholic University of Paraná (PUCPR), Street Imaculada Conceição, 1155, Curitiba, Paraná, 80215-901, Brazil
| | | | | | | | - Luiz César Guarita-Souza
- Experimental Laboratory of Institute of Biological and Health Sciences of Pontifical Catholic University of Paraná (PUCPR), Street Imaculada Conceição, 1155, Curitiba, Paraná, 80215-901, Brazil
| | - Paulo Cesar Lock Silveira
- Laboratory of Experimental Physiopathology, Program of Postgraduate in Science of Health, Universidade do Extremo Sul Catarinense, Criciúma, Santa Catarina state, 88806-000, Brazil. .,Universidade do Extremo Sul Catarinense, Av. Universitária, 1105 Universitário - Block S, Room 16, Criciúma, SC, CEP: 88806-000, Brazil.
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Mendes C, Thirupathi A, Zaccaron RP, Corrêa MEAB, Bittencourt JVS, Casagrande LDR, de Lima ACS, de Oliveira LL, de Andrade TAM, Gu Y, Feuser PE, Machado-de-Ávila RA, Silveira PCL. Microcurrent and Gold Nanoparticles Combined with Hyaluronic Acid Accelerates Wound Healing. Antioxidants (Basel) 2022; 11:2257. [PMID: 36421443 PMCID: PMC9686715 DOI: 10.3390/antiox11112257] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/03/2022] [Accepted: 11/07/2022] [Indexed: 01/30/2024] Open
Abstract
This study aimed to investigate the effects of iontophoresis and hyaluronic acid (HA) combined with a gold nanoparticle (GNP) solution in an excisional wound model. Fifty Wistar rats (n = 10/group) were randomly assigned to the following groups: excisional wound (EW); EW + MC; EW + MC + HA; EW + MC + GNPs; and EW + MC + HA + GNPs. The animals were induced to a circular excision, and treatment started 24 h after injury with microcurrents (300 µA) containing gel with HA (0.9%) and/or GNPs (30 mg/L) in the electrodes (1 mL) for 7 days. The animals were euthanized 12 h after the last treatment application. The results demonstrate a reduction in the levels of pro-inflammatory cytokines (IFNϒ, IL-1β, TNFα, and IL-6) in the group in which the therapies were combined, and they show increased levels of anti-inflammatory cytokines (IL-4 and IL-10) and growth factors (FGF and TGF-β) in the EW + MC + HA and EW + MC + HA + GNPs groups. As for the levels of dichlorofluorescein (DCF) and nitrite, as well as oxidative damage (carbonyl and sulfhydryl), they decreased in the combined therapy group when compared to the control group. Regarding antioxidant defense, there was an increase in glutathione (GSH) and a decrease in superoxide dismutase (SOD) in the combined therapy group. A histological analysis showed reduced inflammatory infiltrate in the MC-treated groups and in the combination therapy group. There was an increase in the wound contraction rate in all treated groups when compared to the control group, proving that the proposed therapies are effective in the epithelial healing process. The results of this study demonstrate that the therapies in combination favor the tissue repair process more significantly than the therapies in isolation.
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Affiliation(s)
- Carolini Mendes
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China
- Laboratory of Experimental Phisiopatology, Program of Postgraduate in Science of Health, Universidade do Extremo Sul Catarinense, Criciúma 88806-000, Brazil
| | - Anand Thirupathi
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China
| | - Rubya Pereira Zaccaron
- Laboratory of Experimental Phisiopatology, Program of Postgraduate in Science of Health, Universidade do Extremo Sul Catarinense, Criciúma 88806-000, Brazil
| | - Maria Eduarda Anastácio Borges Corrêa
- Laboratory of Experimental Phisiopatology, Program of Postgraduate in Science of Health, Universidade do Extremo Sul Catarinense, Criciúma 88806-000, Brazil
| | - João V. S. Bittencourt
- Laboratory of Experimental Phisiopatology, Program of Postgraduate in Science of Health, Universidade do Extremo Sul Catarinense, Criciúma 88806-000, Brazil
| | - Laura de Roch Casagrande
- Laboratory of Experimental Phisiopatology, Program of Postgraduate in Science of Health, Universidade do Extremo Sul Catarinense, Criciúma 88806-000, Brazil
| | - Anadhelly C. S. de Lima
- Laboratory of Experimental Phisiopatology, Program of Postgraduate in Science of Health, Universidade do Extremo Sul Catarinense, Criciúma 88806-000, Brazil
| | - Lara L. de Oliveira
- Laboratory of Experimental Phisiopatology, Program of Postgraduate in Science of Health, Universidade do Extremo Sul Catarinense, Criciúma 88806-000, Brazil
| | - Thiago A. M. de Andrade
- Graduate Program of Biomedical Science, Herminio Ometto Foundation, Araras 13607-339, Brazil
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China
| | - Paulo Emílio Feuser
