Systematic evaluations of skin damage irradiated by an erbium:YAG laser: histopathologic analysis, proteomic profiles, and cellular response

Assessment of Laser Effects on Skin Rejuvenation

Laser skin resurfacing has changed the approach of facial skin rejuvenation over the past decade. This article evaluates the laser effects on skin rejuvenation by the assessment of laser characteristics and histological and molecular changes, accompanied by the expression of proteins during and after laser-assisted rejuvenation of skin. It is important to note that different layers of skin with different cells are normally exposed to the sun's UV radiation which is the most likely factor in aging and damaging healthy skin. To identify the expression of proteins, using validated databases and reviewing existing data could reveal altered proteins which could be analyzed and mapped to investigate their expression and their different effects on cell biological responses. In this regard, proteomics data can be used for better investigation of the changes in the proteomic profile of the treated skin. Different assessments have revealed the survival and activation of fibroblasts and new keratinocytes with an increase of collagen and elastin fibers in the dermis and the reduction of matrix metalloproteinases (MMPs) and heat shock proteins (HSPs) as a result of different low-power laser therapies of skin. There are a wide range of biological effects associated with laser application in skin rejuvenation; therefore, more safety considerations should be regarded in the application of lasers in skin rejuvenation.

The Impact of Proteomic Investigations on the Development and Improvement of Skin Laser Therapy: A Review Article

Introduction: Different molecular approaches have contributed to finding various responses of skin to external and internal tensions such as laser irradiation and many important mediators of skin disease have been identified through these approaches. However, different essential signals of skin biomarker pathways and proteins are partially detected or completely unknown. In the present study, the impact of proteomics on the evaluation of laser therapy for the treatment of skin diseases is investigated. Methods: The keywords of "Proteomics", "Laser therapy", "Skin", and "Skin disease" were searched in Google Scholar, Scopus and PubMed search engines. After screening, 53 documents were included in the study. Results: The global assessments revealed that different proteins in different signaling pathways of skin metabolism in terms of health or illness after laser therapy are expressed differentially. The results indicated that the application of proteomics is a useful method for promoting the results of laser interventions. Conclusion: This kind of research dealt with the practical proteomics of skin diseases and skin laser therapy.

Evaluation of Skin Response After Erbium:Yttrium- Aluminum-Garnet Laser Irradiation: A Network Analysis Approach

Introduction: Application of laser in medicine and cosmetic purposes has raised grossly in recent years. There are contradictory finding about its side effects. In this research critical differentially expressed proteins after irradiation erbium:yttrium-aluminum-garnet (Er:YAG) laser on skin are investigated. Methods: Proteome data including 31 proteins were obtained from a proteomics investigation of laser irradiation, Er:YAG on female mouse skin that are published by Pan et al. The query proteins and 100 related ones were included in the protein-protein interaction (PPI) network. The central nodes were determined and all of nodes were included in action maps. Expression, activation, inhibition, binding, and reaction were considered in action plan. Results: Numbers of 16 proteins were recognized by STRING database and were included in the network. Except PHRF1, the other 15 query proteins were included in the main connected component of the constructed network. Ten central nodes of the network and ten numbers of top query proteins based on degree value were identified as central proteins of the network. All nodes of the network analyzed via action maps and the important acted nodes were determined as RPSA, GAPDH, TPT1, DCTN2, HSPB1, and PDIA3. Conclusion: Two balanced processes including cancer promotion and cancer prevention were after irradiation were identified.

