1
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Zhao J, Chen Z, Li X, Tong Z, Xu Z, Feng P, Wang P. Performance assessment of an injectable hyaluronic acid/polylactic acid complex hydrogel with enhanced biological properties as a dermal filler. J Biomed Mater Res A 2024; 112:721-732. [PMID: 38093473 DOI: 10.1002/jbm.a.37653] [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: 07/04/2023] [Revised: 11/16/2023] [Accepted: 11/27/2023] [Indexed: 03/20/2024]
Abstract
Injectable hyaluronic acid (HA) hydrogel plays an important role in dermal filling. However, conventional HA dermal fillers mostly lack bio-functional diversity and frequently cause adverse reactions because of the chemical stiffness of highly modified degree and crosslinker residues. In this study, polylactic acid (PLA) was embedded into HA hydrogel as a bioactive substance and 1,4-butanediol diglycidyl ether was used as a crosslinker to prepare the HA/PLA composite hydrogel with enhanced biocompatibility and biological performance. We aimed to investigate the properties of HA/PLA composite hydrogels as dermal fillers by assessing the rheological properties, surface microstructure, enzymolysis stability, swelling ratio, degradation rate, cytotoxicity, and anti-wrinkle effect on photo-aged skin. The results showed that the stability and stiffness of the composite hydrogel decreased with an increasing amount of PLA, while the in vivo safety of the HA/PLA hydrogel was enhanced, showing no adverse reactions such as edema, redness, or swelling. Moreover, the composite hydrogel with 2 wt% PLA exhibited excellent anti-wrinkle effects, showing the highest collagen production. Thus, the PLA-embedded HA composite hydrogel showed potential as a dermal filler with high safety, easy injectability, and excellent anti-wrinkle effects.
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Affiliation(s)
- Jiajing Zhao
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, China
| | - Ziwei Chen
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, China
| | - Xiaoshuo Li
- School of Medicine and Pharmacy, Ocean University of China, Qingdao, China
| | - Zheren Tong
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, China
| | - Zijin Xu
- College of Pharmacy, Jiangxi Medical College, Shangrao, China
| | - Peishi Feng
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, China
| | - Ping Wang
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, China
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2
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Gou S, Porcello A, Allémann E, Salomon D, Micheels P, Jordan O, Kalia YN. Injectable Hyaluronan-Based Thermoresponsive Hydrogels for Dermatological Applications. Pharmaceutics 2023; 15:1708. [PMID: 37376156 DOI: 10.3390/pharmaceutics15061708] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/02/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
Most marketed HA-based dermal fillers use chemical cross-linking to improve mechanical properties and extend their lifetime in vivo; however, stiffer products with higher elasticity require an increased extrusion force for injection in clinical practice. To balance longevity and injectability, we propose a thermosensitive dermal filler, injectable as a low viscosity fluid that undergoes gelation in situ upon injection. To this end, HA was conjugated via a linker to poly(N-isopropylacrylamide) (pNIPAM), a thermosensitive polymer using "green chemistry", with water as the solvent. HA-L-pNIPAM hydrogels showed a comparatively low viscosity (G' was 105.1 and 233 for Candidate1 and Belotero Volume®, respectively) at room temperature and spontaneously formed a stiffer gel with submicron structure at body temperature. Hydrogel formulations exhibited superior resistance against enzymatic and oxidative degradation and could be administered using a comparatively lower injection force (49 N and >100 N for Candidate 1 and Belotero Volume®, respectively) with a 32G needle. Formulations were biocompatible (viability of L929 mouse fibroblasts was >100% and ~85% for HA-L-pNIPAM hydrogel aqueous extract and their degradation product, respectively), and offered an extended residence time (up to 72 h) at the injection site. This property could potentially be exploited to develop sustained release drug delivery systems for the management of dermatologic and systemic disorders.