- Laboratory of Experimental Phisiopatology, Program of Postgraduate in Science of Health, Universidade do Extremo Sul Catarinense, Criciúma 88806-000, Brazil
| | - Ricardo A. Machado-de-Ávila
- Laboratory of Experimental Phisiopatology, Program of Postgraduate in Science of Health, Universidade do Extremo Sul Catarinense, Criciúma 88806-000, Brazil
| | - Paulo Cesar Lock Silveira
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China
- Laboratory of Experimental Phisiopatology, Program of Postgraduate in Science of Health, Universidade do Extremo Sul Catarinense, Criciúma 88806-000, Brazil
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Efficacy and Safety of Ablative Fractional Laser-Assisted Delivery of Methotrexate in Adults with Localized Scleroderma: A Randomized and Controlled Clinical Trial. Pharmaceutics 2022; 14:pharmaceutics14112261. [DOI: 10.3390/pharmaceutics14112261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 10/05/2022] [Accepted: 10/09/2022] [Indexed: 11/06/2022] Open
Abstract
Localized scleroderma (LS) is an autoimmune disease with sclerosis of the skin as the main manifestation. Currently, there is no specific treatment for LS. The effectiveness of ablative fractional laser (AFL) therapy for LS has been demonstrated in several studies. Combining ablative fractional Er:YAG laser therapy with topical methotrexate may yield therapeutic benefits for patients with LS. To compare the efficacy and safety of AFL-assisted delivery of methotrexate in adults with LS, we randomly divided patients into an AFL therapy group and an ablative fractional laser-assisted delivery of methotrexate (AFL+MTX) therapy group. Laser and assisted drug delivery treatment were given every four weeks for four months, and 22 patients completed the trial. Ultrasound measurements of dermal thickness and histological fibrosis degree and the Localized Scleroderma Cutaneous Assessment Tool (LoSCAT) score were used to assess therapeutic effects. Treatment results showed that both AFL and AFL-assisted methotrexate delivery were effective in treating LS, and the laser combined with methotrexate therapy was more effective in improving clinical appearance (p value = 0.042) and dermal thickness (p value = 0.016). No serious adverse reaction occurred in either group. In conclusion, AFL and assisted delivery of methotrexate are effective and safe treatments for LS.
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Transcriptomic analysis of human skin wound healing and rejuvenation following ablative fractional laser treatment. PLoS One 2021; 16:e0260095. [PMID: 34843523 PMCID: PMC8629261 DOI: 10.1371/journal.pone.0260095] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 11/02/2021] [Indexed: 11/19/2022] Open
Abstract
Ablative fractional laser treatment is considered the gold standard for skin rejuvenation. In order to understand how fractional laser works to rejuvenate skin, we performed microarray profiling on skin biopsies to identify temporal and dose-response changes in gene expression following fractional laser treatment. The backs of 14 women were treated with ablative fractional laser (Fraxel®) and 4 mm punch biopsies were collected from an untreated site and at the treated sites 1, 3, 7, 14, 21 and 28 days after the single treatment. In addition, in order to understand the effect that multiple fractional laser treatments have on skin rejuvenation, several sites were treated sequentially with either 1, 2, 3, or 4 treatments (with 28 days between treatments) followed by the collection of 4 mm punch biopsies. RNA was extracted from the biopsies, analyzed using Affymetrix U219 chips and gene expression was compared between untreated and treated sites. We observed dramatic changes in gene expression as early as 1 day after fractional laser treatment with changes remaining elevated even after 1 month. Analysis of individual genes demonstrated significant and time related changes in inflammatory, epidermal, and dermal genes, with dermal genes linked to extracellular matrix formation changing at later time points following fractional laser treatment. When comparing the age-related changes in skin gene expression to those induced by fractional laser, it was observed that fractional laser treatment reverses many of the changes in the aging gene expression. Finally, multiple fractional laser treatments, which cover different regions of a treatment area, resulted in a sustained or increased dermal remodeling response, with many genes either differentially regulated or continuously upregulated, supporting previous observations that maximal skin rejuvenation requires multiple fractional laser treatments. In conclusion, fractional laser treatment of human skin activates a number of biological processes involved in wound healing and tissue regeneration.