Effects of Er:YAG and Diode Laser Irradiation on Dental Pulp Cells and Tissues

Vital pulp therapy (VPT) is to preserve the nerve and maintain healthy dental pulp tissue. Laser irradiation (LI) is beneficial for VPT. Understanding how LI affects dental pulp cells and tissues is necessary to elucidate the mechanism of reparative dentin and dentin regeneration. Here, we show how Er:YAG-LI and diode-LI modulated cell proliferation, apoptosis, gene expression, protease activation, and mineralization induction in dental pulp cells and tissues using cell culture, immunohistochemical, genetic, and protein analysis techniques. Both LIs promoted proliferation in porcine dental pulp-derived cell lines (PPU-7), although the cell growth rate between the LIs was different. In addition to proliferation, both LIs also caused apoptosis; however, the apoptotic index for Er:YAG-LI was higher than that for diode-LI. The mRNA level of odontoblastic gene markers-two dentin sialophosphoprotein splicing variants and matrix metalloprotease (MMP)20 were enhanced by diode-LI, whereas MMP2 was increased by Er:YAG-LI. Both LIs enhanced alkaline phosphatase activity, suggesting that they may help induce PPU-7 differentiation into odontoblast-like cells. In terms of mineralization induction, the LIs were not significantly different, although their cell reactivity was likely different. Both LIs activated four MMPs in porcine dental pulp tissues. We helped elucidate how reparative dentin is formed during laser treatments.

Facial microcirculatory and biomechanical skin properties after single high energy (Er):YAG laser application

OBJECTIVE

Owing to skin aging and the growing demand for skin rejuvenation, minimal invasive aesthetic treatments such as laser procedures are increasingly coming into focus. However, until now, little has been known about the objective effects of these procedures with respect to skin microcirculation or changes in skin elasticity.

STUDY DESIGN

Facial skin rejuvenation was performed on 32 volunteers using ablative Erbium: YAG laser. Skin microcirculation and skin elasticity have then been evaluated objectively.

METHODS

Microcirculation (flow, SO₂ , velocity, and rHB) has been analyzed before and directly after the laser session by using the O2C device. Skin elasticity has been evaluated by using the Cutometer device (Uf, Ua, Ur, and Ue) before and directly after the laser treatment, as well as 1 week and then 1, 3, and 6 months post treatment. Further, the outcome for the volunteers regarding their satisfactory level after laser treatment was evaluated.

RESULTS

Twenty volunteers were available for a complete follow-up. Microcirculation displayed statistically significant increase in all values to 2 mm depth. The biomechanical skin parameter of firmness of skin displayed statistically significant improvement in superficial skin layer after 6 months.

CONCLUSION

Concerning microcirculation and skin elasticity the ablative Erbium: YAG laser treatment revealed similar effects on the skin like a superficial burn injury. In contrast to the determined skin elasticity parameters, firmness of skin objectively revealed a skin tightening effect after 6 months. Along with the important epidermal effect, the suitability of ablative laser treatment for skin rejuvenation has been proved in a long-term follow-up. Lasers Surg. Med. 49:891-898, 2017. © 2017 Wiley Periodicals, Inc.

Skin healing and collagen changes of rats after fractional erbium:yttrium aluminum garnet laser: observation by reflectance confocal microscopy with confirmed histological evidence

The fractional erbium:yttrium aluminum garnet (Er:YAG) laser is widely applied. Microstructural changes after laser treatment have been observed with histopathology. Epidermal and dermal microstructures have also been analyzed using reflectance confocal microscopy (RCM). However, no studies have compared these two types of microstructural changes in the same subject at multiple time points after irradiation, and it is unclear if these two types of changes are consistent. We use RCM to observe the effect of different laser energies on skin healing and collagen changes in the skin of Sprague-Dawley rats that had been irradiated by fractional Er:YAG lasering at different energies. RCM was used to observe skin healing and detect collagen changes at different time points. Collagen changes were observed using hematoxylin and eosin (H&E) staining and quantitatively analyzed by western blot. RCM showed that, irrespective of laser energy, microscopic treatment zones (MTZs) were larger at 1 day after irradiation. The MTZs then reduced in size from 3 to 7 days after irradiation. The higher the energy, the larger the MTZ area. The amount of collagen also increased with time from 1 day to 8 weeks. However, the increase in the collagen amount on both RCM and H&E staining was not influenced by the laser energy. Western blotting confirmed that the amount of type I and type III collagens increased over time, but there were no significant differences between the different energy groups (p > 0.05). In conclusion, RCM is a reliable technique for observing and evaluating skin healing and collagen expression after laser irradiation.

