Aging and photoaging

Role of autophagy in skin photoaging: A narrative review

As the largest organ of the human body, the skin serves as the primary barrier against external damage. The continuous increase in human activities and environmental pollution has resulted in the ongoing depletion of the ozone layer. Excessive exposure to ultraviolet (UV) radiation enhances the impact of external factors on the skin, leading to photoaging. Photoaging causes physical and psychological damage to the human body. The prevention and management of photoaging have attracted increased attention in recent years. Despite significant progress in understanding and mitigating UV-induced photoaging, the precise mechanisms through which autophagy contributes to the prevention of photoaging remain unclear. Given the important role of autophagy in repairing UV-induced DNA damage and scavenging oxidized lipids, autophagy is considered a novel strategy for preventing the occurrence of photoaging and other UV light-induced skin diseases. This review aims to elucidate the biochemical and clinical features of photoaging, the relationship of skin photoaging and chronological aging, the mechanisms underlying skin photoaging and autophagy, and the role of autophagy in skin photoaging.

Efficacy of combined treatment with human adipose tissue stem cell-derived exosome-containing solution and microneedling for facial skin aging: A 12-week prospective, randomized, split-face study

BACKGROUND

Studies have reported promising results of mesenchymal stem cell therapies for skin aging. However, in the use of mesenchymal stem cells, some drawbacks including rarely possible tumorigenicity and low engraftment rates have limited their widespread clinical use. Adipose tissue stem cell-derived exosomes (ASCEs) are emerging as effective cell-free therapeutic agents.

AIMS

It was evaluated the clinical efficacy of combining the application of human ASCE-containing solution (HACS) with microneedling to treat facial skin aging.

METHODS

A 12-week, prospective, randomized, split-face, comparative study was conducted. Twenty-eight individuals underwent three treatment sessions separated by 3-week intervals and were followed up for 6 weeks after the last session. At each treatment session, HACS and microneedling were administered to one side of the face, and normal saline solution and microneedling were administered to the other side as a control.

RESULTS

The Global Aesthetic Improvement Scale score was significantly higher on the HACS-treated side than on the control side at the final follow-up visit (p = 0.005). Objective measurements obtained by different devices including PRIMOS Premium, Cutometer MPA 580, Corneometer CM 825, and Mark-Vu confirmed greater clinical improvements in skin wrinkles, elasticity, hydration, and pigmentation on the HACS-treated side than on the control side. The results of the histopathological evaluation were consistent with the clinical findings. No serious adverse events were observed.

CONCLUSIONS

These findings demonstrate that combined treatment using HACS and microneedling is effective and safe for treating facial skin aging.

9-Hydroxyoctadecadienoic acid plays a crucial role in human skin photoaging

Human skin is regularly exposed to ultraviolet (UV) rays from sunlight, leading to photoaging, which differs from intrinsic aging. Although the acute effects of UV exposure have been extensively studied, limited research has addressed the long-term consequences of chronic UV exposure. This study aimed to investigate the underlying causes of chronic photoaging. A questionnaire-based assessment of sunlight exposure was conducted among volunteers in their 20s and 50s, and the stratum corneum of their skin was analyzed for bioactive lipid content. Volunteers were categorized into low and high UV exposure groups based on the questionnaire scores. The analysis results revealed a significant increase in 9-hydroxyoctadecadienoic acid (9-HODE) levels in the skin of individuals in their 50s with high UV exposure. However, UV exposure did not affect 9-HODE levels in the skin of individuals in their 20s. In vitro experiments further indicated that 9-HODE contributes to chronic inflammation, pigmentary changes, and extracellular matrix alterations during photoaging. Specifically, 9-HODE stimulated cytokine production [interleukin-6 (IL6), IL8, and granulocyte-macrophage colony-stimulating factor (GM-CSF)] and reduced dickkopf-1 (DKK1) production in keratinocytes. In fibroblasts, 9-HODE stimulated matrix metalloproteinase-1 (MMP1) and MMP3 production while reducing collagen I (COL1) production. The expression of G2A, the receptor for 9-HODE, was also confirmed in fibroblasts, suggesting that 9-HODE exerts its effects via G2A, as observed in keratinocytes. Overall, these findings indicate that 9-HODE is a mediator of chronic photoaging and highlight its potential significance in photoaging prevention.

Efficacy evaluation of endolift laser for treatment of nasolabial folds and marionette lines

BACKGROUND

The nasolabial folds are the most marked sign of aging. Endolift laser was used for the treatment of nasolabial folds and marionette lines (one of the facial danger zones).

METHODS

Ten female subjects were engaged in this study. Patients underwent Endolift laser for nasolabial folds and marionette lines treatment. The efficacy of the Endolift technique on the nasolabial folds and marionette lines was evaluated by biometric assessment with Cutometer, Visioface, and the Skin Ultrasound Imaging system. Also, patient's satisfaction and blinded dermatologists' assessment were assessed.

RESULTS

The Visoface results displayed that the Endolift laser treatment significantly declined the depth and area of the nasolabial wrinkles. The skin ultrasonography results reported that the epidermis and dermis density and thickness were significantly increased. Also, the cutometer outcomes showed that the Endolift laser treatment can increase skin elasticity. The results showed that a large number of patients were very satisfied with the technique.

CONCLUSION

In conclusion, Endolift laser has an effective technique for decreasing the nasolabial folds, marionette lines, and improve the appearance of the face without any sever side effect. This technique does not need general anesthesia and recovery time.

Microneedle fractional radiofrequency in the treatment of periorbital dark circles

BACKGROUND

Periorbital hyperpigmentation (POH) is a common disorder in the patients. Women are more upset with POH in compare to males. Several methods have been used to the POH, with different efficacy and adverse reactions.

AIM

The aim of the present study is to evaluate the efficacy of microneedle fractional radiofrequency (MRF) in treating POH.

METHODS

So, nine patients with POH and the age range of 25-57 years, were treated by microneedle fractional radiofrequency (MRF). The outcome was evaluated via biometric assessment. The colorimeter was used to assess the skin lightness. Mexameter was used for evaluated the amount of Melanin in the periorbital skin. Cutometer was used for skin elasticity assessment. The skin ultrasound imaging system was utilized to estimate the epidermis and dermis diameter and density. Furthermore, Visioface was applied to assessed the skin color and wrinkles. Also patient's satisfaction and physician's assessment were evaluated.

