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Margara A, Haykal D, Musella D, Bellia G, Boriani F. Hyaluronan Hybrid Cooperative Complexes Injection as a Biostimulation for Postobese Skin Laxity in the Arm: A Histopathologic Study. Aesthet Surg J Open Forum 2023; 6:ojad110. [PMID: 38887212 PMCID: PMC11181863 DOI: 10.1093/asjof/ojad110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024] Open
Abstract
Background The Hybrid Cooperative Complexes of high and low molecular weight hyaluronic acids (HHCC) improve skin structure and bioactivity. Massive weight loss damages cellular composition and morphological structure of skin. An injective treatment of postobese skin consisting of HHCC may have a role in counteracting these histopathological alterations. Objectives To analyze the histological effects of HHCC injection in the cutaneous tissues of massive weight loss patients suffering from arm laxity. Methods Nine ex-obese patients with postweight-loss-related arm laxity and ptosis requiring brachioplasty were prospectively recruited at the first author's department. HHCC injection was performed on only 1 arm, which included 2 injective sessions separated by 30 days. One month posttreatment, patients underwent a bilateral brachioplasty, and the surgical specimens were histologically examined, searching for any variation in the cutaneous connective tissue following injections. Histology on treated specimens showed a statistically significant increased density of elastic fibers along with a lower fragmentation of the same fibers compared to the untreated tissue. Fibroblasts demonstrated a swollen appearance as if involved in a bioactivation process. Results Treatment with HHCC increases the number of elastin fibers and determines a more regular elastin deposition and architecture, as well as the bioactivation of fibroblasts. The contralateral untreated area showed an irregular structure with elastosis and elastolysis. Conclusions More studies are necessary, but histologically proven benefits are demonstrated in the HHCC-treated skins when compared with basal controlateral skin. These data support the use of HHCC formulations for the treatment of postobese skin laxity. Level of Evidence 5
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Affiliation(s)
| | - Diala Haykal
- Corresponding Author: Dr Diala Haykal, 49 Ter Rue de Paris, 91120 Palaiseau, France. E-mail: ; Instagram: @centre_laser_palaiseau; Twitter: @drdialahaykal
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Pivazyan L, Avetisyan J, Loshkareva M, Abdurakhmanova A. Skin Rejuvenation in Women using Menopausal Hormone Therapy: A Systematic Review and Meta-Analysis. J Menopausal Med 2023; 29:97-111. [PMID: 38230593 PMCID: PMC10796198 DOI: 10.6118/jmm.22042] [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: 02/03/2023] [Revised: 08/21/2023] [Accepted: 09/18/2023] [Indexed: 01/18/2024] Open
Abstract
OBJECTIVES To evaluate the effect of menopausal hormone therapy (MHT) on skin aging in menopausal women. METHODS Studies were identified by searching PubMed, Cochrane Library, Google Scholar, and ClinicalTrials.gov databases using the key words "hormone replacement therapy" AND "skin" AND "menopausal." Studies that used and compared oral/transdermal MHT with placebo or another type of treatment in menopausal women aged 45-55 years were selected. RESULTS From 1,526 studies identified, 15 studies comprising 1,589 patients were included in the final analysis. Our meta-analysis aimed to compare skin elasticity (standard [Std] mean difference = 0.28; 95% confidence interval [CI], 0.03-0.54; P = 0.03), skin thickness (Std. mean difference = 1.27; 95% CI, 0.88-1.66; P < 0.00001), collagen content (Std. mean difference = 2.01; 95% CI, 1.42-2.61; P < 0.00001), and skin dryness (Std. mean difference = 0.15; 95% CI, -0.05 to 0.35; P = 0.14). CONCLUSIONS MHT increases elasticity and collagen content in the skin, thereby reducing the severity of wrinkles and increasing skin thickness. Nevertheless, more well-conducted clinical trials are required to answer all questions in an evidence-based manner.
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Affiliation(s)
- Laura Pivazyan
- National Medical Research Center for Obstetrics, Gynecology and Perinatology Named after Academician V.I. Kulakov of the Ministry of Healthcare of Russian Federation, Moscow, Russia.
| | - Julietta Avetisyan
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Maria Loshkareva
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Amina Abdurakhmanova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Oral Supplementation and Systemic Drugs for Skin Aging: A Narrative Review. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:114-124. [PMID: 36206809 DOI: 10.1016/j.ad.2022.09.014] [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: 05/12/2022] [Revised: 09/20/2022] [Accepted: 09/20/2022] [Indexed: 11/07/2022] Open
Abstract
Skin aging is influenced by intrinsic and extrinsic factors and involves multiple pathogenic mechanisms. The most widely used treatments are topical products and minimally invasive procedures. Evidence on the benefits of systemic therapy is limited for several reasons: Reliance on mostly small and predominantly female samples, short study durations, methodologic heterogeneity, and a lack of consensus on which outcome measures are clinically relevant. Furthermore, systemic drugs and oral supplements are not without adverse effects. Oral hydrolyzed collagen and oral hyaluronic acid are well tolerated, and numerous clinical trials show they can mitigate some signs of skin aging. Low-dose oral isotretinoin is another option, but it has a higher risk of adverse effects. Evidence is lacking on the effects of the many dietary supplements on offer, such as vitamins, flavonoids, plant extracts, and trace elements. The future of skin aging management would appear to lie in the use of senolytic and senomorphic agents targeting senescent cells in the skin.
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[Translated article] Oral Supplementation and Systemic Drugs for Skin Aging: A Narrative Review. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:T114-T124. [PMID: 36464003 DOI: 10.1016/j.ad.2022.09.021] [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: 05/12/2022] [Accepted: 09/20/2022] [Indexed: 12/03/2022] Open
Abstract
Skin aging is influenced by intrinsic and extrinsic factors and involves multiple pathogenic mechanisms. The most widely used treatments are topical products and minimally invasive procedures. Evidence on the benefits of systemic therapy is limited for several reasons: reliance on mostly small and predominantly female samples, short study durations, methodologic heterogeneity, and a lack of consensus on which outcome measures are clinically relevant. Furthermore, systemic drugs and oral supplements are not without adverse effects. Oral hydrolyzed collagen and oral hyaluronic acid are well tolerated, and numerous clinical trials show they can mitigate some signs of skin aging. Low-dose oral isotretinoin is another option, but it has a higher risk of adverse effects. Evidence is lacking on the effects of the many dietary supplements on offer, such as vitamins, flavonoids, plant extracts, and trace elements. The future of skin aging management would appear to lie in the use of senolytic and senomorphic agents targeting senescent cells in the skin.