Nano-level monitoring of Er(III) by fabrication of coated graphite electrode based on newly synthesized Schiff base as neutral carrier

Plasticized membranes using N-(-3-((thiazol-2-ylimino)methyl)benzylidene)thiazol-2-amine (S1) and 5-((-3-((5-mercapto-1,3,4-thiadiazol-2-ylimino)methyl)benzylidene)amino)-1,3,4-thiadiazole-2-thiol (S2) have been prepared and explored as Er (III) selective electrodes. Effect of various plasticizers viz. dibutylphthalate, tri-n-butylphosphate, dioctylphthalate, acetophenone, 1-chloronapthalene, o-nitrophenyloctylether, and anion excluders viz. sodium tetraphenylborate and potassium tetrakis-p-(chlorophenyl)borate was studied in detail and improved performance was observed. Optimum performance was observed for the membrane electrode having a composition of S2: PVC: o-NPOE: KTpClPB in the ratio of 4: 38: 55: 3 (w/w, mg). The performance of the PME based on S2 was compared with CGE. The electrodes exhibit Nernstian slope for Er (III) ion with detection limit 5.4 × 10(-8)mol L(-1) for PME and 6.1 × 10(-9)mol L(-1) for CGE. The response time for PME and CGE was found to be 12s and 9s respectively. The practical utility of the CGE has been demonstrated by its usage as an indicator electrode in potentiometric titration of EDTA with Er (III) solution and determination of fluoride ions in mouthwash solution. The proposed electrode was also applied to the determination of added Er(3+) ion in water and binary mixtures. It is found that the electrode could be able to recover the Er(3+) ion in 96.2-99.5%.

Coumarin derivatives, but not coumarin itself, cause skin irritation via topical delivery

Coumarin and its derivatives are widely employed as a fragrance in cosmetics and skin care products. The skin absorption level and possible disruption to the skin by topical application of coumarins were evaluated in this study. Percutaneous absorption of osthole, daphnoretin, coumarin, byakangelicin, and 7-hydroxycoumarin was assessed in vitro and in vivo. Skin physiology measurements and immunoblotting were utilized as methodologies for validating toxicity. The relationship between structures and permeation/toxicity of coumarins was elucidated. Both equimolar concentration and saturated solubility in 30% ethanol were used as the applied dose. Osthole with the most lipophilic characteristic demonstrated the greatest skin accumulation, followed by coumarin and 7-hydroxycoumarin. Coumarin was the permeant with the highest flux across the skin. The trend of in vivo deposition was consistent with that of the in vitro profiles. Skin uptake of osthole was 8-fold higher than that of coumarin. Hair follicles played a significant role as a pathway for transport of coumarin according to the examination of follicular accumulation. Osthole and 7-hydroxycoumarin slightly, but significantly, enhanced transepidermal water loss after a consecutive 5-day administration. The immunoblotting profiling verified the role of proliferation in skin damage induced by osthole, byakangelicin, and 7-hydroxycoumarin. The proliferation-related proteins examined in this work included glucose-regulated proteins, cytokeratin, and C-myc. Daphnoretin and coumarin showed a negligible alteration on protein biomarkers. The experimental results suggested that skin irritation caused by coumarins was mainly derived from the analogs but not from coumarin itself.

Risk assessment of excess drug and sunscreen absorption via skin with ablative fractional laser resurfacing : optimization of the applied dose for postoperative care