RESULTS

The results displayed that the periorbital skin lightness 32.38% ± 5.67 and elasticity of the R2: 40.29% ± 8.18, R5: 39.03 ± 5.38 and R7: 42.03% ± 14.16 were significantly improved after treatment (p < 0.05). Also the melanin content of the skin was decreased (49.41% ± 9.12). The skin layers were denser in the dermis and also in the epidermis (skin density: 30.21% ± 10.16 and skin thickness: 41.12% ± 13.21) (p < 0.05). The results revealed the decrease in the percent change of the skin color (30.34% ± 9.30) and wrinkle (area: 25.84% ± 6.43 and volume: 30.66% ± 8.12) (p < 0.05). Similarly, the physician and patient's assessment were confirmed the obtained outcomes.

CONCLUSION

In conclusion, the microneedle RF technique is practicable, effective and safe method for periorbital dark circles treatment.

Protective effect of Schizonepeta tenuifolia Briq. ethanolic extract against UVB-induced skin aging and photodamage in hairless mice

The purpose of this study was to illuminate the mechanism by which Schizonepeta tenuifolia Briq. (ST) ethanolic extract prevents skin photoaging in HR-1 hairless mice (HR-1). The ST ethanolic extract alleviated wrinkle formation, epidermal skin thickness, and collagen degradation in skin tissues of ultraviolet B (UVB)-irradiated HR-1 mice. Expression of matrix metalloproteinases (a wrinkle-related marker) was reduced, and tissue inhibitor of metalloproteinase 1 expression was upregulated following application of ST ethanolic extract. Furthermore, skin dehydration and levels of hyaluronidase-1 and -2 (enzymes that break hyaluronic acid) were decreased. Moreover, protein expression of hyaluronan synthases (markers of skin hydration) and hyaluronic acid levels increased following ST ethanolic extract treatment in UVB-induced photoaging HR-1 mice. In addition, the phosphorylation of mitogen-activated protein kinases (MAPKs), including p38, extracellular signal-regulated kinase, and Jun N-terminal kinase was suppressed, and expression of nuclear factor-kappa was reduced. Treatment with ST ethanolic extract also reduced advanced glycation end product (AGE) accumulation and expression of the receptor for AGE (RAGE) in skin tissue. These results suggest that ST ethanolic extract moderates skin damage caused by UVB irradiation via regulating the expression of wrinkle- and hydration-related proteins, MAPKs, and RAGE.

A Prospective Trial of the Microneedle Fractional Radiofrequency System Application in the Treatment of Infraorbital Dark Circles

Background

Infraorbital dark circles (IDC) are commonly consulted in aesthetic practice. There is not yet a multifactorial approach to facilitating their treatment.

Objective

To investigate the safety and efficacy of the microneedle fractional radiofrequency (MRF) system for the treatment of IDC.

Methods

A prospective, split-face, evaluator-blind clinical trial was conducted to study the change in the overall appearance, color, and wrinkles in 21 female patients with mixed type IDC before and after MFR treatment.

Results

Both patients and independent evaluators found significant improvement on the global aesthetic scales after the MFR treatment, especially on periorbital wrinkles (p=0.031). Trends in decreased melanin density in the IDC area were found, but no statistical differences were established. No side effects were observed.

Conclusion

MFR is a safe and effective modality for improving mixed type IDC by correcting the structural factors.

Anti-Aging Effect of the Stromal Vascular Fraction/Adipose-Derived Stem Cells in a Mouse Model of Skin Aging Induced by UVB Irradiation

Adipose-derived stem cells(ADSCs) have been used for anti-photo-aging. But the purification of ADSCs requires in vitro amplification and culture, there is considerable risk of direct treatment for patients. Stromal vascular fraction(SVF) is a biologically and clinically interesting heterogeneous cell population contains ADSCs. There are few reports on anti-aging effects of SVF in photo-aging skin. The present study investigated the anti-aging effect of stromal vascular fraction (SVF) and adipose-derived stem cells (ADSCs) injection in photo-aging skin. The relationship between the dosage of injection and effect was also discussed. Thirty healthy, 6-week-old, nude rats were randomly divided into the control and experimental groups. The experimental group needing ultraviolet B (UVB) irradiation five days per week, and a duration of 8 weeks. According to different dose regimens of SVF and ADSCs, experiment rats were randomly grouped as the model control group, low-dose (LD) treatment group, middle-dose (MD) treatment group and high-dose (HD) treatment group. At 7 and 28 days post-treatment, specimens were harvested for histological and immunohistochemical analysis. We found that certain concentrations of cells (MD and HD groups) could improve the texture of photoaged skin. Changes in the epidermal cell layer were clearly observed after 7 days of treatment. The epidermal layer becomes thinner and more tender. After 28 days of treatment, the dermal tissue was thickened and the collagen content and proportion were improved. All these indicators showed no significant difference between the same dosages in the two treatment groups. Our results demonstrate that SVF may have anti-aging potential in photo-aging skin and the ADSCs play an important role in SVF. SVF maybe a potential agent for photo-anging skin and the most effective dose of SVF was 106 cells /100 µl/injection point. The proper injection interval may be 1.5 cm.

The Dermoscopic Features of Photoaging and Its Association with Sun Index Score in the Coastal Population at Cilincing, Jakarta: A Cross-Sectional Study

Purpose

Repeated exposure to ultraviolet light is the most significant factor that contributes to photoaging. Dermoscopy photoaging scale (DPAS) is a noninvasive examination utilized for the diagnosis of photoaging. However, there has been no study analyzing the correlation between DPAS and sun index. Hence, this study aims to find out the dermoscopic features of photoaging and its association with sun index score in the coastal population.