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Menopause induces changes to the stratum corneum ceramide profile, which are prevented by hormone replacement therapy. Sci Rep 2022; 12:21715. [PMID: 36522440 PMCID: PMC9755298 DOI: 10.1038/s41598-022-26095-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
The menopause can lead to epidermal changes that are alleviated by hormone replacement therapy (HRT). We hypothesise that these changes could relate to altered ceramide production, and that oestrogen may have a role in keratinocyte ceramide metabolism. White Caucasian women were recruited into three groups: pre-menopausal (n = 7), post-menopausal (n = 11) and post-menopausal taking HRT (n = 10). Blood samples were assessed for hormone levels, transepidermal water loss was measured to assess skin barrier function, and stratum corneum lipids were sampled from photoprotected buttock skin. Ceramides and sphingomyelins were analysed by ultraperformance liquid chromatography with electrospray ionisation and tandem mass spectrometry. Post-menopausal stratum corneum contained lower levels of ceramides, with shorter average length; changes that were not evident in the HRT group. Serum oestradiol correlated with ceramide abundance and length. Ceramides had shorter sphingoid bases, indicating altered de novo ceramide biosynthesis. Additionally, post-menopausal women had higher sphingomyelin levels, suggesting a possible effect on the hydrolysis pathway. Treatment of primary human keratinocytes with oestradiol (10 nM) increased production of CER[NS] and CER[NDS] ceramides, confirming an effect of oestrogen on cutaneous ceramide metabolism. Taken together, these data show perturbed stratum corneum lipids post-menopause, and a role for oestrogen in ceramide production.
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The Evaluation of Efficacy and Safety of A Radiofrequency Hydro-Injector Device for the Skin around the Eye Area. J Clin Med 2021; 10:jcm10122582. [PMID: 34208109 PMCID: PMC8230740 DOI: 10.3390/jcm10122582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/03/2021] [Accepted: 06/08/2021] [Indexed: 11/17/2022] Open
Abstract
In recent years, variable rejuvenation techniques, such as hyaluronic acid (HA) fillers and radiofrequency (RF) devices, have become popular. We evaluated the RF hydro-injector (RFHI) device that simultaneously delivers both a microneedle intradermal RF treatment and a HA filler injection to overcome the disadvantages of HA filler and RF devices alone. This study aimed to assess the efficacy and safety of the RFHI device for the rejuvenation of the periorbital area, including the lateral canthal lines (LCLs) and the infraorbital area. A total of 24 subjects were enrolled in this study and underwent 2 to 3 treatments using the RFHI device. The investigator's global assessment of the lateral canthal line (IGA-LCL) and the global esthetic improvement scale (GAIS) were used to evaluate the improvement in the LCL. Cutometer® was used to evaluate the skin's elasticity, and the Antera 3D image capture system® was used to evaluate the degree of wrinkles, roughness, and pore volume. At the 8 week follow-up after the first treatment session, both the IGA-LCL and GAIS showed significant improvement. The improvement in the wrinkles, roughness, and pore volume, measured by the Antera 3D image capture system®, was statistically significant. No serious adverse event was reported. This RFHI device, which delivers both microneedle intradermal RF treatment and HA filler injection, is effective and safe for periorbital rejuvenation.
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Cho S. Pathogenesis and prevention of skin aging. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2021. [DOI: 10.5124/jkma.2021.64.6.438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: As global life expectancy increases, an interest in maintaining health and beauty in old age has increased. As a barrier organ, the skin is an ideal model for studying both genetically-programmed (intrinsic) and environmentallyinduced (extrinsic) aging.Current Concepts: Among the extrinsic aging factors, solar ultraviolet radiation is the most important, accounting for 80% of facial skin aging. Other nongenetic factors include air pollution, cigarette smoke, nutrition, temperature, sleep, and stress. Through complex interplay, genome, exposome and microbiome all contribute to skin aging. Intrinsic aging causes thinning of the skin and fine wrinkles, while extrinsic aging leads to thick rubbery skin texture, deep wrinkles and dyspigmentation in exposed areas. Fibroblast senescence is a fundamental mechanism of skin aging, with these cells persisting and exhibiting a senescence-associated secretory phenotype which secrets proinflammatory cytokines. Chronic low-level inflammation associated with aging, termed inflamm-aging, is exacerbated by oxidative damage caused by extrinsic factors.Discussion and Conclusion: Understanding the pathogenesis of skin aging may help in developing anti-aging strategies in general. In addition to applying sunscreen every morning and retinoic acid every night, taking antioxidant-rich foods and maintaining a healthy lifestyle are all important for preventing skin aging.