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Affiliation(s)
- Si Gou
- School of Pharmaceutical Sciences, University of Geneva, 1211 Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, 1211 Geneva, Switzerland
| | - Alexandre Porcello
- KYLYS Sàrl, 34, Route de la Galaise, c/o FONGIT, Plan-les-Ouates, 1228 Geneva, Switzerland
| | - Eric Allémann
- KYLYS Sàrl, 34, Route de la Galaise, c/o FONGIT, Plan-les-Ouates, 1228 Geneva, Switzerland
| | - Denis Salomon
- Clinique Internationale de Dermatologie Genève SA, 1201 Geneva, Switzerland
| | - Patrick Micheels
- Private Practice, 8, Chemin de la Fontaine, Chêne-Bougeries, 1224 Geneva, Switzerland
| | - Olivier Jordan
- KYLYS Sàrl, 34, Route de la Galaise, c/o FONGIT, Plan-les-Ouates, 1228 Geneva, Switzerland
| | - Yogeshvar N Kalia
- School of Pharmaceutical Sciences, University of Geneva, 1211 Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, 1211 Geneva, Switzerland
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3
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Silica Hydrogels as Platform for Delivery of Hyaluronic Acid. Pharmaceutics 2022; 15:pharmaceutics15010077. [PMID: 36678706 PMCID: PMC9864809 DOI: 10.3390/pharmaceutics15010077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/21/2022] [Accepted: 12/23/2022] [Indexed: 12/28/2022] Open
Abstract
Hyaluronic acid (HA) is chondroprotective and anti-inflammatory drug used clinically for treatment of inflammatory disorders (arthritis, skin diseases, bowel diseases, etc.). In addition, HA is a crucial ingredient in the cosmetic products used to eliminate the unpleasant consequences of inflammatory skin diseases. The main disadvantages that limit its use are its low mechanical properties and its rapid biodegradation. In this paper, silica hydrogels are considered as a promising matrix for HA to improve its properties. The hybrid HA-silica hydrogels were synthesized by the sol-gel method. Morphology of the hydrogels was investigated by optical microscopy and scanning electron microscopy methods. Taking into account their potential applications for topical and injectable delivery, much attention was paid to investigation of deformation properties of the hydrogels under shear, compression, and tension. Their resistance to enzymatic degradation in vitro was estimated. Kinetics and mechanisms of HA release from the hybrid hydrogels in vitro were also studied. It was found that the indicated properties can be controlled by synthesis conditions, HA molecular weight, and its loading in the hydrogels. Silica hydrogels are a prospective platform for the development of new soft formulations and cosmetic compositions of HA with improved pharmacological and consumer properties.
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4
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Jennen DGJ, van Herwijnen M, Jetten M, Vandebriel RJ, Keizers P, Geertsma RE, de Jong WH, Kleinjans JCS. Transcriptomic Analysis in Human 3D Skin Model Injected with Resorbable Hyaluronic Acid Fillers Reveals Foreign Body Response. Int J Mol Sci 2022; 23:ijms232113046. [PMID: 36361846 PMCID: PMC9654658 DOI: 10.3390/ijms232113046] [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: 10/02/2022] [Revised: 10/20/2022] [Accepted: 10/24/2022] [Indexed: 11/16/2022] Open
Abstract
Usage of injectable dermal fillers applied for aesthetic purposes has extensively increased over the years. As such, the number of related adverse reactions has increased, including patients showing severe complications such as product migration, topical swelling and inflammatory reactions of the skin. In order to understand the underlying molecular events of these adverse reactions we performed a genome-wide gene expression study on the multi-cell type human Phenion® Full-Thickness Skin Model exposed to five experimental hyaluronic acid (HA) preparations with increasing cross-linking degree, four commercial fillers from Perfectha®, and non-resorbable filler Bio-Alcamid®. In addition, we evaluated whether cross-linking degree or particle size of the HA-based fillers could be associated with the occurrence of adverse effects. In all cases, exposure to different HA fillers resulted in a clearly elevated gene expression of cytokines and chemokines related to acute inflammation as part of the foreign body response. Furthermore, for one experimental filler genes of OXPHOS complexes I-V were significantly down-regulated (adjusted p-value < 0.05), resulting in mitochondrial dysfunction which can be linked to over-expression of pro-inflammatory cytokines TNFα and IL-1β and chemokine CCL2. Our hypothesis that cross-linking degree or particle size of the HA-based fillers is related to the biological responses induced by these fillers could only partially be confirmed for particle size. In conclusion, our innovative approach resulted in gene expression changes from a human 3D skin model exposed to dermal fillers that mechanistically substantiate aforementioned adverse reactions, and thereby adds to the weight of evidence that these fillers may induce inflammatory and fibrotic responses.