Patients and Methods

This was a descriptive cross-sectional study on individuals living in Cilincing, a coastal area, at North Jakarta. Healthy male or female subjects aged over 18 years old with sun exposure equal or more than 2 hours daily were recruited consecutively. History taking was performed to document the sociodemographic characteristics (age, gender, skin type, smoking habit) and sun index score. Physical examination and dermoscopic examination were conducted to determine DPAS score. Associations of DPAS and photoaging profiles were analyzed with Chi-squared test while correlation between DPAS score and sun index was analyzed with Pearson correlation test.

Results

A total of 100 subjects were included in this study. The median DPAS of the subjects was 9 (1-21). Right cheek had the highest median DPAS of 3 (0-6), followed by the left cheek with median DPAS of 3 (0-7). Men had a higher median DPAS score than women (9 vs 8). There was a significant difference between DPAS score and age (p<0.001). There was no significant correlation between DPAS score and sun index (r = -0.005; p = 0.957).

Conclusion

Factors associated with high DPAS score were cheek predilection, male, actively smoking, Fitzpatrick skin type IV, and increasing age. DPAS score has no correlation with sun index.

An in vitro evaluation of luffa cylindrica stem sap in preadipocytes and dermal fibroblasts

BACKGROUND

Luffa cylindrica stem sap (LuCS) has been ethnopharmacologically used as a cosmetic ingredients to improve the facial condition in Asians, but there is no scientific proof about the advantages of LuCS as a supplement for skin elasticity inducer.

PURPOSE

Presently, we have validated the beneficial effect of LuCS in human preadipocyte and fibroblast.

METHODS

In vitro activities of LuCS on expression of cellular elastin and collagen type I were validated using Western blot analysis in human fibroblasts. Effect of LuCS on preadipocyte development was performed using MDI medium containing isobutyl-methylxanthine, dexamethasone, and insulin and then evaluated using oil red O staining.

RESULTS

Treatment of LuCS stimulated the expression of cellular elastin and type I procollagen in human skin fibroblasts. Exposure to LuCS induced lipid accumulation of preadipocytes via activation of CEBP/α signaling pathway in preadipocytes. Expression of collagen I, elastin, or CEBP/α mRNA was decreased by age. 3-bromo-3-methylisoxazol-5-amine enhanced the synthesis of cellular lipid in preadipocytes.

CONCLUSIONS

Collectively, these results suggest the rationale of LuCS treatment in enhancing the skin condition.

Exploring the Potential of Nannochloropsis sp. Extract for Cosmeceutical Applications

Recently, there has been emerging interest in various natural products with skin protective effects as they are recognized as safe and efficient. Microalgae have developed chemical defense systems to protect themselves against oxidative stress caused by UV radiation by producing various bioactive compounds including a number of secondary metabolites, which have potential for cosmeceutical applications. In addition, microalgae have various advantages as a sustainable source for bioactive compounds with diverse functions due to their rapid growth rate, high productivity, and use of non-arable land. In this study, we aimed to investigate the cosmeceutical potential of ethanol extract from Nannochloropsis sp. G1-5 (NG15) isolated from the southern West Sea of the Republic of Korea. It contained PUFAs (including EPA), carotenoids (astaxanthin, canthaxanthin, β-carotene, zeaxanthin, violaxanthin), and phenolic compounds, which are known to have various skin protective functions. We confirmed that the NG15 extract showed various skin protective functions with low cytotoxicity, specifically anti-melanogenic, antioxidant, skin-moisturizing, anti-inflammatory, anti-wrinkling, and UV protective function, by measuring tyrosinase inhibition activity; melanin content; DPPH radical scavenging activity; expression of HAS-2, MMP-1, and Col1A1 genes; and elastase inhibition activity as well as cell viability after UV exposure. Our results indicated that the NG15 extract has the potential to be used for the development of natural cosmetics with a broad range of skin protective functions.

Evaluating the effect of Luffa cylindrica stem sap on dermal fibroblasts; An invitro study

Luffa cylindrica stem sap (LuCS) has been traditionally used as a facial cosmetic supplement to enhance the skin condition of Asians. However, LuCS has yet to be described and there is no solid scientific evidence regarding the use of LuCS as an anti-wrinkle agent. In the present study, we have evaluated the functional effect of LuCS and its underlying mechanisms based on scientific evidence. Treatment with LuCS stimulated the growth and migration of human skin fibroblasts. LuCS treatment activated EGFR signaling via the enhanced expression of EGFR and down-regulation of PPARγ in human skin fibroblasts. Exposure to LuCS induced the synthesis of cellular type I procollagen and elastin in consort with the down-regulation of various proteinases including MMP-1, -2 and -9 in human skin fibroblasts. LuCS treatment also reversed the skin damage induced by UV-A irradiation in human skin fibroblasts. 3-bromo-3-methylisoxazol-5-amine was identified as the functional component using UPLC-MS-MS analysis and increased production of cellular type I procollagen. Collectively, these results suggest the efficacy of LuCS supplementation in improving the skin condition via anti-wrinkle effect.

The effect of hyperbaric oxygen therapy on the pathophysiology of skin aging: a prospective clinical trial

INTRODUCTION

Skin biopsies can be used to evaluate physiological effects of aging targeted intervention at the tissue/cellular levels. Recent clinical trials have shown that hyperbaric oxygen therapy (HBOT) can target aging hallmarks, including telomere shortening, senescent cells clearance and angiogenesis. The aim of this study was to evaluate the effects of HBOT on the skin of a normal, non-pathological, aging population.

METHODS

The study was performed as a prospective clinical trial. After signing informed consent and undergoing baseline evaluations, the subjects were assigned to a three-month control period followed by three months of HBOT daily sessions. Skin biopsies were taken at baseline, after three months of no intervention (control) and 1-2 weeks following the last HBOT session. Trichrome, Orecin, lipofuscin and CD31 staining were used to evaluate collagen fibers, elastic fibers, senescent cells and blood vessels, respectively.

RESULTS

Out of the cohort of 70 participants in the normal aging population study, thirteen male patients (age 68.07±2.5y) gave consent for repeated skin biopsies. Following HBOT, there was a significant increase in collagen density (p<0.001, effect size(es)=1.10), elastic fiber length (p<0.0001, es=2.71) and the number of blood vessels (p=0.02, es=1.00). There was a significant decrease in fiber fragmentation (p=0.012) and in tissue senescent cells (p=0.03, es=0.84) post-HBOT. No changes were noted in elastic fiber density or thickness.