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Khmaladze I, Leonardi M, Fabre S, Messaraa C, Mavon A. The Skin Interactome: A Holistic "Genome-Microbiome-Exposome" Approach to Understand and Modulate Skin Health and Aging. Clin Cosmet Investig Dermatol 2021; 13:1021-1040. [PMID: 33380819 PMCID: PMC7769076 DOI: 10.2147/ccid.s239367] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 11/26/2020] [Indexed: 12/13/2022]
Abstract
Higher demands on skin care cosmetic products for strong performance drive intense research to understand the mechanisms of skin aging and design strategies to improve overall skin health. Today we know that our needs and influencers of skin health and skin aging change throughout our life journey due to both extrinsic factors, such as environmental factors and lifestyle factors, as well as our intrinsic factors. Furthermore, we need to consider our microflora, a collection of micro-organisms such as bacteria, viruses, and fungi, which is a living ecosystem in our gut and on our skin, that can have a major impact on our health. Here, we are viewing a holistic approach to understand the collective effect of the key influencers of skin health and skin aging both reviewing how each of them impact the skin, but more importantly to identify molecular conjunction pathways of these different factors in order to get a better understanding of the integrated “genome-microbiome-exposome” effect. For this purpose and in order to translate molecularly the impact of the key influencers of skin health and skin aging, we built a digital model based on system biology using different bioinformatics tools. This model is considering both the positive and negative impact of our genome (genes, age/gender), exposome: external (sun, pollution, climate) and lifestyle factors (sleep, stress, exercise, nutrition, skin care routine), as well as the role of our skin microbiome, and allowed us in a first application to evaluate the effect of the genome in the synthesis of collagen in the skin and the determination of a suitable target for boosting pro-collagen synthesis. In conclusion, we have, through our digital holistic approach, defined the skin interactome concept, as an advanced tool to better understand the molecular genesis of skin aging and further develop a strategy to balance the influence of the exposome and microbiome to protect, prevent, and delay the appearance of skin aging signs and preserve good skin health condition. In addition, this model will aid in identifying and optimizing skin treatment options based on external triggers, as well as helping to design optimal treatments modulating the intrinsic pathways.
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Affiliation(s)
- Ia Khmaladze
- Skin Research Institute, Oriflame Cosmetics AB, Stockholm, Sweden
| | - Michele Leonardi
- Skin Research Institute, Oriflame Cosmetics AB, Stockholm, Sweden
| | - Susanne Fabre
- Skin Research Institute, Oriflame Cosmetics AB, Stockholm, Sweden
| | - Cyril Messaraa
- Research and Development, Oriflame Cosmetics Ltd, Bray, Ireland
| | - Alain Mavon
- Skin Research Institute, Oriflame Cosmetics AB, Stockholm, Sweden
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Lee YJ, Kim HT, Lee YJ, Paik SH, Moon YS, Lee WJ, Chang SE, Lee MW, Choi JH, Jung JM, Won CH. Comparison of the effects of polynucleotide and hyaluronic acid fillers on periocular rejuvenation: a randomized, double-blind, split-face trial. J DERMATOL TREAT 2020; 33:254-260. [PMID: 32248707 DOI: 10.1080/09546634.2020.1748857] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Filler injection has become an extremely popular method for facial skin rejuvenation, including the periorbital area. In the recent years, new polynucleotide (PN)-containing filler products have been used for esthetic purposes.Aim: We aimed to investigate the efficacy and safety of PN filler injection in the periorbital area.Patients/methods: A total of 27 subjects were enrolled in this randomized, pair-matched, and active-controlled study. Each subject received filler injections thrice with two-week intervals, with a PN filler injection on one side and a non-crosslinked hyaluronic acid (HA) filler injection on the contralateral side of the periorbital area.Results: Improvements in the visual analog scale and global esthetic improvement scale scores were not significantly different between the PN and HA groups. The improvement rates of skin elasticity and hydration decreased over time in both groups, with the PN group showing a higher improvement rate. The improvement rates of roughness and pore volume were higher in the PN group than in the HA group. The improvement rate of dermal density was not significantly different between the groups. No serious adverse events were reported.Conclusion: The PN filler injection is effective and safe for periorbital rejuvenation.
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Affiliation(s)
- Ye Jin Lee
- Department of Dermatology, Kyunghee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Hak Tae Kim
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - You Jin Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seung Hwan Paik
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Young Seon Moon
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Woo Jin Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sung Eun Chang
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Mi Woo Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jee Ho Choi
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Joon Min Jung
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Chong Hyun Won
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Uchiyama T, Tsunenaga M, Miyanaga M, Ueda O, Ogo M. Oral intake of lingonberry and amla fruit extract improves skin conditions in healthy female subjects: A randomized, double-blind, placebo-controlled clinical trial. Biotechnol Appl Biochem 2019; 66:870-879. [PMID: 31342566 DOI: 10.1002/bab.1800] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 07/20/2019] [Indexed: 11/11/2022]
Abstract
In this study, we examined the effect of ingestion of lingonberry and amla fruit extract (LAE) on several human skin conditions. To conduct a randomized, double-blinded, placebo-controlled study, we randomly divided 99 healthy female subjects into three groups; the first group received a drink containing 25 mg of lingonberry extract and 30 mg of amla fruit extract; the second group received a drink containing double the volume of extracts received by the first group; and the third group received a placebo drink. Each participant drank 50 mL of their assigned drink once daily for 12 weeks. The primary endpoint was skin elasticity, and the secondary endpoints included skin thickness, stratum corneum water content, and degree of wrinkles around the eyes. After 12 weeks of LAE drink intake, skin elasticity showed significant, dose-dependent improvements (P < 0.01). Skin thickness, stratum corneum water content, and the degree of wrinkles also significantly improved (P < 0.001) in a dose-dependent manner. The improvements in skin elasticity and thickness, as well as in the stratum corneum water content and the degree of wrinkles, observed upon oral intake of LAE indicate that LAE may be considered a candidate anti-aging agent for preventing skin weakening.
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Affiliation(s)
- Taro Uchiyama
- Shiseido Global Innovation Center, Yokohama, Kanagawa-ken, Japan
| | - Makoto Tsunenaga
- Shiseido Global Innovation Center, Yokohama, Kanagawa-ken, Japan
| | - Miho Miyanaga
- Shiseido Global Innovation Center, Yokohama, Kanagawa-ken, Japan
| | - Osamu Ueda
- Shiseido Global Innovation Center, Yokohama, Kanagawa-ken, Japan
| | - Masashi Ogo
- Shiseido Global Innovation Center, Yokohama, Kanagawa-ken, Japan
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Kim SH, Lee SJ, Kim HJ, Lee JH, Jeong HS, Suh IS. Aging-related changes in the mid-face skin elasticity in East Asian women. Arch Craniofac Surg 2019; 20:158-163. [PMID: 31256551 PMCID: PMC6615427 DOI: 10.7181/acfs.2019.00213] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 06/17/2019] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Age-related changes in facial skin is a major concern in women. This study aimed to objectively evaluate normal skin elasticity and age-related differences in the faces of East Asian women. There are no standard values for data related to normal skin on East Asian women. METHODS We studied 129 healthy East Asian women without a history of cosmetic procedures or surgeries. Skin elasticity was assessed at the cheek and lower eyelid points, which were assessed on both the right and left sides of the face. RESULTS The age of the subjects showed significant negative correlations with the R2 and R7 parameters, which represent skin elasticity after deformation. CONCLUSION We therefore concluded that the primary decrease in skin elasticity in East Asian women occurs in the midface region.