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Curtolo G, Araújo JDP, Lima JA, Brandt JV, Bittencourt JVS, Venturini LM, Silveira PCL, Rogers S, Franzini CM, de Goes VFF, Andrade TAM. Silver nanoparticles formulations for healing traumatic injuries in oral mucosa of rats. Arch Oral Biol 2021; 129:105202. [PMID: 34214784 DOI: 10.1016/j.archoralbio.2021.105202] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To evaluate formulations of 1 % silver (Ag) nanoparticles for treating traumatic lesions induced in the oral mucosa of rats, because these lesions are commonly observed in the dental clinic, and their therapeutic forms are scarce. METHODS Wistar rats were punch-injured (two circular fragments, 4.0 mm in diameter) in the oral mucosa (one on each side), and were treated topically (twice per week) with the treatments/groups including: no injury, control, vehicle, diluted Ag, soluble Ag, and solid Ag. On the 2nd, 7th, and 14th days postinjury, biopsies were collected for immunohistochemistry and biochemical analysis. RESULTS The group diluted Ag revealed a higher level of inflammatory infiltrate on the 2nd day, whereas solid Ag presented lower levels. The Ag solid group presented higher IL-1β on the 2nd day and increased IL-10 and TGF-β1 throughout the follow-up. Moreover, all three Ag groups presented lower levels of oxidative stress markers and, on the 7th day, the diluted Ag and solid Ag groups revealed higher antioxidants. Diluted Ag and soluble Ag groups presented greater blood vessels proliferation, whereas soluble Ag and solid Ag groups revealed greater VEGF on the 2nd and 14th days. Furthermore, all three Ag groups were highlighted during fibroplasia, although collagenesis was similar to that observed in the control group. CONCLUSIONS Although diluted Ag was noticeable for its important angiogenesis and fibroplasia, solid Ag was the most suitable formulation in healing oral lesions as it efficiently controlled inflammation and oxidative stress, thus favoring angiogenesis and tissue formation.
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Affiliation(s)
- Gabriella Curtolo
- Graduate Program in Biomedical Sciences, University Center of Herminio Ometto Foundation - FHO, Dr. Maximiliano Baruto Ave, 500. Jardim Universitario, 13607-339, Araras, Sao Paulo, Brazil
| | - Jaqueline de Paula Araújo
- Graduate Program in Biomedical Sciences, University Center of Herminio Ometto Foundation - FHO, Dr. Maximiliano Baruto Ave, 500. Jardim Universitario, 13607-339, Araras, Sao Paulo, Brazil
| | - Joyce Alessandra Lima
- Graduate Program in Biomedical Sciences, University Center of Herminio Ometto Foundation - FHO, Dr. Maximiliano Baruto Ave, 500. Jardim Universitario, 13607-339, Araras, Sao Paulo, Brazil
| | - João Victor Brandt
- Laboratory of Magnetic Materials and Colloids, Department of Physical Chemistry, Institute of Chemistry, Sao Paulo State University (UNESP), Prof. Francisco Degni Ave, 55. Jardim Quitandinha, 14800-900, Araraquara, SP, Brazil
| | - João Vitor Silvano Bittencourt
- Laboratory of Experimental Physiopathology, Graduate Program in Science of Health, Universidade do Extremo Sul Catarinense - UNESC, Universitaria Ave, 1105. Universitario, Bloco S - Room 017, 88806-000, Criciuma, Santa Catarina, Brazil
| | - Ligia Milanez Venturini
- Laboratory of Experimental Physiopathology, Graduate Program in Science of Health, Universidade do Extremo Sul Catarinense - UNESC, Universitaria Ave, 1105. Universitario, Bloco S - Room 017, 88806-000, Criciuma, Santa Catarina, Brazil
| | - Paulo Cesar Lock Silveira
- Laboratory of Experimental Physiopathology, Graduate Program in Science of Health, Universidade do Extremo Sul Catarinense - UNESC, Universitaria Ave, 1105. Universitario, Bloco S - Room 017, 88806-000, Criciuma, Santa Catarina, Brazil
| | - Sylvia Rogers
- Graduate Program in Odontology, University Center of Herminio Ometto Foundation - FHO, Dr. Maximiliano Baruto Ave, 500. Jardim Universitario, 13607-339, Araras, Sao Paulo, Brazil
| | - Cristina Maria Franzini
- Graduate Program in Odontology, University Center of Herminio Ometto Foundation - FHO, Dr. Maximiliano Baruto Ave, 500. Jardim Universitario, 13607-339, Araras, Sao Paulo, Brazil
| | - Vivian Fernandes Furletti de Goes
- Graduate Program in Odontology, University Center of Herminio Ometto Foundation - FHO, Dr. Maximiliano Baruto Ave, 500. Jardim Universitario, 13607-339, Araras, Sao Paulo, Brazil
| | - Thiago Antônio Moretti Andrade
- Graduate Program in Biomedical Sciences, University Center of Herminio Ometto Foundation - FHO, Dr. Maximiliano Baruto Ave, 500. Jardim Universitario, 13607-339, Araras, Sao Paulo, Brazil.
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10
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Harrison LM, Shapiro R, Johnson RM. Tissue Modification in Nonsurgical Facelift Options. Facial Plast Surg 2020; 36:688-695. [PMID: 33368123 DOI: 10.1055/s-0040-1721115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Nonsurgical facelifts are a term for a heterogeneous group of procedures used by physicians to improve facial rejuvenation without the use of operative techniques. Patients demand these services due to the reduced recovery time and generally lower risk. However, nonsurgical techniques, to be effective, must induce conformational change in the cells and tissues of the face. Therefore, these techniques are significant procedures that have associated risks. Understanding the tissue modifications and mechanisms of action of these techniques is vital to their safe and effective use. The purpose of this article is to provide a background of tissue modification in nonsurgical facelift options.