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Affiliation(s)
- Danyel G. J. Jennen
- Department of Toxicogenomics, GROW School for Oncology and Reproduction, Maastricht University, 6200 Maastricht, The Netherlands
- Correspondence:
| | - Marcel van Herwijnen
- Department of Toxicogenomics, GROW School for Oncology and Reproduction, Maastricht University, 6200 Maastricht, The Netherlands
| | - Marlon Jetten
- Department of Toxicogenomics, GROW School for Oncology and Reproduction, Maastricht University, 6200 Maastricht, The Netherlands
| | - Rob J. Vandebriel
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), 3720 Bilthoven, The Netherlands
| | - Peter Keizers
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), 3720 Bilthoven, The Netherlands
| | - Robert E. Geertsma
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), 3720 Bilthoven, The Netherlands
| | - Wim H. de Jong
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), 3720 Bilthoven, The Netherlands
| | - Jos C. S. Kleinjans
- Department of Toxicogenomics, GROW School for Oncology and Reproduction, Maastricht University, 6200 Maastricht, The Netherlands
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Evaluation of Adverse Effects of Resorbable Hyaluronic Acid Fillers: Determination of Macrophage Responses. Int J Mol Sci 2022; 23:ijms23137275. [PMID: 35806280 PMCID: PMC9266407 DOI: 10.3390/ijms23137275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/26/2022] [Accepted: 06/26/2022] [Indexed: 12/01/2022] Open
Abstract
Resorbable tissue fillers for aesthetic purposes can induce severe complications including product migration, late swelling, and inflammatory reactions. The relation between product characteristics and adverse effects is not well understood. We hypothesized that the degree of cross-linking hyaluronic acid (HA) fillers was associated with the occurrence of adverse effects. Five experimental HA preparations similar to HA fillers were synthesized with an increasing degree of cross-linking. Furthermore, a series of commercial fillers (Perfectha®) was obtained that differ in degradation time based on the size of their particulate HA components. Cytotoxic responses and cytokine production by human THP-1-derived macrophages exposed to extracts of the evaluated resorbable HA fillers were absent to minimal. Gene expression analysis of the HA-exposed macrophages revealed the responses related to cell cycle control and immune reactivity. Our results could not confirm the hypothesis that the level of cross-linking in our experimental HA fillers or the particulate size of commercial HA fillers is related to the induced biological responses. However, the evaluation of cytokine induction and gene expression in macrophages after biomaterial exposure presents promising opportunities for the development of methods to identify cellular processes that may be predictive for biomaterial-induced responses in patients.
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La Gatta A, Bedini E, Aschettino M, Finamore R, Schiraldi C. Hyaluronan Hydrogels: Rheology and Stability in Relation to the Type/Level of Biopolymer Chemical Modification. Polymers (Basel) 2022; 14:polym14122402. [PMID: 35745978 PMCID: PMC9228881 DOI: 10.3390/polym14122402] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 02/04/2023] Open
Abstract
BDDE (1,4-butanediol-diglycidylether)-crosslinked hyaluronan (HA) hydrogels are widely used for dermo-aesthetic purposes. The rheology and stability of the gels under physiological conditions greatly affect their clinical indications and outcomes. To date, no studies investigating how these features are related to the chemistry of the polymeric network have been reported. Here, four available HA-BDDE hydrogels were studied to determine how and to what extent their rheology and stability with respect to enzymatic hydrolysis relate to the type and degree of HA structural modification. 1H-/13C-NMR analyses were associated for the quantification of the “true” HA chemical derivatization level, discriminating between HA that was effectively crosslinked by BDDE, and branched HA with BDDE that was anchored on one side. The rheology was measured conventionally and during hydration in a physiological medium. Sensitivity to bovine testicular hyaluronidase was quantified. The correlation between NMR data and gel rheology/stability was evaluated. The study indicated that (1) the gels greatly differed in the amounts of branched, crosslinked, and overall modified HA, with most of the HA being branched; (2) unexpectedly, the conventionally measured rheological properties did not correlate with the chemical data; (3) the gels’ ranking in terms of rheology was greatly affected by hydration; (4) the rheology of the hydrated gels was quantitatively correlated with the amount of crosslinked HA, whereas the correlations with the total HA modification level and with the degree of branched HA were less significant; (5) increasing HA derivatization/crosslinking over 9/3 mol% did not enhance the stability with respect to hyaluronidases. These results broaden our knowledge of these gels and provide valuable information for improving their design and characterization.
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Affiliation(s)
- Annalisa La Gatta
- Department of Experimental Medicine, School of Medicine, University of Campania “Luigi Vanvitelli”, Via L. De Crecchio 7, 80138 Naples, Italy; (M.A.); (R.F.); (C.S.)
- Correspondence:
| | - Emiliano Bedini
- Department of Chemical Sciences, University of Naples Federico II, Via Cintia 4, 80126 Naples, Italy;
| | - Maria Aschettino
- Department of Experimental Medicine, School of Medicine, University of Campania “Luigi Vanvitelli”, Via L. De Crecchio 7, 80138 Naples, Italy; (M.A.); (R.F.); (C.S.)
| | - Rosario Finamore
- Department of Experimental Medicine, School of Medicine, University of Campania “Luigi Vanvitelli”, Via L. De Crecchio 7, 80138 Naples, Italy; (M.A.); (R.F.); (C.S.)
| | - Chiara Schiraldi
- Department of Experimental Medicine, School of Medicine, University of Campania “Luigi Vanvitelli”, Via L. De Crecchio 7, 80138 Naples, Italy; (M.A.); (R.F.); (C.S.)