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Affiliation(s)
- Seong Hwan Kim
- Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Seong Joo Lee
- Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Hyun Jo Kim
- Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Ju Ho Lee
- Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Hii Sun Jeong
- Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - In Suck Suh
- Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
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Yurdakul OV, Rezvani A. Can ultrasound be an assessment tool for sagittal spine mobility and chest expansion in patients with ankylosing spondylitis? Medicine (Baltimore) 2018; 97:e12609. [PMID: 30278577 PMCID: PMC6181605 DOI: 10.1097/md.0000000000012609] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
We aimed to examine whether ultrasound (US) is useful for evaluating spinal mobility and chest expansion in ankylosing spondylitis (AS) patients and determine a cutoff value to identify reduced sagittal lumbar mobility.Our cross-sectional study included 50 AS patients and 50 controls. Metric measurements and Bath AS indices were measured in AS patients. The distance between C6-C7, T11-T12, and L4-L5 vertebrae was measured, and the difference and percentage of difference between erect position and maximal cervical and lumbar flexion was calculated (T11-T12dif, T11-T12%, L4-L5dif, L4-L5%, T+L dif, T+L%). Intercostal divergence was measured 1.5 cm away on the left from the sternocostal space during maximum inhalation and maximum exhalation, and the difference and percentage of difference between them was calculated (ICdif, IC%).All metric measurements were lower in the AS group except for tragus-to-wall distance. T11-T12dif, T11-T12%, L4-L5dif, T+L dif, and T+L% values were higher in the control group, while other US measurements did not differ between the groups. All US measurements except ICdif and IC% correlated with the Bath AS Metrology Index.Thus, US may be used for assessing spinal mobility in patients with AS. T11-T12dif <0.79 cm may show decreased lumbar sagittal mobility.
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Affiliation(s)
| | - Aylin Rezvani
- Medipol University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey
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Araújo LAD, Addor F, Campos PMBGM. Use of silicon for skin and hair care: an approach of chemical forms available and efficacy. An Bras Dermatol 2017; 91:331-5. [PMID: 27438201 PMCID: PMC4938278 DOI: 10.1590/abd1806-4841.20163986] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 11/21/2014] [Indexed: 11/26/2022] Open
Abstract
Silicon is the second most abundant element on Earth, and the third most abundant
trace element in human body. It is present in water, plant and animal sources.
On the skin, it is suggested that silicon is important for optimal collagen
synthesis and activation of hydroxylating enzymes, improving skin strength and
elasticity. Regarding hair benefits, it was suggested that a higher silicon
content in the hair results in a lower rate of hair loss and increased
brightness. For these beneficial effects, there is growing interest in
scientific studies evaluating the efficacy and safety of using dietary
supplements containing silicon. Its use aims at increasing blood levels of this
element and improving the skin and its annexes appearance. There are different
forms of silicon supplements available and the most important consideration to
be made in order to select the best option is related to safety and
bioavailability. Silicon supplements are widely used, though there is wide
variation in silicon bioavailability, ranging from values below 1% up to values
close to 50%, depending on the chemical form. Therefore, the aim of this study
was to evaluate the scientific literature related to the different chemical
forms of silicon supplements available and the limitations and recent progress
in this field. According to reported studies, among the different chemical forms
available, the orthosilicic acid (OSA) presents the higher bioavailability,
whereas the others forms have absorption inversely proportional to the degree of
polymerization. However, clinical studies evaluating safety and efficacy are
still lacking.
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Abstract
As the population ages, the incidence of dementia increases. All types of dementia, whether they are reversible or irreversible, lead to loss of intellectual function and judgment, memory impairment, and personality changes. The skills to feed oneself, use eating utensils, and consume items recognized as food, thereby maintaining nutrition status, may be lost as dementia progresses. Reports indicate that nutrition status may be maintained when patients are hand fed, but this is labor intensive and therefore expensive. Feeding via a percutaneous endoscopic gastrostomy tube is often chosen as an acceptable alternative. Research indicates that there is little benefit in this population when aggressive nutrition support is instituted. Providing tube feeding to patients with dementia does not necessarily extend life, increase weight, or reduce the incidence of pressure ulcers or aspiration. There are many legal and ethical issues involved in the decision to place a feeding tube in demented patients. The primary issue in patients with dementia may be autonomy and the right of an individual to decide whether or not a tube should be placed at all. Legally, there is clear precedent that the courts see the insertion of a feeding tube as extraordinary care that the patient has the right to refuse. However, much of case law is derived from cases of patients who were in a persistent vegetative state. Advance directives help to determine what the patient would want for himself. Considering all the options before the patient can no longer make decisions is the most desirable course.
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Affiliation(s)
- Ronni Chernoff
- Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System, Little Rock, AR 72205, USA.