CONCLUSIONS

The study indicates, for the first time in humans, that HBOT can significantly modulate the pathophysiology of the skin aging in a healthy aging population. The demonstrated mechanisms include angiogenesis and senescent cell clearance.

Faces of cellular senescence in skin aging

The skin is comprised of different cell types with different proliferative capacities. Skin aging occurs with chronological age and upon exposure to extrinsic factors such as photodamage. During aging, senescent cells accumulate in different compartments of the human skin, leading to impaired skin physiology. Diverse skin cell types may respond differently to senescence-inducing stimuli and it is not clear how this results in aging-associated skin phenotypes and pathologies. This review aims to examine and provide an overview of current evidence of cellular senescence in the skin. We will focus on cellular characteristics and behaviour of different skin cell types undergoing senescence in the epidermis and dermis, with a particular focus on the complex interplay between mitochondrial dysfunction, autophagy and DNA damage pathways. We will also examine how the dermis and epidermis cope with the accumulation of DNA damage during aging.

Isolated isoquercitrin from Green ball apple peel inhibits photoaging in CCD-986Sk fibroblasts cells via modulation of the MMPs signaling

BACKGROUND

Ultraviolet B (UVB) irradiation is viewed as the main factor of skin aging, associated with acceleration of elastin, collagen degradation and expression of matrix metalloproteinases (MMPs). Apples are one of the most commonly eaten fruits in the world, and isoquercitrin is the main active ingredient in new bred varieties "Green ball" apple. Therefore, we are studying the functionality of the active ingredient of apple, a natural raw material that does not have toxicity or sensitivity problems.

OBJECTIVES

The aim of this study, we scrutinized the effects of isoquercitrin on skin photoaging in UVB-exposed human fibroblasts (CCD-986Sk).

METHODS

To investigate the inhibition effect on photoaging factor regulation, isolated isoquercitrin were treated with UVB, which induces photoaging-related factors in CCD-986Sk fibroblast cells. Pro-inflammatory factors were measured by ELISA, Western blotting and real-time PCR.

RESULTS

Isoquercitrin exhibited antioxidant activity and UVB-induced generation of photoaging-related factor inhibition without showing any toxicity. Anti-photoaging effect for protein levels using Isoquercitin was competent, of both the combate MMP-1 and MMP-9. Also, effect of COL1A2 product significantly increase, from up regulating the TIMP-1 mediated pathway in CCD-986Sk cells via the inhibition of MMPs. Isoquercitrin also downregulated the mRNA gene expression of MMPs while upregulating type I procollagen, HAS2 by modulating TIMP-1 and TGF-β in UVB-irradiated CCD-986Sk cells.

CONCLUSIONS

Collectively, our results show that isoquercitrin might be useful as a functional food while being a good candidate in the development of cosmetic products and medicines for the remedy of UVB-induced skin photoaging.

Matrix metalloproteinase inhibitor and sunscreen effective compounds from Rumex crispus L.: isolation, identification, bioactivity and molecular docking study

INTRODUCTION

Rumex (Polygonaceae) species are widely grown worldwide and their main compounds are anthranoids, tannins, naphthalenes and flavonoids. Matrix metalloproteinase (MMP) enzymes that cause the breakdown of the extracellular matrix and harmful ultraviolet (UV) rays are two important causes of skin ageing. Although there have been many studies on anthraquinones, there are not many studies on their anti-ageing effects.

OBJECTIVE

The aim of this study was to determine the anti-ageing effects of pure compounds isolated from Rumex crispus L. by measuring their MMP inhibitory and sunscreen activities.

METHODOLOGY

Molecular docking studies on anthranoid, flavonoid, tannin and naphthalene skeletons with MMP enzymes were applied for the first time. Various chromatographic methods were used for isolation studies. The structure elucidation was performed by spectroscopic [UV, infrared (IR), electrospray ionisation mass spectrometry (ESI-MS), nuclear magnetic resonance (NMR)] methods. To determine the anti-ageing capacity of compounds, MMP-1, MMP-8, MMP-13 enzyme inhibitory effects and sun protection factors (SPFs) were investigated for the first time.

RESULTS

Molecular docking results showed that skeletons had low binding energy to the target and were likely to inhibit MMP enzymes. Then, eight anthraquinones and a naphthalene glycoside were isolated from the underground parts of Rumex crispus L. According to the results, MMP inhibitory effects of compounds were found to be high. In vitro and molecular docking study results confirmed each other. All anthraquinones showed high sun protection and emodin showed highest UV capability with SPF of 30.59.

CONCLUSION

This study shows that anthraquinones may be evaluated as new potential MMP inhibitors, sun protective and anti-ageing agents.

Penta-1,2,3,4,6-O-Galloyl-β-D-Glucose Inhibits UVB-Induced Photoaging by Targeting PAK1 and JNK1

Penta-O-galloyl-β-D-glucose (PGG) is a gallotannin polyphenolic compound that occurs naturally in fermented Rhus verniciflua. The present study aimed to examine the effect of PGG on UVB-induced skin aging and its molecular mechanisms in HaCaT human keratinocytes and SKH-1 hairless mice models. PGG suppressed UVB-induced matrix metalloproteinase-1 (MMP-1) expression in HaCaT cells by inhibiting phosphorylation of RAF/MEK/ERK, MKK3/6/p38, and c-Jun. UVB-induced ERK and p38 signaling pathways that induce the MMP-1 expression were mediated by PAK1 in HaCaT cells. PGG suppressed PAK1 and JNK1 kinase activities, and directly bound both PAK1 in an ATP-competitive manner and JNK1 in an ATP-noncompetitive manner. Consistently, PGG decreased UVB-induced wrinkle formation, epidermal thickness, type 1 collagen and MMP-13 expression in mouse skin. Overall, these results indicate that PGG exhibits anti-photoaging effects in vitro and in vivo by the suppression of PAK1 and JNK1 kinase activities, and may be useful for the prevention of skin aging.