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Affiliation(s)
- Lucas M Harrison
- Department of Plastic Surgery, Wright State University, Dayton, Ohio
| | - Ryan Shapiro
- Department of Plastic Surgery, Wright State University, Dayton, Ohio
| | - R Michael Johnson
- Department of Plastic Surgery, Wright State University, Dayton, Ohio
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11
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Kim JH, Kim K, Ahn S, Lee Y, Kim JS, Suh DH, No JH, Kim YB. Pilot study of radiofrequency thermal therapy performed twice on the entire vaginal wall for vaginal laxity. Eur J Obstet Gynecol Reprod Biol 2020; 254:159-163. [PMID: 33010693 DOI: 10.1016/j.ejogrb.2020.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/11/2020] [Accepted: 09/14/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Radiofrequency thermal (RFT) therapy is commonly performed to treat vaginal laxity (VL), but the optimal technique of RFT therapy is unclear. We aimed to evaluate the efficacy and safety of RFT therapy performed twice on the whole vaginal wall in women with VL. METHODS This was a single-arm, open-label clinical trial conducted in a tertiary hospital in the Republic of Korea from July 2018 to January 2019. Non-pregnant, adult women with VL, defined as a score ≤3 on a vaginal laxity questionnaire (VLQ), were recruited. RFT therapy consisted of 2 office procedures performed 3 weeks apart. Starting from the upper vaginal wall at the 12 o'clock position, the whole vaginal wall was slowly rubbed with a heated vaginal probe for 20 minutes. After the 2nd RFT therapy session, patients had follow-up visits at 4 and 12 weeks, and changes in the VLQ score, Female Sexual Function Index (FSFI) score, Female Sexual Distress Scale (FSDS) score, and vaginal pressure at rest and during the Valsalva maneuver and treatment-emergent adverse events (TEAEs) were examined. RESULTS Thirty subjects were enrolled, but 28 were evaluated for efficacy measurements. RFT therapy improved the VLQ score (means at baseline, 4 weeks, and 12 weeks were 2.5, 4.9, and 4.8, respectively; p < 0.0001), FSFI score (means at baseline, 4 weeks, and 12 weeks were 21.9, 27.0, and 27.2, respectively; p < 0.0001), and FSDS score (means at baseline, 4 weeks, and 12 weeks were 33.8, 21.1, and 18.6, respectively; p < 0.0001); however, vaginal pressure did not increase. The effect of RFT therapy peaked at the 4-week follow-up and plateaued at week 12. No TEAE was observed, except transient grade 1 vaginal pain. CONCLUSION RFT therapy performed twice on the whole vaginal wall showed promising efficacy and safety profiles and has merit for further investigation.
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Affiliation(s)
- Ju Hyun Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Kidong Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.
| | - Soyeon Ahn
- Division of Statistics, Medical Research Collaborating Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Yumi Lee
- Department of Nursing, Pukyong National University, Republic of Korea
| | - Jung Sup Kim
- Department of Korean Language and Literature, Kyung Hee University, Republic of Korea
| | - Dong Hoon Suh
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Jae Hong No
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Yong Beom Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
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12
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Huang J, Chen J, Wo Y, Wang X, Zhang Y, Chen X, Zhang Z, Biskup E. CO 2 Fractional Laser Combined with 5-Fluorouracil Ethosomal Gel Treatment of Hypertrophic Scar Macro-, Microscopic, and Molecular Mechanism of Action in a Rabbit Animal Model. Rejuvenation Res 2020; 24:131-138. [PMID: 32578501 DOI: 10.1089/rej.2019.2204] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The treatment of hypertrophic scar (HS) has thus far been a clinical challenge. We evaluated the therapeutic effect of CO2 fractional laser combined with 5-fluorouracil ethosomal gel (5-FU EG) in rabbit HS model. HS model was established as standardized scars on the ventral surface of rabbit ears, divided into four groups: control (no intervention), EG treatment, laser treatment, and combined treatment group (laser plus 5-FU EG). Clinical macroscopic and H&E-stained microscopic observations were conducted to assess HS improvement. The mRNA levels of types I and III collagen, transforming growth factor-β1 (TGF-β1), and interleukin-6 (IL-6) were detected by real-time PCR. After 14 days, H&E staining shows that the thickness of HS in treatment groups was significantly lower compared with the control group, and the thickness in laser treatment group and combined treatment group was significantly lower compared with the EG treatment group. The mRNA levels of types I and III collagen, TGF-β1 were significantly low in all treatment groups, whereas IL-6 was highest in the laser treatment group at day 14. The macro- and microscopic effects of the combined and CO2 fractional laser treatment were better compared with 5-FU EG only. Inhibition of types I and III collagen, TGF-β1 are the possible underlying mechanism of action, whereas the function of IL-6 remains to be further studied. Our study suggests that the effect of combined 5-FU EG and laser, as well as laser-only treatment are superior to 5-FU EG monotreatment. The mechanism of HS improvement is related to reduction of collagen I/III and the inhibition of TGF-β1 expression.