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15
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Imokawa G. Epithelial-mesenchymal interaction mechanisms leading to the over-expression of neprilysin are involved in the UVB-induced formation of wrinkles in the skin. Exp Dermatol 2016; 25 Suppl 3:2-13. [PMID: 27539896 DOI: 10.1111/exd.13083] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2016] [Indexed: 12/21/2022]
Abstract
In clinical studies, the formation of facial wrinkles has been closely linked to the loss of elastic properties of the skin. Repetitive UVB irradiation of animal skin at suberythemal doses significantly reduces its elastic properties, resulting in the formation of wrinkles. That also elicits a marked alteration in the three-dimensional structure of elastic fibres, which is closely associated with a subsequent reduction in the elastic properties of the skin. While UVB irradiation stimulates the activity of skin fibroblast-derived elastase in the dermis, a synthetic inhibitor specific for skin fibroblast-derived elastase as well as an extract of Zingiber officinale (L.) Rose capable of inhibiting skin fibroblast-derived elastase, but not neutrophil elastase, prevented wrinkle formation in our studies of animal and human facial skin, respectively. The close interrelationship among wrinkle formation, elastic properties and elastic fibre linearity is revealed by the effects of different concentrations of the elastase inhibitor, which indicates that enhanced elastase activity by dermal fibroblasts plays a pivotal role in the UVB wrinkling mechanism. Fortunately, we were able to identify human skin fibroblast-derived elastase as the previously known enzyme neprilysin/neutral endopeptidase. Using both a UVB-conditioned medium assay and a co-culture system, we characterized the epithelial-mesenchymal interaction between keratinocytes and fibroblasts which leads to increased expression of neprilysin at the transcriptional, translational and enzymatic levels. Our results demonstrate that interleukin-1α and granulocyte-macrophage colony-stimulating factor are intrinsic cytokines secreted by UVB-exposed keratinocytes that stimulate the expression of neprilysin by skin fibroblasts.
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Affiliation(s)
- Genji Imokawa
- Research Institute for Biological Functions, Chubu University, Kasugai, Aichi, Japan
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Tadini KA, Mercurio DG, Campos PMBGM. Acetyl hexapeptide-3 in a cosmetic formulation acts on skin mechanical properties - clinical study. BRAZ J PHARM SCI 2015. [DOI: 10.1590/s1984-82502015000400016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
abstract Acetyl hexapeptide-3 has been used in anti-aging topical formulations aimed at improving skin appearance. However, few basic studies address its effects on epidermis and dermis, when vehiculated in topical formulations. Thus, the objective of this study was to determine the clinical efficacy of acetyl hexapeptide-3 using biophysical techniques. For this purpose, formulations with and without acetyl hexapeptide-3 were applied to the ventral forearm and the face area of forty female volunteers. Skin conditions were evaluated after 2 and 4-week long daily applications, by analyzing the stratum corneum water content and the skin mechanical properties, using three instruments, the Corneometer(r) CM 825, CutometerSEM 575 and ReviscometerRV600. All formulations tested increased the stratum corneum water content in the face region, which remained constant until the end of the study. In contrast, only formulations containing acetyl hexapeptide-3 exhibit a significant effect on mechanical properties, by decreasing the anisotropy of the face skin. No significant effects were observed in viscoelasticity parameters. In conclusion, the effects of acetyl hexapeptide-3 on the anisotropy of face skin characterize the compound as an effective ingredient for improving conditions of the cutaneous tissue, when used in anti-aging cosmetic formulations.
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Kim K, Jeon S, Kim JK, Hwang JS. Effects of Kyunghee Facial Resistance Program (KFRP) on mechanical and elastic properties of skin. J DERMATOL TREAT 2015. [DOI: 10.3109/09546634.2015.1056078] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Biological mechanisms underlying the ultraviolet radiation-induced formation of skin wrinkling and sagging I: reduced skin elasticity, highly associated with enhanced dermal elastase activity, triggers wrinkling and sagging. Int J Mol Sci 2015; 16:7753-75. [PMID: 25856675 PMCID: PMC4425048 DOI: 10.3390/ijms16047753] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 03/27/2015] [Accepted: 03/31/2015] [Indexed: 11/17/2022] Open
Abstract
The repetitive exposure of skin to ultraviolet B (UVB) preferentially elicits wrinkling while ultraviolet A (UVA) predominantly elicits sagging. In chronically UVB or UVA-exposed rat skin there is a similar tortuous deformation of elastic fibers together with decreased skin elasticity, whose magnitudes are greater in UVB-exposed skin than in UVA-exposed skin. Comparison of skin elasticity with the activity of matrix metalloproteinases (MMPs) in the dermis of ovariectomized rats after UVB or UVA irradiation demonstrates that skin elasticity is more significantly decreased in ovariectomized rats than in sham-operated rats, which is accompanied by a reciprocal increase in elastase activity but not in the activities of collagenases I or IV. Clinical studies using animal skin and human facial skin demonstrated that topical treatment with a specific inhibitor or an inhibitory extract of skin fibroblast-derived elastase distinctly attenuates UVB and sunlight-induced formation of wrinkling. Our results strongly indicated that the upregulated activity of skin fibroblast-derived elastase plays a pivotal role in wrinkling and/or sagging of the skin via the impairment of elastic fiber configuration and the subsequent loss of skin elasticity.
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Boucetta KQ, Charrouf Z, Aguenaou H, Derouiche A, Bensouda Y. The effect of dietary and/or cosmetic argan oil on postmenopausal skin elasticity. Clin Interv Aging 2015; 10:339-49. [PMID: 25673976 PMCID: PMC4321565 DOI: 10.2147/cia.s71684] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background During menopause, the decrease of estrogenic secretion induces the disruption of skin functioning, thus causing the decline in skin elasticity characteristic of skin aging. The purpose of this study was to evaluate in postmenopausal women the effect of daily consumption and/or application of argan oil on skin elasticity. Materials and methods Sixty postmenopausal women consumed butter during the stabilization period and were randomly divided into two groups for the intervention period: the treatment group of 30 participants received dietary argan oil, the control group of 30 participants received olive oil, and both groups applied cosmetic argan oil in the left volar forearm during a 60-day period. Assessments of skin elasticity parameters, ie, the three R-parameters (R2 or gross-elasticity of the skin, R5 or net elasticity of the skin, and R7 or biological elasticity), and the resonance running time (RRT) at both volar forearms of the two groups were performed during three visits: before starting oils consumption and application, after 30 days of oils consumption and application, and after 60 days of oils consumption and application. Results The consumption of argan oil led to a significant increase of gross-elasticity of the skin (R2) (P<0.001), net elasticity of the skin (R5) (P<0.001), biological elasticity (R7) (P<0.001), and a significant decrease of RRT (P=0.002). The application of argan oil led to a significant increase of gross-elasticity of the skin (R2) (P<0.001), net elasticity of the skin (R5) (P<0.001), biological elasticity (R7) (P=0.001), and a significant decrease of RRT (P<0.001). Conclusion Our findings suggest that the daily consumption and/or topical application of argan oil have an anti-aging effect on the skin demonstrated by the improvement of skin elasticity, characterized by an increase of R-parameters (R2, R5, and R7) and a decrease of RRT.