Assessment of the efficacy and safety of platelet poor plasma gel as autologous dermal filler for facial rejuvenation

BACKGROUND

The popularity of dermal fillers has grown rapidly in the last few years for facial rejuvenation. Plasma gel is an autologous gelatinous material that is prepared from the patient's own platelet poor plasma.

OBJECTIVE

To evaluate the clinical efficacy and safety of plasma gel injection as a dermal filler for facial rejuvenation.

PATIENTS AND METHODS

The current study was carried out on 52 females presented with facial aging divided into two groups: Group A included 34 females with facial wrinkles, and Group B included 18 females with tear trough deformity. After taking written informed consent, they received two sessions of plasma gel injections at 2-week interval and followed up monthly for 3 months. They were assessed clinically before treatment sessions and at the end of follow-up period.

RESULTS

Both studied groups showed immediate significant clinical improvement after plasma gel injection that maintained till the end of follow-up period. This finding was confirmed by significant reduction in the mean values of Wrinkle Severity Rating Scale (WSRS) in Group A and Tear Trough Rating Scale (TTRS) in group B, and significant improvement of skin homogeneity and texture in both groups. In general, the reported side effects were minimal and transient.

CONCLUSION

Autologous platelet poor plasma gel injection seems to be a cost-effective, safe, well-tolerated, and minimally invasive technique producing significant aesthetic correction of facial wrinkles and tear trough deformity.

Aging of the skin barrier

The skin barrier is mainly present in the stratum corneum (SC), composed of corneocytes surrounded by intercellular lipid lamellae, and attached by corneodesmosome. The tight junction attached to the lateral walls of keratinocytes in the upper part of the stratum granulosum is also included in the skin barrier. During aging, the following structures and functions of the skin barrier are changed or disturbed: (1) skin barrier structure, (2) permeability barrier function, (3) epidermal calcium gradient, (4) epidermal lipid synthesis and SC lipid processing, (5) cytokine production and response after insults, (6) SC acidity, (7) SC hydration, and (8) antimicrobial barrier. Patients with diabetes also show changes in the skin barrier similar to those in aged skin, and the characteristics of the skin barrier are very similar. Understanding the pathogenic mechanisms of the skin barrier in aging will permit us to develop therapeutic strategies for aged or diabetic skin.

Hydroxytyrosol from olive fruits prevents blue-light-induced damage in human keratinocytes and fibroblasts

Skin aging is a complex biological process influenced by a combination of endogenous or intrinsic and exogenous or extrinsic factors due to environmental damage. The primary environmental factor that causes human skin aging is the ultraviolet irradiation from the sun. Recently, it was established that the long-term exposure to light-emitting-diode-generated blue light (LED-BL) from electronic devices seems to have a relevant implication in the molecular mechanisms of premature photoaging. BL irradiation induces changes in the synthesis of various skin structures through DNA damage and overproduction of reactive oxygen species (ROS), matrix metalloproteinase-1 and -12, which are responsible for the loss of the main components of the extracellular matrix of skin like collagen type I and elastin. In the current study, using human keratinocytes and fibroblasts exposed to specific LED-BL radiation doses (45 and 15 J/cm ² ), we produced an in vitro model of skin photoaging. We verified that, compared with untreated controls, the treatment with LED-BL irradiation results in the alteration of metalloprotease-1 (collagenase), metalloprotease-12 (elastase), 8-dihydroxy-2'-deoxyguanosine, proliferating cell nuclear antigen, and collagen type I. Moreover, we showed that the photoaging prevention is possible via the use of hydroxytyrosol extracted from olive fruits, well known for antioxidant properties. Our results demonstrated that hydroxytyrosol protects keratinocytes and fibroblasts from LED-BL-induced damage. Thus, hydroxytyrosol might be proposed as an encouraging candidate for the prevention of BL-induced premature photoaging.

The Effect of Rhus verniciflua Stokes Extracts on Photo-Aged Mouse Skin

Background

Rhus verniciflua Stokes (RV) has traditionally been used in Korea as an indigenous food (Rhus chicken soup) and as an herbal medicinal plant. While the anticancer, antimicrobial, and anti-inflammatory properties of RV have been actively studied in the medical field, its antioxidant effects in the skin that resist the reactive oxygen species in keratinocytes and fibroblasts is less understood.

Objective

We designed to evaluate the effects of R. verniciflua Stokes extract (RVE) on the photo-aged skin by an in vitro experiment using human fibroblasts and an in vivo experiment using a photo-aged murine model.

Methods

For the in vitro experiments, human fibroblasts irradiated with ultraviolet (UV) B were treated with RVE or vehicle, and the growth levels and the expression level of type 1 procollagen were compared. For the in vivo experiment, photo-aged mice irradiated with UVB and UVA were administered drinking water with or without RVE, and histological changes and the expression level of type 1 procollagen and matrix metalloprotease (MMP)-13 were compared.

Results

In vitro experiments using fibroblasts irradiated with UVB showed that RVE promoted growth and significantly increased the expression of type 1 procollagen as compared to the control group. In the photo-aged mice, RVE increased collagen content in the dermis and promoted the synthesis of type 1 procollagen without any visible decrease in MMP-13 as compared to control group.

Conclusion

In addition to the previously reported antioxidant effects of RVE, oral intake of RVE effectively inhibited photo-aging in hairless mice by enhancing collagen synthesis.

Comparison of efficacy of chemical peeling with 25% trichloroacetic acid and 0.1% retinoic acid for facial rejuvenation

INTRODUCTION

Skin aging is a problem which negatively affects the psyche of the person, social relations, as well as work life and health and which compels the patients to find appropriate treatment methods. Numerous treatment methods have been developed in order to delay aging and to reduce the aging effects in addition to having a younger, healthier and more beautiful facial appearance.

AIM

To compare the efficiency, cosmetic results and possible adverse effects of the peeling treatment with 25% trichloroacetic acid (TCA) and 0.1% retinoic acid for facial rejuvenation in patients presenting with skin aging.

MATERIAL AND METHODS

Fifty female patients in total presenting with medium and advanced degree skin aging were subject to this study. Two separate treatment groups were formed; the first group underwent chemical skin treatment with 25% TCA while the other group was applied with 0.1% retinoic acid treatment. Following the 4 months' treatment the patients were controlled three times in total for post lesional hypopigmentation, hyperpigmentation, scars, skin irritation and other possible changes per month. The pretreatment and first follow-up visit, and final control images were comparatively evaluated by three observers via specific software.