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Chen R, Yang W, Sun J, Liu Y, An Q, Zhang F, Bai Z, Luan Q. Triple Cross-Linked Hyaluronic Acid Based on Tri-Hyal Technique Has More Durable Effect on Dermal Renewal. CLINICAL, COSMETIC AND INVESTIGATIONAL DERMATOLOGY 2022; 15:691-701. [PMID: 35450398 PMCID: PMC9017695 DOI: 10.2147/ccid.s362785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/07/2022] [Indexed: 12/23/2022]
Abstract
Background Hyaluronic acid (HA)-based fillers are applied to treat facial wrinkles and volume loss. Many efforts have been made to improve properties of HA to prolong the duration in aesthetic indications. A new cross-linking technique called “Tri-Hyal”, could make HAs to achieve desired rheological characteristics. HAs synthesized by Tri-Hyal are triple cross-linked and sustained-release, which could increase duration of promoting skin rejuvenation after injection. Purpose To evaluate the efficiency and persistence of HAs with Tri-Hyal on skin rejuvenation and further investigate underlying mechanisms, we compared the performances of cross-linked HA (AF) based on Tri-Hyal with another highly acceptable HA filler (Res) in vivo and in vitro. Methods Male BALB/c mice were divided into three groups, treated with AF, Res and vehicle, respectively. Skin biopsies were taken on day 0, 30, 90 and 180 after injection and hematoxylin and eosin (H&E), Masson’s trichrome (MT), immunohistochemical (IHC) stainings for CD31, TGF-β and MMP9 were performed. EdU incorporation, cell counting kit-8 (CCK-8), SA-β-Gal staining and activity were measured by biochemical analysis. RFP-GFP-LC3 adeno virus was used for autophagic flux detection. Protein levels of CD44, P62 and LC3I/II were detected by Western blot. Reactive oxygen species (ROS) level was detected by flow cytometry with DCFH-DA probe. Results The AF synthesized by Tri-Hyal showed persistent dermal structural correction without attenuation up to 6 months, which was illustrated by skin thickness, formation of elastic fibers and vascular density. Consistently, in fibroblasts the AF improved cell proliferation and slowed the senescent in vitro. Furthermore, it promoted cellular autophagy to reduce ROS level, which would account for its function in skin renewal. Conclusion The HA with Tri-Hyal could stimulate the production of extracellular matrix components more persistently than traditional HA fillers. In terms of mechanisms, it delayed senescence in dermal fibroblasts through reducing oxidative stress mediated by induction of autophagy.
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Affiliation(s)
- Rong Chen
- College of Life Sciences, Northwest University, Xi'an, 710069, People's Republic of China
| | - Wenbin Yang
- Department of Dermatology, Xi'an No.3 Hospital, the Affiliated Hospital of Northwest University, Northwest University, Xi'an, 710069, People's Republic of China
| | - Jing Sun
- Department of Anesthesiology, Northwest Women's and Children's Hospital, Xi'an, 710061, People's Republic of China
| | - Yuan Liu
- Center of Medical Genetics, Northwest Women's and Children's Hospital, Xi'an, 710061, People's Republic of China
| | - Qing An
- Department of Dermatology, Xi'an No.3 Hospital, the Affiliated Hospital of Northwest University, Northwest University, Xi'an, 710069, People's Republic of China
| | - Feijuan Zhang
- Department of Dermatology, Xi'an No.3 Hospital, the Affiliated Hospital of Northwest University, Northwest University, Xi'an, 710069, People's Republic of China
| | - Zhuanli Bai
- Department of Plastic and Aesthetic Maxillofacial Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Qi Luan
- Department of Dermatology, Xi'an No.3 Hospital, the Affiliated Hospital of Northwest University, Northwest University, Xi'an, 710069, People's Republic of China
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8
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Xie Y, Wu S, Li S, Li Q, Zhao H. An evaluation of the long-term safety and biodegradability of hyaluronic acid dermal fillers (YVOIRE ® ) for the correction of nasolabial folds: Two multicenter, prospective, observational cohort studies. J Cosmet Dermatol 2022; 21:2387-2397. [PMID: 35357748 DOI: 10.1111/jocd.14952] [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: 06/26/2021] [Revised: 02/20/2022] [Accepted: 03/28/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND The therapeutic effects of hyaluronic acid dermal fillers to correct facial wrinkles and folds usually last up to 6-12 months. Few studies have evaluated their long-term safety. AIMS To evaluate the long-term safety and biodegradability of two hyaluronic acid dermal fillers (YVOIRE® classic s and YVOIRE® volume s) for the correction of nasolabial folds (NLFs) in two prospective, observational studies. METHODS Subjects scheduled to receive the injections of YVOIRE® classic s (N = 503) or YVOIRE® volume s (N = 503) at NLFs were followed up until complete clinical biodegradation, defined as a change in Wrinkle Severity Rating Scale (WSRS) score of ≥0 from baseline. The primary biodegradation endpoint was the proportion of subjects with complete clinical biodegradation during or after the 104-week post-treatment period. RESULTS Complete clinical biodegradation was observed in 93.5% [95% CI 91.0-95.5%] of 494 assessable YVOIRE® classic s recipients and 98.5% [95% CI 97.0-99.4%] of 469 YVOIRE® volume s recipients during the 104-week post-treatment period. In most subjects, complete clinical biodegradation was observed within 52 weeks of the last treatment. Treatment-related adverse events (AEs) (mostly mild local injection-site reactions) occurred within 52 weeks post-treatment, in 68.2% and 75.0% of YVOIRE® classic s and YVOIRE® volume s recipients, respectively. During the 12- to 18-months after YVOIRE® volume s injection, 0.6% of subjects had treatment-related AEs (local injection-site reactions). No treatment-related AEs occurred 12- to 24-months after YVOIRE® classic s injection. CONCLUSIONS YVOIRE® classic s and YVOIRE® volume s can be safely used to correct NLFs. Total clinical biodegradation tends to occur within 12 months of injection.