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Affiliation(s)
- Kenza Qiraouani Boucetta
- Research Team on Formulation and Biopharmacy, Research Center for Drug, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | | | - Hassan Aguenaou
- Mixed Unit of Research in Nutrition, ITU/CNESTEN, Ibn Tofail University, Kenitra, Morocco
| | | | - Yahya Bensouda
- Research Team on Formulation and Biopharmacy, Research Center for Drug, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
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Peng Y, Xuan M, Leung VYL, Cheng B. Stem cells and aberrant signaling of molecular systems in skin aging. Ageing Res Rev 2015; 19:8-21. [PMID: 25446806 DOI: 10.1016/j.arr.2014.10.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 10/24/2014] [Accepted: 10/30/2014] [Indexed: 02/07/2023]
Abstract
The skin is the body's largest organ and it is able to self-repair throughout an individual's life. With advanced age, skin is prone to degenerate in response to damage. Although cosmetic surgery has been widely adopted to rejuvinate skin, we are far from a clear understanding of the mechanisms responsible for skin aging. Recently, adult skin-resident stem/progenitor cells, growth arrest, senescence or apoptotic death and dysfunction caused by alterations in key signaling genes, such as Ras/Raf/MEK/ERK, PI3K/Akt-kinases, Wnt, p21 and p53, have been shown to play a vital role in skin regeneration. Simultaneously, enhanced telomere attrition, hormone exhaustion, oxidative stress, genetic events and ultraviolet radiation exposure that result in severe DNA damage, genomic instability and epigenetic mutations also contribute to skin aging. Therefore, cell replacement and targeting of the molecular systems found in skin hold great promise for controlling or even curing skin aging.
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Affiliation(s)
- Yan Peng
- Department of Orthopaedics & Traumatology, LKS Faculty of Medicine, The University of Hong Kong, L9-12, Lab block, Hong Kong, SAR, China; Department of Plastic Surgery, Guangzhou General Hospital of Guangzhou command, The Key Laboratory of Trauma Treatment & Tissue Repair of Tropical Area, PLA, GuangDong, 510010, PR China
| | - Min Xuan
- Southern Medical University, Guangzhou, 510010, PR China; Department of Plastic Surgery, Guangzhou General Hospital of Guangzhou command, The Key Laboratory of Trauma Treatment & Tissue Repair of Tropical Area, PLA, GuangDong, 510010, PR China
| | - Victor Y L Leung
- Department of Orthopaedics & Traumatology, LKS Faculty of Medicine, The University of Hong Kong, L9-12, Lab block, Hong Kong, SAR, China.
| | - Biao Cheng
- Southern Medical University, Guangzhou, 510010, PR China.
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Proksch E, Segger D, Degwert J, Schunck M, Zague V, Oesser S. Oral Supplementation of Specific Collagen Peptides Has Beneficial Effects on Human Skin Physiology: A Double-Blind, Placebo-Controlled Study. Skin Pharmacol Physiol 2014; 27:47-55. [DOI: 10.1159/000351376] [Citation(s) in RCA: 112] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Accepted: 03/24/2013] [Indexed: 11/19/2022]
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Bottai G, Mancina R, Muratori M, Di Gennaro P, Lotti T. 17β-estradiol protects human skin fibroblasts and keratinocytes against oxidative damage. J Eur Acad Dermatol Venereol 2012; 27:1236-43. [PMID: 22988828 DOI: 10.1111/j.1468-3083.2012.04697.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Reactive oxygen species (ROS) cause severe damage to extracellular matrix and to molecular structure of DNA, proteins and lipids. Accumulation of these molecular changes apparently constitutes the basis of cell ageing. 17b-estradiol (E2) has a key role in skin ageing homeostasis as evidenced by the accelerated decline in skin appearance seen in the perimenopausal years. Oestrogens improve many aspects of the skin such as skin thickness, vascularization, collagen content and quality. Despite these clinical evidences, the effects of oestrogens on skin at the cellular level need further clarification. MATERIALS AND METHODS HaCaT and human fibroblasts were cultured under various conditions with E2 and H2 O2 ; then were subjected to immunofluorescence and western blot analysis. Lipoperoxidation was investigated using BODIPY. RESULTS In human fibroblasts oxidative stress decreases procollagen-I synthesis, while E2 significantly increases it. Fibroblasts and HaCaT cells viability in the presence of E2 demonstrates a notably increased resistance to H2 O2 effects. Furthermore E2 is able to counteract H2 O2 -mediated lipoperoxidation and DNA oxidative damage in skin cells. DISCUSSION In this study we highlight that the menopause-associated oestrogens decline is involved in reduced collagen production and that E2 could counteract the detrimental effects of oxidative stress on the dermal compartment during skin aging. Furthermore, our data show that physiological concentrations of oestrogens are able to interfere with ROS-mediated cell viability reduction and to protect human skin cells against oxidative damage to cellular membranes and nucleic acids structure. CONCLUSION Our experimental data show that the presence of 17β-estradiol may protect skin cells against oxidative damage and that the dramatic lowering of oestrogen levels during menopause, could render skin more susceptible to oxidative damage.
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Affiliation(s)
- G Bottai
- Department of Critical Care Medicine and Surgery, Division of Clinical, Preventive and Oncology Dermatology, University of Florence, Florence, Italy Department of Clinical Physiopathology, Andrology Unit, and Center of Excellence 'DeNothe', University of Florence, Florence, Italy Dermatology and Venereology Division, University of Rome "G. Marconi", Rome, Italy
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Abstract
Cutaneous ageing manifests itself as a progressive reduction in function and reserve capacity of skin tissue. Collagen atrophy is a major factor in skin ageing. There is a strong correlation between skin collagen loss and oestrogen deficiency due to the menopause. Skin ageing is associated with a progressive increase in extensibility and a reduction in elasticity. With increasing age, the skin also becomes more fragile and susceptible to trauma, leading to more lacerations and bruising. Furthermore, wound healing is impaired in older women. Oestrogen use after the menopause increases collagen content, dermal thickness and elasticity, and it decreases the likelihood of senile dry skin. Large-scale clinical trials are necessary to help make informed recommendations regarding postmenopausal oestrogen use and its role in the prevention of skin ageing. Oestrogen has profound effects on connective tissue turnover, no matter the site. It has been shown that menopause has similar effects on the connective tissue of the carotid artery media, intervertebral discs and bones.