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Affiliation(s)
- Jun Huang
- Department of Dermatology, Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
| | - Jun Chen
- Department of Dermatology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Yan Wo
- Department of Anatomy and Physiology, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Xue Wang
- Department of Dermatology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Yixin Zhang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | | | - Zhen Zhang
- Department of Dermatology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.,Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Ewelina Biskup
- Shanghai University of Medicine and Health Sciences, Shanghai, China.,Department of Internal Medicine, University Hospital of Basel, Basel, Switzerland
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13
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Natari S, Kim KE, Ryu SI, Park JH, Kim I. Device‐Induced Neocollagenesis: Profibrotic Response or True Neocollagenesis? Lasers Surg Med 2020; 52:1010-1019. [DOI: 10.1002/lsm.23258] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 03/19/2020] [Accepted: 04/21/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Sheila Natari
- Department of Dermatology, College of Medicine Korea University 145, Anam‐ro, Seongbuk‐gu Seoul 02831 Republic of Korea
| | - Ko Eun Kim
- Department of Dermatology, College of Medicine Korea University 145, Anam‐ro, Seongbuk‐gu Seoul 02831 Republic of Korea
- Department of Dermatology Korea University Ansan Hospital 123, Jeokgeum‐ro, Danwon‐gu Ansan‐si Gyeonggi‐do 15355 Republic of Korea
| | - Sook In Ryu
- Department of Dermatology, College of Medicine Korea University 145, Anam‐ro, Seongbuk‐gu Seoul 02831 Republic of Korea
- Department of Dermatology Korea University Ansan Hospital 123, Jeokgeum‐ro, Danwon‐gu Ansan‐si Gyeonggi‐do 15355 Republic of Korea
| | - Ji Hyun Park
- Department of Dermatology, College of Medicine Korea University 145, Anam‐ro, Seongbuk‐gu Seoul 02831 Republic of Korea
- Barabom Dermatologic Clinic 153, Wiryedong‐ro, Sujeong‐gu Seongnam‐si Gyeonggi‐do 13642 Republic of Korea
| | - Il‐Hwan Kim
- Department of Dermatology, College of Medicine Korea University 145, Anam‐ro, Seongbuk‐gu Seoul 02831 Republic of Korea
- Department of Dermatology Korea University Ansan Hospital 123, Jeokgeum‐ro, Danwon‐gu Ansan‐si Gyeonggi‐do 15355 Republic of Korea
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14
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Tawfic SO, El‐Tawdy A, Shalaby S, Foad A, Shaker O, Sayed SS, Metwally D. Evaluation of Fractional CO
2
Versus Long Pulsed Nd:YAG Lasers in Treatment of Hypertrophic Scars and Keloids: A Randomized Clinical Trial. Lasers Surg Med 2020; 52:959-965. [DOI: 10.1002/lsm.23249] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 04/04/2020] [Accepted: 04/06/2020] [Indexed: 01/01/2023]
Affiliation(s)
| | - Amira El‐Tawdy
- Department of Dermatology Cairo University Cairo 11562 Egypt
| | - Suzan Shalaby
- Department of Dermatology Cairo University Cairo 11562 Egypt
| | - Ahmed Foad
- Department of Dermatology Cairo University Cairo 11562 Egypt
| | - Olfat Shaker
- Department of Biochemistry Cairo University Cairo 11562 Egypt
| | | | - Dina Metwally
- Department of Dermatology Cairo University Cairo 11562 Egypt
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15
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Romero-Otero J, Lauterbach R, Aversa A, Serefoglu EC, García-Gómez B, Parnham A, Skrodzka M, Krychman M, Reisman Y, Corona G, Lowenstein L. Laser-Based Devices for Female Genitourinary Indications: Position Statements From the European Society for Sexual Medicine (ESSM). J Sex Med 2020; 17:841-848. [PMID: 32201147 DOI: 10.1016/j.jsxm.2020.02.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 02/09/2020] [Accepted: 02/12/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Laser-based technologies have been commercially marketed as "wonder treatments" without a sufficient and adequate body of evidence. In addition, on July 30, 2018, the U.S. Food and Drug Administration issued a warning regarding the safety of the use of laser-based devices for the following indications: vaginal "rejuvenation" or cosmetic vaginal procedures, vaginal conditions and symptoms related to menopause, urinary incontinence, and sexual function. AIM To perform a thorough review of the available literature regarding laser-based vaginal devices for the treatment of female genitourinary indications and summarize the results in several short statements according to the level of evidence. METHODS A comprehensive review of the literature regarding laser treatments for gynecological indications was performed based on several databases. Eligible were studies that included at least 15 patients. OUTCOMES Several aspects, including preclinical data, have been investigated. For each topic covered, data on laser-based devices were analyzed. RESULTS Despite the high heterogeneity of studies and its limitations, the committee released several statements regarding the use of laser-based devices for genitourinary indications. CLINICAL IMPLICATIONS Available data in the clinical setting are still poor, and the impact of these technologies on vaginal symptoms and signs has not been clearly established. STRENGTHS & LIMITATIONS All studies have been evaluated by a panel of experts providing recommendations for clinical practice. CONCLUSION It is too early in the evolution and research of laser-based devices to make decisive recommendations regarding vaginal treatments. There is grave need to carry out randomized controlled trials with proper design for safety reasons, possible harm, and short-/long-term benefits for the different indications studied.