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Affiliation(s)
- Yun Xie
- Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sufan Wu
- Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China
| | - Shirong Li
- Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Qingfeng Li
- Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongyi Zhao
- Beijing Hospital, Ministry of Health, Beijing, China
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9
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Kim JH, Kim ES, Kim SW, Hong SP, Kim J. Effects of Polynucleotide Dermal Filler in the Correction of Crow's Feet Using an Antera Three-Dimensional Camera. Aesthetic Plast Surg 2022; 46:1902-1909. [PMID: 35357558 DOI: 10.1007/s00266-022-02832-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 02/24/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Dermal fillers are gaining interest for tissue enlargement and skin improvement. Among them, polynucleotides have demonstrated multiple skin beneficial effects. The effects of polynucleotide fillers were objectively evaluated using an Antera 3D camera, subjectively evaluated by participants and investigators. METHODS Thirty subjects with crow's feet were enrolled in the study. The subjects received polynucleotide filler for crow's feet. Crow's feet grading score (CFGS), global esthetic improvement scale (GAIS), and Antera 3D imaging results were evaluated. RESULTS Twenty-eight subjects (93.3%) completed the study. An improvement in CFGS compared with that at baseline (p < 0.001) was observed 18 weeks after the first injection of polynucleotides. Additionally, at the final visit, there were improvements in wrinkle, texture, pore, depression, and Hb values compared with those at baseline (p < 0.05). However, no significant difference in melanin level was detected between the initial and final visits. CONCLUSIONS Improvements in wrinkles, pores, texture, depression, and Hb level after polynucleotide filler injection were verified by objective and subjective evaluations. To the best of our knowledge, this is the first report on the objective evaluation of polynucleotide fillers in crow's feet using the Antera 3D camera. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Jeong Ho Kim
- Department of Plastic and Reconstructive Surgery, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
| | - Eon Su Kim
- Department of Plastic and Reconstructive Surgery, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
| | - Sug Won Kim
- Department of Plastic and Reconstructive Surgery, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
| | - Seung Phil Hong
- Department of Dermatology, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
| | - Jiye Kim
- Department of Plastic and Reconstructive Surgery, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea.
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10
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Wu YZ, Huang HT, Ho CJ, Shih CL, Chen CH, Cheng TL, Wang YC, Lin SY. Molecular Weight of Hyaluronic Acid Has Major Influence on Its Efficacy and Safety for Viscosupplementation in Hip Osteoarthritis: A Systematic Review and Meta-Analysis. Cartilage 2021; 13:169S-184S. [PMID: 34109828 PMCID: PMC8808882 DOI: 10.1177/19476035211021903] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND This study aimed to compare the efficacy and safety of intra-articular hyaluronic acid (HA) injection with different molecular weights (MWs) for treating hip osteoarthritis (OA). METHODS A systematic literature search for relevant studies was conducted in 3 electronic databases, including PubMed, BMJ Journals, and Cochrane Library, from inception to April 2020. Extracted outcomes included visual analogue scale (VAS) (1, 3, and 6 months), Lequesne index (3 and 6 months), and adverse effects. HAs were classified into low-molecular-weight (LMW), moderate-molecular-weight (MMW), high-molecular-weight (HMW), and ultra-high-molecular-weight (UHMW) groups. Meta-analysis was performed using Review Manager 5.3. RESULTS A total of 15 studies with 614 patients were included. Our meta-analysis showed that the HMW HA group had the best improvement in VAS and Lequesne index compared with other HA groups for all the follow-up visits. Moreover, the HMW group demonstrated significantly better improvement than the other groups in VAS at 6-month follow-up and in Lequesne index at 3- and 6-month follow-ups. Analysis for adverse effects revealed low rates of systemic adverse effects (≤0.6%) in all groups and similar rate of local adverse effects (around 10%) among the groups except for UHMW HA group (37.5%). CONCLUSION Among different MWs of HA for treating hip OA, HMW HA injection demonstrated the best efficacy for up to 6 months after treatment without increased risk of adverse effects. Further studies with more comprehensive data and a higher level of evidence are required to prove our results.