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Affiliation(s)
- J Calleja-Agius
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Tal-Qroqq, Malta.
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Firooz A, Sadr B, Babakoohi S, Sarraf-Yazdy M, Fanian F, Kazerouni-Timsar A, Nassiri-Kashani M, Naghizadeh MM, Dowlati Y. Variation of biophysical parameters of the skin with age, gender, and body region. ScientificWorldJournal 2012; 2012:386936. [PMID: 22536139 PMCID: PMC3317612 DOI: 10.1100/2012/386936] [Citation(s) in RCA: 123] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Accepted: 11/17/2011] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Understanding the physiological, chemical, and biophysical characteristics of the skin helps us to arrange a proper approach to the management of skin diseases. OBJECTIVE The aim of this study was to measure 6 biophysical characteristics of normal skin (sebum content, hydration, transepidermal water loss (TEWL), erythema index, melanin index, and elasticity) in a normal population and assess the effect of sex, age, and body location on them. METHODS Fifty healthy volunteers in 5 age groups (5 males and females in each) were enrolled in this study. A multifunctional skin physiology monitor (Courage & Khazaka electronic GmbH, Germany) was used to measure skin sebum content, hydration, TEWL, erythema index, melanin index, and elasticity in 8 different locations of the body. RESULTS There were significant differences between the hydration, melanin index, and elasticity of different age groups. Regarding the locations, forehead had the highest melanin index, where as palm had the lowest value. The mean values of erythema index and melanin index and TEWL were significantly higher in males and anatomic location was a significant independent factor for all of 6 measured parameters. CONCLUSION Several biophysical properties of the skin vary among different gender, age groups, and body locations.
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Affiliation(s)
- Alireza Firooz
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, 415 Taleghani Avenue, Tehran 14166 13675, Iran
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Pimenta F, Leal I, Maroco J, Ramos C. Menopause Symptoms' Severity Inventory (MSSI-38): assessing the frequency and intensity of symptoms. Climacteric 2011; 15:143-52. [PMID: 21995678 DOI: 10.3109/13697137.2011.590617] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Menopausal instruments usually assess the frequency or intensity of symptoms. The present study develops and validates an inventory to assess the severity of menopausal symptoms through the measurement of their frequency and intensity, and explores the differences between women with different menopausal status. METHODS A community sample of 992 Portuguese women in pre-, peri- and postmenopause completed the proposed inventory with 47 items. Factor exploratory and confirmatory analyses, and comparative statistics for paired and independent samples, were applied using PASW Statistics v.19 and AMOS v.18 software. RESULTS The final structure with 38 items organized in 12 factors showed overall good psychometric properties (in terms of factor analysis, convergent, discriminant and criterion validity, as well as regarding reliability, sensitivity, and measure invariance in two different and independent samples). The Wilcoxon test confirmed significant differences between frequency and intensity of symptoms. Moreover, peri- and postmenopausal women in this community sample presented low symptom severity (ranging from 0.4 to 1.4 in a scale from 0 to 4). Although postmenopausal participants presented higher levels (when compared with their perimenopausal counterparts), the two groups only diverged significantly in some physical symptoms (namely, aches and pain, vasomotor symptoms, numbness, skin and facial hair changes, urinary and sexual symptoms). CONCLUSION This research emphasizes that severity measurement of symptoms should account for both frequency and intensity. Moreover, it contributes a fully validated 12-dimension inventory for menopausal symptoms, the Menopause Symptoms' Severity Inventory-38. Regarding differences between peri- and postmenopausal women, the increment in symptoms only happens in physical symptoms, although the severity levels are not exacerbated.
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Affiliation(s)
- F Pimenta
- Psychology and Health Research Unit; ISPA-Instituto Universitário, Rua Jardim do Tabaco 34, Lisbon, Portugal
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Abstract
Aging of the skin is associated with skin thinning, atrophy, dryness, wrinkling, and delayed wound healing. These undesirable aging effects are exacerbated by declining estrogen levels in postmenopausal women. With the rise in interest in long-term postmenopausal skin management, studies on the restorative benefits that estrogen may have on aged skin have expanded. Systemic estrogen replacement therapy (ERT) has been shown to improve some aspects of skin. Estrogen restores skin thickness by increasing collagen synthesis while limiting excessive collagen degradation. Wrinkling is improved following estrogen treatment since estrogen enhances the morphology and synthesis of elastic fibers, collagen type III, and hyaluronic acids. Dryness is also alleviated through increased water-holding capacity, increased sebum production, and improved barrier function of the skin. Furthermore, estrogen modulates local inflammation, granulation, re-epithelialization, and possibly wound contraction, which collectively accelerates wound healing at the expense of forming lower quality scars. Despite its promises, long-term ERT has been associated with harmful systemic effects. In the search for safe and effective alternatives with more focused effects on the skin, topical estrogens, phytoestrogens, and tissue-specific drugs called selective estrogen receptor modulators (SERMs) have been explored. We discuss the promises and challenges of utilizing topical estrogens, SERMs, and phytoestrogens in postmenopausal skin management.