RESULTS

The healing rates of the group subject to retinoic acid were statistically higher (p < 0.05) compared to patients in the TCA group in the final follow-up visit following the treatment according to the first and second observers. On the other hand, according to the third observer, patients applied with retinoic acid presented with higher healing rates compared to those treated with TCA, however; this rate was not statistically significant (p > 0.05). The frequency of TCA- and retinoic acid-associated adverse effects was similar in both groups (p > 0.05). As a result of both treatments, a reduction in the quality of life scores as well as a pronounced recovery (p = 0.001) in the quality of life of those patients with skin aging was observed.

CONCLUSIONS

The photo aging treatment option with 0.1% retinoic acid is cheaper and more feasible for patients compared to 25% TCA, and it is also as reliable and effective as TCA.

A prospective study of safety and efficacy of combination therapy with bipolar radiofrequency-based intense pulsed light, infrared light, and diode laser in Chinese subjects with photoaged skin

OBJECTIVE

To further evaluate the safety and effectiveness of bipolar RF-based optical therapy combining intense pulsed light (IPL), infrared light, and diode laser in the treatment of photoaged skin in Chinese subjects.

METHODS

Twenty-seven subjects received five treatments at 3-week intervals. Triple therapy was applied in one session to the face. Images and data were obtained 30 and 180 days after the last treatment. Objective measurements (including photometric analysis of skin pigmentation, texture and wrinkles, ultrasonic measurement of dermal thickness and dermal echo intensity, and public and self-assessment of apparent age), clinical assessment, and safety were evaluated.

RESULTS

Objective measurements of pigmentation, texture, wrinkles, and dermal echo intensity improved significantly, regardless of age. Self-assessment of apparent age at 30 and 180 days was reduced by an average of 2.7 and 2.2 years, respectively, and public assessment of apparent age was reduced by an average of 3.14 years and 2.95 years, respectively. Global scores for photoaging were improved in all patients. Adverse events were generally transient and mild.

CONCLUSION

Sequential combination treatment reported here could significantly reduce skin pigmentation, texture and wrinkles, improve dermal intensity, and reduce the self and publicly perceived age. This therapy is safe and well tolerated.

Cooperation of endothelin-1 signaling with melanosomes plays a role in developing and/or maintaining human skin hyperpigmentation

Skin hyperpigmentation is characterized by increased melanin synthesis and deposition that can cause significant psychosocial and psychological distress. Although several cytokine-receptor signaling cascades contribute to the formation of ultraviolet B-induced cutaneous hyperpigmentation, their possible involvement in other types of skin hyperpigmentation has never been clearly addressed. Since our continuous studies using skin specimens from more than 30 subjects with ethnic skin diversity emphasized a consistent augmentation in the expression of endothelin-1 (ET-1) and its receptor (Endothelin B receptor, ET-B) in hyperpigmented lesions, including senile lentigos (SLs), the precise function of ET-1 signaling was investigated in the present study. In line with previous studies, ET-1 significantly induced melanogenesis followed by increases in melanosome transport in melanocytes and in its transfer to keratinocytes while inhibition of ET-B function substantially depressed melanogenic ability in tissue-cultured SLs. Additionally, in agreement with a previous report that the formation of autophagosomes rather than melanosomes is stimulated according to starvation or defective melanosome production, ET-1 was found to remarkably augment the expression of components necessary for early melanosome formation, indicating its counteraction against autophagy-targeting melanosome degradation in melanocytes. Despite the lack of substantial impact of ET-1 on keratinocyte melanogenic functions, the expression of ET-1 was enhanced following melanosome uptake by keratinocytes. Taken together, our data suggest that ET-1 plays a substantial role in the development and/or maintenance of skin hyperpigmentation in reciprocal cooperation with increased melanosome incorporation.

Anti-wrinkle effects of fermented and non-fermented Cyclopia intermedia in hairless mice

Background

The fermented leaves and stems of Cyclopia intermedia are used to brew honeybush tea, an herbal tea indigenous to South Africa with reported anti-wrinkle effects. Wrinkle formation caused by photoaging clearly involves changes in extracellular matrix components and mechanical properties of the skin.

Methods

The inhibitory effects of honeybush extract and fermented honeybush on wrinkle formation were determined by analyzing skin replicas, histologically examining epidermal thickness, and identifying damage to collagen fibers.

Results

Honeybush extract and fermented honeybush reduced the length and depth of skin winkles caused by UV irradiation and inhibited thickening of the epidermal layer, in addition to suppressing collagen tissue breakdown reactions, indicating its potential use as a skin wrinkle prevention agent.

Conclusions

This in vivo study demonstrates that honeybush produces significant anti-wrinkle effects and is therefore of interest in anti-aging skin care products.

Evaluation of 5-aminolevulinic acid-mediated photorejuvenation of neck skin

OBJECTIVE

To evaluate the outcomes of the combination of red light or intense pulsed laser (IPL) with 5-aminolevulinic acid (ALA)-mediated photodynamic therapy (PDT) in the treatment of photodamaged neck skin.

METHODS

The anterior of the neck was divided into four 2 cm × 2 cm sections and randomly assigned to red-light, red-light-PDT, IPL or IPL-PDT group. ALA cream of 5% was applied to PDT regions for 2h prior to light irradiation. Treatment was repeated once. The stratum corneum (SC) hydration, transepidermal water loss (TEWL), L(*), a(*), b(*) values, melanin index (MI), erythema index (EI), skin elasticity and skin thickness were examined by a blinded investigator. The function and volume of thyroid were also measured.

RESULTS

After red-light-PDT, IPL-PDT and IPL treatment, the appearance of photoaging lesion was improved. The SC hydration, L(*) value, elasticity and thickness increased, whereas the TEWL and MI value decreased. These changes in red-light-PDT and IPL-PDT group were more obvious than IPL group. The a(*) and EI value increased in red-light-PDT group. No significant change was noticed in red-light group. Partial irradiation of the thyroid did not affect the function and volume of the thyroid.