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Affiliation(s)
- Javier Romero-Otero
- Urology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria, Madrid, Spain.
| | - Roy Lauterbach
- Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel
| | - Antonio Aversa
- Department of Experimental and Clinical Medicine, University of Catanzaro Magna Graecia, Catanzaro, Italy
| | - Ege Can Serefoglu
- Department of Urology, Biruni University School of Medicine, Istambul, Turkey
| | | | - Arie Parnham
- Andrology Department, University College, London, UK
| | - Marta Skrodzka
- Southern California Center for Sexual Health and Survivorship Medicine, Newport Beach, CA, USA
| | | | - Yacov Reisman
- Endocrinology Unit, Medical Department, Azienda USL, Maggiore-Bellaria Hospital, Bologna, Italy
| | - Giovanni Corona
- Urology Department, Hospital Universitario HM Montepríncipe, Madrid, Spain
| | - Lior Lowenstein
- Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel
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16
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Min S, Yoon JY, Park SY, Moon J, Kwon HH, Suh DH. Combination of platelet rich plasma in fractional carbon dioxide laser treatment increased clinical efficacy of for acne scar by enhancement of collagen production and modulation of laser-induced inflammation. Lasers Surg Med 2017; 50:302-310. [PMID: 29266290 DOI: 10.1002/lsm.22776] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND Platelet-rich plasma (PRP) which contains large amounts of growth factors has been tried to enhance therapeutic efficacy of laser treatment for acne scar with unknown underlying mechanism. OBJECTIVES The present study was conducted to investigate the molecular mechanism of increased clinical efficacy of PRP when combined with fractional laser treatment for treating acne scars. METHODS Subjects with mild to moderate acne scars were treated with two sessions of fractional CO2 laser therapy given with and without co-administration of PRP. Skin biopsy specimens were obtained at baseline, 1, 3, 7, and 28 days for investigation of molecular profiles associated with skin changes produced by laser plus PRP treatment. RESULTS The PRP treatment increased clinical efficacy with decreased severity of adverse effects such as erythema, swelling and oozing. Productions of TGFβ1 and TGFβ3 proteins were more highly elevated on the PRP-treated side of the face compared to the control side at day 28. Furthermore, PRP-treated side showed significant increase of c-myc, TIMP, and HGF expression. Experimental fibroblast culture model was also used. PRP administration after laser irradiation increased expressions of p-Akt, TGFβ1, TGFβ3, β-catenin, collagen 1, and collagen 3 in both dose-dependent and time dependent manners in fibroblast. Moreover, we acquired clinical and histological data through randomized control clinical trial. CONCLUSION Taken together with human study results combined with the data from cell experiments we suggest that PRP treatment increased fibrogenetic molecules induced by fractional CO2 laser, which have association with clinical effect. Lasers Surg. Med. 50:302-310, 2018. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Seonguk Min
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.,Acne and Rosacea Research Laboratory, Seoul National University Hospital, Seoul, Korea
| | - Ji Young Yoon
- Acne and Rosacea Research Laboratory, Seoul National University Hospital, Seoul, Korea
| | - Seon Yong Park
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.,Acne and Rosacea Research Laboratory, Seoul National University Hospital, Seoul, Korea
| | - Jungyoon Moon
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.,Acne and Rosacea Research Laboratory, Seoul National University Hospital, Seoul, Korea
| | - Hyuck Hoon Kwon
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.,Acne and Rosacea Research Laboratory, Seoul National University Hospital, Seoul, Korea
| | - Dae Hun Suh
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.,Acne and Rosacea Research Laboratory, Seoul National University Hospital, Seoul, Korea
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17
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Fractional carbon dioxide laser for the treatment of facial atrophic acne scars: prospective clinical trial with short and long-term evaluation. Lasers Med Sci 2017; 32:2047-2054. [PMID: 28894992 DOI: 10.1007/s10103-017-2322-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 09/05/2017] [Indexed: 10/18/2022]
Abstract
The aim of this study was to evaluate the efficacy and safety of fractional carbon dioxide laser for the treatment of acne scars. Thirty-one participants, 15 female and 16 male, whose mean age was 34.84 ± 10.94 years, were included in this prospective study. The study took place between 2012 and 2016. Participants were evaluated with the "ECCA Grading Scale" before the first session, 3 months (short-term evaluation) and 3 years after the last session (long-term evaluation). Participants received two or three treatment sessions at 4-week intervals, with a 10,600 nm fractional carbon dioxide laser with pulse energies ranging between 100 and 160 mJ, 120 spot type, 75-100 spot/cm2 density, and 30 W power. Self-assessments by the participants were done 3 months and 3 years after the last session. The mean ECCA score was 107.90 ± 39.38 before the first session, and 82.17 ± 36.23 at the time of short-term evaluation (p = 0.000). The grade of improvement at the short-term evaluation was as follows: no improvement, mild, moderate, and significant improvement for 7 (22.6%), 11 (35.5%), 9 (29%), and 4 (12.9%) of the participants, respectively. Regarding self-assessments, 80.6 and 61.3% of the participants rated themselves as having at least mild improvement at the short-term and the long-term follow-up periods, respectively. The results of this study suggest that fractional carbon dioxide laser is an efficient treatment option for acne scars. Furthermore, self-assessment results show that more than half of the participants still experience at least mild improvement at the end of 3 years.