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Affiliation(s)
- Yen-Zung Wu
- Department of Orthopedics, Kaohsiung
Medical University Hospital, Kaohsiung Medical University, Kaohsiung
| | - Hsuan-Ti Huang
- Departments of Orthopedics, School of
Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung,Orthopaedic Research Center, Kaohsiung
Medical University, Kaohsiung,Regeneration Medicine and Cell Therapy
Research Center, Kaohsiung Medical University, Kaohsiung,Department of Orthopedics, Kaohsiung
Municipal Ta-Tung Hospital, Kaohsiung
| | - Cheng-Jung Ho
- Department of Orthopedics, Kaohsiung
Medical University Hospital, Kaohsiung Medical University, Kaohsiung,Departments of Orthopedics, School of
Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung,Orthopaedic Research Center, Kaohsiung
Medical University, Kaohsiung,Regeneration Medicine and Cell Therapy
Research Center, Kaohsiung Medical University, Kaohsiung
| | - Chia-Lung Shih
- Clinical Medicine Research Center,
Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City
| | - Chung-Hwan Chen
- Departments of Orthopedics, School of
Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung,Orthopaedic Research Center, Kaohsiung
Medical University, Kaohsiung,Regeneration Medicine and Cell Therapy
Research Center, Kaohsiung Medical University, Kaohsiung,Department of Orthopedics, Kaohsiung
Municipal Ta-Tung Hospital, Kaohsiung,Institute of Medical Science and
Technology, National Sun Yat-Sen University, Kaohsiung
| | - Tsung-Lin Cheng
- Orthopaedic Research Center, Kaohsiung
Medical University, Kaohsiung,Regeneration Medicine and Cell Therapy
Research Center, Kaohsiung Medical University, Kaohsiung,Department of Physiology, College of
Medicine, Kaohsiung Medical University, Kaohsiung
| | - Ying-Chun Wang
- Departments of Orthopedics, School of
Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung,Department of Orthopedics, Kaohsiung
Municipal Ta-Tung Hospital, Kaohsiung
| | - Sung-Yen Lin
- Department of Orthopedics, Kaohsiung
Medical University Hospital, Kaohsiung Medical University, Kaohsiung,Departments of Orthopedics, School of
Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung,Orthopaedic Research Center, Kaohsiung
Medical University, Kaohsiung,Regeneration Medicine and Cell Therapy
Research Center, Kaohsiung Medical University, Kaohsiung,Sung-Yen Lin, Department of Orthopedics,
Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100,
Tzyou 1st Road, Sanmin District, Kaohsiung City, Kaohsiung, 80756.
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Montealegre G, Uribe R, Martínez-Ceballos MA, Rojas-Villarraga A. ASIA syndrome symptoms induced by gluteal biopolymer injections: Case-series and narrative review. Toxicol Rep 2021; 8:303-314. [PMID: 33552929 PMCID: PMC7856393 DOI: 10.1016/j.toxrep.2021.01.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 12/11/2022] Open
Abstract
Background The number of plastic surgery procedures have been rising in the last few years. The morbi-mortality due to illegal use of biopolymers is a public health problem. One of the clinical consequences, foreign body modelling reaction, may be a precursor of ASIA (Autoimmune/Inflammatory disease induced by adjuvants) syndrome.The objective of this article is to present a case-series study of patients who developed ASIA syndrome following gluteal injection with biopolymers and emphasize the importance of toxic exposure in triggering autoimmune responses. A surgical technique used on some of the patients in the study is described. Methods A group of thirteen patients, diagnosed with foreign body modelling reaction, who developed ASIA syndrome confirmed by approved criteria was followed between May 2016 and May 2018. The "Butterfly Wings Technique," a new surgical procedure for patients who have medium to severe compromise, was used on five of them.A narrative literature review was done to look for subjects with ASIA syndrome and gluteal biopolymer infiltration. Results All the patients in the present case-series with foreign body modelling reaction developed ASIA syndrome. Some of them had a background of familial autoimmunity. Five of the patients were surgically treated and saw a clinical improvement after the extraction of the biopolymer with the proposed technique.The narrative literature review identified 7 articles related to the disease through the database search. Conclusions We suggest that foreign body modelling reaction should be considered a precursor to ASIA syndrome. New research projects will be needed in the future to evaluate the factors that determine when ASIA syndrome is triggered in a patient with this reaction.