CONCLUSION

IPL-PDT and red-light-PDT showed better rejuvenation effect than IPL or red light alone on the neck skin.

Age-related dermal collagen changes during development, maturation and ageing - a morphometric and comparative study

The tissue organisation of dermal collagen is gaining importance as a contributing factor both in development and ageing, as well as in skin maturation processes. In this work we aim to study different representative parameters of this structural organisation in 45 human skin samples of assorted ages, by means of image analysis. The variation of these parameters on the basis of age was assessed using several regression models (linear, quadratic and cubic). The area occupied by collagen was significantly reduced as a function of age in the papillary dermis (R(2) = 0.437, P < 0.0001), as well as the thickness of the collagen bundles (R(2) = 0.461, P < 0.0001), following statistical models of cubic and quadratic regression, respectively. The width of the papillary dermis increased in a significant manner over a linear regression model (R(2) = 0.26, P < 0.0001). In the reticular dermis, the cubic regression indicated a significant decline (R(2) = 0.392, P = 0.002) of the area filled with collagen according to the age. Both collagen thickness and bundle orientation parameters fit a quadratic regression over the age in a significant way (R(2) = 0.433 and R(2) = 0.334, respectively, both P < 0.0001). The width of the reticular dermis followed also a significant quadratic distribution according to age (R(2) = 0.193, P = 0.011). These parameters could partially explain the lifelong functional changes taking place in the skin and propose a baseline providing a useful entry point for future investigation.

Whitening effects of adipose-derived stem cells: a preliminary in vivo study

Many studies have reported various growth factors secreted from adipose-derived stem cells (ADSCs). In particular, regenerative effects in skin have received much attention in the clinical fields. The in vitro whitening effects of ADSCs have been reported. A previous study demonstrated that ADSCs secrete growth factors that inhibit both melanin synthesis and tyrosinase activity. This study aimed to investigate the in vivo whitening effect of ADSCs using mouse models. In the study, ADSCs were isolated from the adipose tissue of C57BL/6 mice and cultured. The ADSCs (1 × 10(6) cells in 30 μl of Hanks' balanced salt solution [HBSS]) then were injected intradermally in the dorsal area of the right ear, and 30 μl of HBSS was injected on the left ear as a control. After 7 days, both ears were irradiated with ultraviolet B (UVB) (150 mJ/cm(2)) three times at 2-day intervals. The sections of each ear were stained with hematoxylin-eosin, Fontana-Masson, and HMB-45 (a melanocytic cell-specific monoclonal antibody). The histologic parameters evaluated included inflammation (+/-), erosion (+/-), and melanin formation (graded on a scale of 1 to 3). No significant differences in inflammation or erosion were observed by hematoxylin and eosin staining (inflammation: p = 0.388; erosion: p = 0.355). However, significantly more melanin formation was observed in the control group than in the ADSC injection group by Fontana-Masson and HMB-45 staining (Fontana-Masson: p = 0.025; HMB-45: p = 0.015). The study findings suggest that ADSCs inhibit melanin formation induced by UV exposure. Potentially, ADSCs may be used as anti-aging agents, including skin whitening. Before human clinical studies can be conducted, further study is required to determine the mechanisms underlying the whitening effects of ADSCs and the safety of ADSC use.

LEVEL OF EVIDENCE II

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 .

Curcumin inhibits UVB-induced matrix metalloproteinase-1/3 expression by suppressing the MAPK-p38/JNK pathways in human dermal fibroblasts

Curcumin (diferuloylmethane) is a polyphenol derived from turmeric (Curcuma longa), which is commonly used as a spice. Recent studies have shown that curcumin has a wide range of pharmacological activities, including anticarcinogenic, antioxidant, anti-inflammatory and antiangiogenic activities. However, the antiphotoageing effects of curcumin have yet to be characterized. In this study, we investigated the inhibitory effects of curcumin on matrix metalloproteinase (MMP)-1 and MMP-3 expression in human dermal fibroblast cells. Western blot analysis revealed that curcumin inhibited ultraviolet (UV) B-induced MMP-1 and MMP-3 expression. Furthermore, curcumin significantly blocked UVB-induced reactive oxygen species generation in fibroblasts. Curcumin treatment significantly blocked the UVB-induced activation of nuclear factor (NF)-κB and activator protein (AP)-1. Additionally, curcumin strongly repressed the UVB-induced phosphorylation of p38 and c-Jun N-terminal kinase. Curcumin prevented UVB-induced MMP expression through mitogen-activated protein kinase/NF-κB inhibition and AP-1 activation. In conclusion, curcumin may be useful for preventing and treating skin photoageing.

The impact of intradermal injections of modified hyaluronic acid on the morphological skin condition in female patients with involutional changes

Goal. To provide a clinical assessment of the efficacy and tolerance of hyaluronic acid (HA) drugs modified with vitamin С and amino acids in patients with involutional skin changes. Methods. As many as 90 female patients underwent a course of treatment for age-related skin changes including three procedures of intradermal injections of modified HA. The skin condition was assessed prior to and after the treatment by using non-invasive methods (corneometry, pH-metry, sebometry, elastometry, visio-scanning, ultrasonic derma-scanning and confocal laser scanning microscopy). Results. The authors demonstrated good tolerance of modified HA and skin condition improvement (better elasticity, moisture level, improvement of the skin structure and microrelief, reduction in the intensity of expression and static wrinkles, restoration of color uniformity and elimination of xerosis manifestations). Conclusion. The study results are sufficient to recommend modified HA drugs for correcting involutional skin changes.

Decursin inhibits UVB-induced MMP expression in human dermal fibroblasts via regulation of nuclear factor-κB

Decursin, a coumarin compound, was originally isolated from the roots of Angelica gigas almost four decades ago, and it was found to exhibit cytotoxicity against various types of human cancer cells and anti-amnesic activity in vivo through the inhibition of AChE activity. However, the anti-skin photoaging effects of decursin have not been reported to date. In the present study, we investigated the inhibitory effects of decursin on the expression of matrix metalloproteinase (MMP)-1 and MMP-3 in human dermal fibroblast (HDF) cells. Western blot analysis and real-time PCR revealed that decursin inhibited the ultraviolet (UV)B-induced expression of MMP-1 and MMP-3 in a dose-dependent manner. Decursin significantly blocked the UVB-induced activation of nuclear factor-κB (NF-κB). However, decursin showed no effect on MAPK or AP-1 activity. In this study, decursin prevented the UVB-induced expression of MMPs via the inhibition of NF-κB activation. In conclusion, decursin may be a potential agent for the prevention and treatment of skin photoaging.