The ablative fractional laser is a new modality used for surgical resurfacing. It is expected that laser treatment can generally deliver drugs into and across the skin, which is toxicologically relevant. The aim of this study was to establish skin absorption characteristics of antibiotics, sunscreens, and macromolecules via laser-treated skin and during postoperative periods. Nude mice were employed as the animal model. The skin received a single irradiation of a fractional CO2 laser, using fluences of 4-10 mJ with spot densities of 100-400 spots/cm(2). In vitro skin permeation using Franz cells was performed. Levels of skin water loss and erythema were evaluated, and histological examinations with staining by hematoxylin and eosin, cyclooxygenase-2, and claudin-1 were carried out. Significant signs of erythema, edema, and scaling of the skin treated with the fractional laser were evident. Inflammatory infiltration and a reduction in tight junctions were also observed. Laser treatment at 6 mJ increased tetracycline and tretinoin fluxes by 70- and 9-fold, respectively. A higher fluence resulted in a greater tetracycline flux, but lower skin deposition. On the other hand, tretinoin skin deposition increased following an increase in the laser fluence. The fractional laser exhibited a negligible effect on modulating oxybenzone absorption. Dextrans with molecular weights of 4 and 10 kDa showed increased fluxes from 0.05 to 11.05 and 38.54 μg/cm(2)/h, respectively. The optimized drug dose for skin treated with the fractional laser was 1/70-1/60 of the regular dose. The skin histology and drug absorption had recovered to a normal status within 2-3 days. Our findings provide the first report on risk assessment of excessive skin absorption after fractional laser resurfacing.

Skin permeation of small-molecule drugs, macromolecules, and nanoparticles mediated by a fractional carbon dioxide laser: the role of hair follicles

PURPOSE

To evaluate skin permeation enhancement mediated by fractional laser for different permeants, including hydroquinone, imiquimod, fluorescein isothiocyanate-labeled dextran (FD), and quantum dots.

METHODS

Skin received a single irradiation of a fractional CO(2) laser, using fluence of 2 or 4 mJ with densities of 100 ∼ 400 spots/cm(2). In vitro and in vivo skin penetration experiments were performed. Fluorescence and confocal microscopies for imaging delivery pathways were used.

RESULTS

The laser enhanced flux of small-molecule drugs 2 ∼ 5-fold compared to intact skin. A laser fluence of 4 mJ with a 400-spot/cm(2) density promoted FD flux at 20 and 40 kDa from 0 (passive transport) to 0.72 and 0.43 nmol/cm(2)/h, respectively. Microscopic images demonstrated a significant increase in fluorescence accumulation and penetration depth of macromolecules and nanoparticles after laser exposure. Predominant routes for laser-assisted delivery may be intercellular and follicular transport. CO(2) laser irradiation produced 13-fold enhancement in follicular deposition of imiquimod. Laser-mediated follicular transport could deliver permeants to deeper strata. Skin barrier function as determined by transepidermal water loss completely recovered by 12 h after irradiation, much faster than conventional laser treatment (4 days).

CONCLUSIONS

Fractional laser could selectively enhance permeant targeting to follicles such as imiquimod and FD but not hydroquinone, indicating the importance of selecting feasible drugs for laser-assisted follicle delivery.

Network analysis and proteomic identification of vimentin as a key regulator associated with invasion and metastasis in human hepatocellular carcinoma cells

Poor prognoses have long been associated with the high relapse and metastasis of human hepatocellular carcinoma (HCC). To achieve long-term survival, it is necessary to identify new HCC biomarkers and investigate their roles in cell mobility and invasiveness. Of note, overexpression of vimentin (Vim) was significantly correlated with tumor nuclear grade (p=0.01) and the invasive potential, indicating that Vim may be a promising candidate in regulating HCC metastasis. RNA interference-mediated silencing of Vim (siVim) suppressed the invasive and migratory propensity, and matrix metalloproteinase (MMP)-9 activity, and elicited morphological changes in poorly differentiated SK-Hep-1 cells. Moreover, we performed a comprehensive proteomic analysis to survey global protein changes mediated by siVim in SK-Hep-1 cells. Significant changes in cytoskeleton protein but not messenger RNA levels encoding these targeted proteins were observed. All of the data in the current study and a network analysis implied that abolition of Vim may disturb the expression and stability of various cytoskeletal proteins through promoting the ubiquitin system, resulting in impaired cell adhesion and motility. Collectively, an integrated approach represents a modality to explore novel relationships in a proteome complex and highlights the functional roles of Vim in HCC metastasis. This article is part of a Special Issue entitled: Translational Proteomics.