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Affiliation(s)
- Giovanni Montealegre
- Fundación Universitaria de Ciencias de la Salud (FUCS), Hospital San José, Bogotá, Colombia
| | - Rosa Uribe
- Fundación Universitaria de Ciencias de la Salud (FUCS), Hospital San José, Bogotá, Colombia
| | | | - Adriana Rojas-Villarraga
- Fundación Universitaria de Ciencias de la Salud (FUCS), Cra 19 No. 8A – 32, Bogotá, Colombia
- Corresponding author.
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Two Randomized Controlled Trials of Hyaluronic Acid Fillers for the Correction of Nasolabial Folds. Plast Reconstr Surg Glob Open 2020; 8:e2975. [PMID: 32802667 PMCID: PMC7413804 DOI: 10.1097/gox.0000000000002975] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 05/22/2020] [Indexed: 11/27/2022]
Abstract
YVOIRE Classic s (YC) and Restylane (RES) have similar rheological properties, which suit mid-dermis injection, while the rheological properties of YVOIRE Volume s (YV) are comparable to those of Perlane (PER), which suit deep dermis injection to treat deep wrinkles. Two similarly designed studies aimed to evaluate the performance and safety of YC and YV injected into the nasolabial folds (NLFs). METHODS These were split-face designed, evaluator-blind, noninferiority studies. Fifty-eight subjects with moderate-to-severe NLFs were enrolled in the first study and treated with YC and RES, and 57 subjects were enrolled in the second study and treated with YV and PER. The Wrinkle Severity Rating Scale ranged from 1 (no visible fold) to 5 (extremely deep and long folds), and subject satisfaction was evaluated. RESULTS The least squares mean Wrinkle Severity Rating Scale scores (standard error) at week 26 were 2.56 (0.09) for both YC- and RES-treated NLFs and 2.89 (0.08) and 2.91 (0.08) for YV- and PER-treated NLFs, respectively. The difference between the groups was 0 and 0.02, and the lower limit of its 95% confidence interval was -0.0725 and -0.0125, which was greater than the predefined margin (-0.29), proving the noninferiority of YC and YV to RES and PER, respectively. The safety profiles and subject satisfaction of YC and YV were similar to those of RES and PER, respectively. CONCLUSION YC is comparable to RES and YV is comparable to PER in terms of performance and safety profiles, with NLF-correcting effects lasting for up to 26 weeks.
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Amorim S, Reis CA, Reis RL, Pires RA. Extracellular Matrix Mimics Using Hyaluronan-Based Biomaterials. Trends Biotechnol 2020; 39:90-104. [PMID: 32654775 DOI: 10.1016/j.tibtech.2020.06.003] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 12/13/2022]
Abstract
Hyaluronan (HA) is a critical element of the extracellular matrix (ECM). The regulated synthesis and degradation of HA modulates the ECM chemical and physical properties that, in turn, influence cellular behavior. HA triggers signaling pathways associated with the adhesion, proliferation, migration, and differentiation of cells, mediated by its interaction with specific cellular receptors or by tuning the mechanical properties of the ECM. This review summarizes the recent advances on strategies used to mimic the HA present in the ECM to study healthy or pathological cellular behavior. This includes the development of HA-based 2D and 3D in vitro tissue models for the seeding and encapsulation of cells, respectively, and HA particles as carriers for the targeted delivery of therapeutic agents.
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Affiliation(s)
- Sara Amorim
- 3B's Research Group, I3Bs, Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, 4805-017 Barco, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Celso A Reis
- Instituto de Investigação e Inovação em Saúde - i3S, Universidade do Porto, Porto, Portugal; Institute of Molecular Pathology and Immunology of the University of Porto, IPATIMUP, Porto, Portugal; Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal; Department of Pathology and Oncology, Faculty of Medicine, Porto University, Porto, Portugal
| | - Rui L Reis
- 3B's Research Group, I3Bs, Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, 4805-017 Barco, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Ricardo A Pires
- 3B's Research Group, I3Bs, Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, 4805-017 Barco, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.