Efficacy of a novel treatment serum in the improvement of photodamaged skin

Synopsis

A novel treatment serum formulated to target multiple pathways in the anti-ageing cascade was tested both in vitro and in clinical settings. In vitro testing was performed to assess the ability to stimulate key proteins and genes fundamental to the anti-ageing cascade. The antioxidant potential of the formulation was studied in a UV-irradiation clinical study. A 12-week, open-label, single-centre study was conducted to determine whether this uniquely formulated topical treatment serum could improve visible signs of facial photodamage. Clinical evaluations showed statistically significant reductions in fine wrinkles and coarse wrinkles and improvements in skin texture, tone and radiance starting at week 4 with continued improvements at weeks 8 and 12. Subject self-assessments confirmed that the beneficial effects of the treatment serum were readily observed by the users. The treatment serum was well tolerated with no treatment-related adverse events reported during the 12-week study. Use of this novel treatment serum produced significant improvements in the visible signs of facial photodamage.

Résumé

Un nouveau sérum de traitement conçu pour cibler de multiples voies dans la cascade anti-âge a été testé à la fois in vitro et dans les conditions cliniques. Les tests in vitro ont été réalisés afin d'évaluer la capacité de stimuler les protéines et les gènes clés fondamentales de la cascade anti-vieillissement. Le potentiel antioxydant de la formulation a été étudié dans une étude clinique utilisant le rayonnement UV. Une étude de douze semaines, en mode ouvert, monocentrique a été menée afin de déterminer si ce sérum spécialement formulé pour le traitement topique peut améliorer les signes visibles du photo-vieillissement du visage. Des évaluations cliniques ont montré une réduction statistiquement significative des rides et des ridules secondaires et l'amélioration de la texture de la peau, du tonus et d'éclat à partir de la semaine 4 avec des améliorations continues aux semaines 8 et 12. Les autoévaluations par les sujets ont confirmé que les effets bénéfiques du sérum de traitement étaient facilement observés par les utilisateurs. Le sérum de traitement a été bien toléré avec aucun événement indésirable rapporté au cours de l'étude de 12 semaines. L'utilisation de ce nouveau sérum de traitement produit des améliorations significatives dans les signes visibles du photovieillissement du visage.

In vitro Comparison of Light-Emitting Diodes and Carnosic Acid Effects on Keratinocyte Proliferation and Wound Healing

Introduction:

Light-emitting diode (LED) therapy uses different wavelengths of light and has been reported to accelerate cutaneous wound healing. Carnosic acid is an antioxidant that is also thought to be photoprotective. We designed an in vitro study to examine the effects of LED and carnosic acid on the proliferation and migration of human keratinocytes.

Materials and Methods:

Clinically normal human keratinocytes were cultured and exposed to two wavelengths: 620 nm and 660 nm LED at different fluences. In the second part of this study, a different batch of human keratinocytes was grown in culture, and different concentrations of carnosic acid were added.

Results:

At the two wavelengths that were used, LED did not appear to have any therapeutic effect and was not effective in stimulating keratinocyte proliferation. Exposure to greater energy levels (increased fluence) produced increased cell damage that was directly proportional to the increase in energy. On the other hand, treatment of the cell cultures with the antioxidant carnosic acid resulted in an increase of keratinocyte cell proliferation, and this increase was also proportional to the concentration of carnosic acid.

Conclusions:

This study did not support the hypothesis that LED treatment results in keratinocyte proliferation; however, carnosic acid, a potent antioxidant, stimulated keratinocyte production and could be implicated in wound healing and rejuvenation.

Brazilin inhibits UVB-induced MMP-1/3 expressions and secretions by suppressing the NF-κB pathway in human dermal fibroblasts

Brazilin (7, 11b-dihydrobenz[b]indeno[1,2-d]pyran-3,6a,9,10 (6H)-tetrol), the major component of Caesalpinia sappan L., is a natural red pigment used for histological staining. Recent studies have shown that brazilin exhibits distinct biological effects, including anti-hepatotoxicity, antiplatelet activity, and anti-inflammatory activities. In the present study, we evaluated the effects of brazilin on MMP-1 and -3 expressions in human dermal fibroblasts exposed to ultraviolet B (UVB) irradiation. Brazilin showed protective effect on UVB-induced loss of cell viability of fibroblasts. Brazilin also blocked significantly UVB-induced Reactive Oxygen Species generation in fibroblasts. Brazilin inhibited UVB-induced MMP-1/3 expressions and secretions in a dose-dependent manner. Moreover, UVB-induced NF-κB activation was completely blocked by treatment with brazilin. These findings suggest that brazilin inhibits UVB-induced MMP-1/3 expressions and secretions by suppressing of NF-κB activation in human dermal fibroblasts. Thus, brazilin might be used as a potential agent for treatment of UV-induced skin photoaging.

Cell-based cytokine therapy for skin rejuvenation

The interaction between stem cells from human exfoliated deciduous teeth (SHEDs)-derived growth factors and human dermal fibroblast (HDF) has been investigated for the first time, as the application of SHEDs for dermal wound healing remains speculative. Stem cells from human exfoliated deciduous teeth have effects on HDFs by increasing collagen synthesis and by activating proliferation and migration activity of HDFs, suggesting that SHEDs or SHED-derived conditioned medium (SH-CM) can be used for the treatment of photoaging. Our results suggest that SHEDs and SH-CM should be constitutionally suited for photoaging treatment. Mainly with secreted growth factors or extracellular matrix proteins, SHEDs contribute to enhanced wound-healing potential of HDFs. Further mechanism studies using neutralizing antibodies against each growth factor may clarify the role of soluble factors of SHEDs in wound-healing process.