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18
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Shingyochi Y, Kanazawa S, Tajima S, Tanaka R, Mizuno H, Tobita M. A Low-Level Carbon Dioxide Laser Promotes Fibroblast Proliferation and Migration through Activation of Akt, ERK, and JNK. PLoS One 2017; 12:e0168937. [PMID: 28045948 PMCID: PMC5207507 DOI: 10.1371/journal.pone.0168937] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 12/08/2016] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Low-level laser therapy (LLLT) with various types of lasers promotes fibroblast proliferation and migration during the process of wound healing. Although LLLT with a carbon dioxide (CO2) laser was also reported to promote wound healing, the underlying mechanisms at the cellular level have not been previously described. Herein, we investigated the effect of LLLT with a CO2 laser on fibroblast proliferation and migration. MATERIALS AND METHODS Cultured human dermal fibroblasts were prepared. MTS and cell migration assays were performed with fibroblasts after LLLT with a CO2 laser at various doses (0.1, 0.5, 1.0, 2.0, or 5.0 J/cm2) to observe the effects of LLLT with a CO2 laser on the proliferation and migration of fibroblasts. The non-irradiated group served as the control. Moreover, western blot analysis was performed using fibroblasts after LLLT with a CO2 laser to analyze changes in the activities of Akt, extracellular signal-regulated kinase (ERK), and Jun N-terminal kinase (JNK), which are signaling molecules associated with cell proliferation and migration. Finally, the MTS assay, a cell migration assay, and western blot analysis were performed using fibroblasts treated with inhibitors of Akt, ERK, or JNK before LLLT with a CO2 laser. RESULTS In MTS and cell migration assays, fibroblast proliferation and migration were promoted after LLLT with a CO2 laser at 1.0 J/cm2. Western blot analysis revealed that Akt, ERK, and JNK activities were promoted in fibroblasts after LLLT with a CO2 laser at 1.0 J/cm2. Moreover, inhibition of Akt, ERK, or JNK significantly blocked fibroblast proliferation and migration. CONCLUSIONS These findings suggested that LLLT with a CO2 laser would accelerate wound healing by promoting the proliferation and migration of fibroblasts. Activation of Akt, ERK, and JNK was essential for CO2 laser-induced proliferation and migration of fibroblasts.
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Affiliation(s)
- Yoshiaki Shingyochi
- Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Shigeyuki Kanazawa
- Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Satoshi Tajima
- Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Rica Tanaka
- Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Hiroshi Mizuno
- Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Morikuni Tobita
- Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
- * E-mail:
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Pagano I, Gieri S, Nocera F, Scibilia G, Fraggetta F, Galia A, Gioè M, Pecorino B, Scollo P. Evaluation of the CO<sub>2</sub> Laser Therapy on Vulvo-Vaginal Atrophy (VVA) in Oncological Patients: Preliminary Results. ACTA ACUST UNITED AC 2017. [DOI: 10.4236/jct.2017.85039] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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20
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Tang M, Cheng Y, Yang C, Liu S, Sheng Y, Li Y, Yin W, Zhou W, Yang S, Zhang X. Nevus spilus: treatment with fractional CO2 laser in combination with MedLite C6 laser: a preliminary study. Lasers Med Sci 2016; 32:1659-1662. [DOI: 10.1007/s10103-016-2128-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 12/08/2016] [Indexed: 10/20/2022]
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21
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Bennani I, Lopez R, Bonnet D, Prevot G, Constantin A, Chauveau D, Paul C, Bulai Livideanu C. Improvement of Microstomia in Scleroderma after Carbon Dioxide Laser Treatment. Case Rep Dermatol 2016; 8:142-50. [PMID: 27403126 PMCID: PMC4924459 DOI: 10.1159/000445821] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Limited mouth opening (LMO) is a frequent complication of systemic sclerosis (SS). Its management is complex and there are limited treatment options. We report four patients with SS and severe LMO [interincisal distance (IID) <30 mm] treated with pulsed carbon dioxide (CO2) laser. Pulsed CO2 laser treatment of the white lips was performed after all patients had signed a written informed consent in the absence of alternative treatment. Treatment was carried out under locoregional anaesthesia using a Sharplan 30C CO2 laser in the Silk Touch® resurfacing mode. One to three laser sessions were performed at intervals of 8-12 months between sessions. Assessments were performed at 3 and 12 months with measurement of the IID using a ruler, calculation of the Mouth Handicap in Systemic Sclerosis (MHISS) scale and global evaluation by the patients. Adverse events were also reported. In all four patients, an improvement in IID occurred 3 months after the first session with a mean gain of +5 mm (range: 2-7). At 12 months, a mean gain of +8.5 mm (range: 7-10) in IID was observed. The MHISS score decreased by a mean of •14 (range: 11-17). All patients showed improvement of lip flexibility or mouth opening, allowing better phonation and mastication and easier dental care. Adverse effects were transient erythema and/or dyschromia. CO2 laser appears to be effective and well tolerated in the improvement of LMO in SS.