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Kim JH, Kwon TR, Lee SE, Jang YN, Han HS, Mun SK, Kim BJ. Comparative Evaluation of the Effectiveness of Novel Hyaluronic Acid-Polynucleotide Complex Dermal Filler. Sci Rep 2020; 10:5127. [PMID: 32198443 PMCID: PMC7083941 DOI: 10.1038/s41598-020-61952-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/18/2020] [Indexed: 11/08/2022] Open
Abstract
HA (Hyaluronic acid) filler, the most commonly used dermal filler, causes several side effects. HA-PN (Hyaluronic acid-Polynucleotide), a new composite filler, has excellent biocompatibility and induces tissue regeneration. In this study, we compare the efficacies and safety profiles of these fillers. The characteristics of HA and HA-PN fillers were compared using scanning electron microscopy and rheometry. No morphological difference was noted between the fillers. However, the latter had higher viscosity and elasticity values. The HA-PN filler induced higher cell migration than the HA filler in a wound healing assay. It was also found to stimulate better collagen synthesis in human and mouse fibroblasts. The HA and HA-PN fillers were injected into SKH1 hairless mice to determine changes in their volume for up to 24 weeks. Increased cell migration and collagen synthesis were observed in mice injected with the HA-PN complex filler. Although the safety and durability of the HA and HA-PN fillers were similar, the latter induced a lower transient receptor potential vanilloid 4 expression and caused less stimulation upon injection. In conclusion, HA-PN complex fillers can stimulate fibroblast growth and facilitate volume growth and skin regeneration.
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Affiliation(s)
- Jong Hwan Kim
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Tae-Rin Kwon
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Sung Eun Lee
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
- Department of Medicine, Graduate School, Chung-Ang University, Seoul, Korea
| | - Yoo Na Jang
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
- Department of Medicine, Graduate School, Chung-Ang University, Seoul, Korea
| | - Hye Sung Han
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
- Department of Medicine, Graduate School, Chung-Ang University, Seoul, Korea
| | - Seog Kyun Mun
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Beom Joon Kim
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.
- Department of Medicine, Graduate School, Chung-Ang University, Seoul, Korea.
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Shin SW, Jang YD, Ko KW, Kang EY, Han JH, Bedair TM, Kim IH, Son TI, Park W, Han DK. PCL microspheres containing magnesium hydroxide for dermal filler with enhanced physicochemical and biological performances. J IND ENG CHEM 2019. [DOI: 10.1016/j.jiec.2019.07.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Keizers PHJ, Bakker F, Ferreira J, Wackers PFK, van Kollenburg D, van der Aa E, van Beers A. Benchtop NMR spectroscopy in the analysis of substandard and falsified medicines as well as illegal drugs. J Pharm Biomed Anal 2019; 178:112939. [PMID: 31672579 DOI: 10.1016/j.jpba.2019.112939] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 10/07/2019] [Accepted: 10/17/2019] [Indexed: 12/27/2022]
Abstract
Substandard and falsified medical products may cause harm to patients and fail to treat the diseases or conditions for which they were intended. It is therefore required to have analytical methods available to assess medical product quality. Benchtop NMR spectroscopy provides a generic, inherently quantitative, analytical method capable of separating specific signals from those of a matrix. We have developed an analytical method for the analysis of active ingredients in pharmaceutical products and illegal drugs, based on benchtop NMR spectroscopy. Within its resolution limits, benchtop NMR spectroscopy is useful in determining the identity of the active ingredients in products containing acetaminophen, aspirin, caffeine, diclofenac, ibuprofen, naproxen, sildenafil, tadalafil and sibutramine, cocaine, and gamma hydroxybutyric acid, with a limit of detection of about 1 mg/mL. Furthermore, the content of the active ingredient can be determined with an error of 10%. Additionally, a chemometrics approach is shown to be useful to classify spectra in order to identify the active substances present in the sample, reducing the need for expert interpretation of the spectra acquired.
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Affiliation(s)
- Peter H J Keizers
- National Institute for Public Health and the Environment, P. O. Box 1, 3721 MA, Bilthoven, the Netherlands.
| | - Frank Bakker
- National Institute for Public Health and the Environment, P. O. Box 1, 3721 MA, Bilthoven, the Netherlands
| | - José Ferreira
- National Institute for Public Health and the Environment, P. O. Box 1, 3721 MA, Bilthoven, the Netherlands
| | - Paul F K Wackers
- National Institute for Public Health and the Environment, P. O. Box 1, 3721 MA, Bilthoven, the Netherlands
| | - Dion van Kollenburg
- National Institute for Public Health and the Environment, P. O. Box 1, 3721 MA, Bilthoven, the Netherlands
| | - Eva van der Aa
- National Institute for Public Health and the Environment, P. O. Box 1, 3721 MA, Bilthoven, the Netherlands
| | - Amy van Beers
- National Institute for Public Health and the Environment, P. O. Box 1, 3721 MA, Bilthoven, the Netherlands
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