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Affiliation(s)
- Imane Bennani
- Department of Dermatology, Paul Sabatier University, Toulouse, France
| | - Raphael Lopez
- Departments of Oral and Maxillofacial Surgery, Toulouse University Hospital, Toulouse, France
| | - Delphine Bonnet
- Departments of Internal Medicine, Toulouse University Hospital, Toulouse, France
| | - Gregoire Prevot
- Departments of Pulmonology, Toulouse University Hospital, Toulouse, France
| | - Arnaud Constantin
- Departments of Rheumatology, Toulouse University Hospital, Toulouse, France
| | - Dominique Chauveau
- Departments of Nephrology, Toulouse University Hospital, Toulouse, France
| | - Carle Paul
- Department of Dermatology, Paul Sabatier University, Toulouse, France
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Perino A, Calligaro A, Forlani F, Tiberio C, Cucinella G, Svelato A, Saitta S, Calagna G. Vulvo-vaginal atrophy: a new treatment modality using thermo-ablative fractional CO2 laser. Maturitas 2014; 80:296-301. [PMID: 25596815 DOI: 10.1016/j.maturitas.2014.12.006] [Citation(s) in RCA: 129] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 12/08/2014] [Accepted: 12/11/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To evaluate the efficacy and feasibility of thermo-ablative fractional CO2 laser for the treatment of symptoms related to vulvo-vaginal atrophy (VVA) in post-menopausal women. METHODS From April 2013 to December 2013, post-menopausal patients who complained of one or more VVA-related symptoms and who underwent vaginal treatment with fractional CO2 laser were enrolled in the study. At baseline (T0) and 30 days post-treatment (T1), vaginal status of the women was evaluated using the Vaginal Health Index (VHI), and subjective intensity of VVA symptoms was evaluated using a visual analog scale (VAS). At T1, treatment satisfaction was evaluated using a 5-point Likert scale. RESULTS During the study period, a total of 48 patients were enrolled. Data indicated a significant improvement in VVA symptoms (vaginal dryness, burning, itching and dyspareunia) (P<0.0001) in patients who had undergone 3 sessions of vaginal fractional CO2 laser treatment. Moreover, VHI scores were significantly higher at T1 (P<0.0001). Overall, 91.7% of patients were satisfied or very satisfied with the procedure and experienced considerable improvement in quality of life (QoL). No adverse events due to fractional CO2 laser treatment occurred. CONCLUSION Thermo-ablative fractional CO2 laser could be a safe, effective and feasible option for the treatment of VVA symptoms in post-menopausal women.
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Affiliation(s)
- Antonino Perino
- Department of Obstetrics and Gynaecology, University Hospital "P. Giaccone", Palermo, Italy
| | - Alberto Calligaro
- Department of Public Health, Experimental and Forensic Medicine, Unit of Histology and Embryology University of Pavia, Pavia, Italy
| | - Francesco Forlani
- Department of Obstetrics and Gynaecology, University Hospital "P. Giaccone", Palermo, Italy.
| | - Corrado Tiberio
- Department of Obstetrics and Gynaecology, University Hospital "P. Giaccone", Palermo, Italy
| | - Gaspare Cucinella
- Department of Obstetrics and Gynaecology, University Hospital "P. Giaccone", Palermo, Italy
| | - Alessandro Svelato
- Department of Obstetrics and Gynaecology, University Hospital "P. Giaccone", Palermo, Italy
| | - Salvatore Saitta
- Department of Human Pathology, School and Division of Allergy and Clinical Immunology, University of Messina, Messina, Italy
| | - Gloria Calagna
- Department of Obstetrics and Gynaecology, University Hospital "P. Giaccone", Palermo, Italy
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