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Emmerson E, Hardman MJ. The role of estrogen deficiency in skin ageing and wound healing. Biogerontology 2011; 13:3-20. [PMID: 21369728 DOI: 10.1007/s10522-011-9322-y] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2010] [Accepted: 02/11/2011] [Indexed: 12/12/2022]
Abstract
The links between hormonal signalling and lifespan have been well documented in a range of model organisms. For example, in C. elegans or D. melanogaster, lifespan can be modulated by ablating germline cells, or manipulating reproductive history or pregnenolone signalling. In mammalian systems, however, hormonal contribution to longevity is less well understood. With increasing age human steroid hormone profiles change substantially, particularly following menopause in women. This article reviews recent links between steroid sex hormones and ageing, with special emphasis on the skin and wound repair. Estrogen, which substantially decreases with advancing age in both males and females, protects against multiple aspects of cellular ageing in rodent models, including oxidative damage, telomere shortening and cellular senescence. Estrogen's effects are particularly pronounced in the skin where cutaneous changes post-menopause are well documented, and can be partially reversed by classical Hormone Replacement Therapy (HRT). Our research shows that while chronological ageing has clear effects on skin wound healing, falling estrogen levels are the principle mediator of these effects. Thus, both HRT and topical estrogen replacement substantially accelerate healing in elderly humans, but are associated with unwanted deleterious effects, particularly cancer promotion. In fact, much current research effort is being invested in exploring the therapeutic potential of estrogen signalling manipulation to reverse age-associated pathology in peripheral tissues. In the case of the skin the differential targeting of estrogen receptors to promote healing in aged subjects is a real therapeutic possibility.
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Affiliation(s)
- Elaine Emmerson
- The University of Manchester, A V Hill Building, Manchester, UK
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Galarraga B, McSwiggan S, Caswell FR, Brodie RC, Sharma P, Abel EW, Newton DJ, Belch JJF. A novel approach to measuring skin elasticity in systemic sclerosis: results from a pilot study. Scand J Rheumatol 2011; 40:211-6. [PMID: 21231806 DOI: 10.3109/03009742.2010.530610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Systemic sclerosis (SSc) is characterized by progressive fibrosis of various organs, and causes hard, tethered, and inelastic skin. The modified Rodnan score is used to quantify skin involvement, but this method is subjective and user dependent. The aim of this study was to test the ability of a new skin torsion device to measure skin elasticity in patients with SSc. METHODS The study included 16 female SSc patients and 58 healthy controls. Skin elasticity was assessed on the forearms and backs of the hands using a new hand-held device that gently rotates the skin for 15 s to a maximum of 40 deg, and measures the speed of rotation and the angle of rotation at 15 s. Total and localized modified Rodnan scores were also documented. RESULTS Measurements produced by the skin torsion device had good intra-subject reproducibility, particularly in the control group. The SSc patients had significantly lower skin elasticity than an age-matched subgroup of control subjects, as determined by the median speed of rotation of the device in the hands (1.91 vs. 2.60 deg/s, p < 0.0001) and forearms (1.84 vs. 2.46 deg/s, p < 0.0001), and the rotation at 15 s in the hands (28.6 vs. 39.0 deg, p < 0.0001) and forearms (27.6 vs. 36.9 deg, p < 0.0001). The presence of SSc disease was the only independent predictor of skin elasticity. CONCLUSIONS This pilot study has shown the potential value of a new skin torsion device to assess skin involvement in patients with SSc.
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Affiliation(s)
- B Galarraga
- Vascular and Inflammatory Diseases Research Unit, The Institute of Cardiovascular Research, Dundee, UK
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Effects of a three-session skin rejuvenation treatment using stabilized hyaluronic acid-based gel of non-animal origin on skin elasticity: a pilot study. Arch Dermatol Res 2009; 302:37-45. [DOI: 10.1007/s00403-009-0988-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2009] [Revised: 07/20/2009] [Accepted: 08/04/2009] [Indexed: 10/20/2022]
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30
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Gerhardt LC, Lenz A, Spencer ND, Münzer T, Derler S. Skin-textile friction and skin elasticity in young and aged persons. Skin Res Technol 2009; 15:288-98. [DOI: 10.1111/j.1600-0846.2009.00363.x] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Segger D, Matthies A, Saldeen T. Supplementation with Eskimo®Skin Care improves skin elasticity in women. A pilot study. J DERMATOL TREAT 2009; 19:279-83. [DOI: 10.1080/09546630801958238] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Distante F, Pagani V, Bonfigli A. Stabilized hyaluronic acid of non-animal origin for rejuvenating the skin of the upper arm. Dermatol Surg 2009; 35 Suppl 1:389-93; discussion 394. [PMID: 19207331 DOI: 10.1111/j.1524-4725.2008.01051.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sumino H, Ichikawa S, Kasama S, Takahashi T, Kumakura H, Takayama Y, Kanda T, Murakami M, Kurabayashi M. Effects of raloxifene and hormone replacement therapy on forearm skin elasticity in postmenopausal women. Maturitas 2009; 62:53-7. [DOI: 10.1016/j.maturitas.2008.10.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2008] [Revised: 09/26/2008] [Accepted: 10/09/2008] [Indexed: 10/21/2022]
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Chiu YW, Moore RW, Hsu CE, Huang CT, Liu HW, Chuang HY. Factors influencing women's quality of life in the later half of life. Climacteric 2008; 11:201-11. [PMID: 18568785 DOI: 10.1080/13697130801946779] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Among older women in East Asia, and Taiwan in particular, there is little research on quality of life and the health care they receive to address the symptoms of menopause. This study evaluated factors which influence quality of life among post middle-age women in Taiwan. METHODS This cross-sectional study recruited 1250 women between 43 and 77 years of age during the year 2002. The factors investigated were demographics, menstruation status, menopausal symptoms, osteoporosis status, and use of hormone replacement therapy (HRT). SF-36 was used to assess the health-related quality of life of these women. Correlation, multiple regression and path analysis were used to test for direct and indirect relationships among the variables. RESULTS There are statistical significances between menopause symptoms and quality of life across different age groups. Path analysis shows a direct positive effect of HRT and a direct negative effect of climacteric symptoms on both physical and mental components of quality of life. Age, marital status, education and osteoporosis also have direct and indirect effects, some positive and others negative, on the components of quality of life. CONCLUSIONS When developing programs to enhance health in post middle-age women, consideration should be given to symptom relief as well as quality of life.
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Affiliation(s)
- Y-W Chiu
- Department of Community Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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Abstract
In recent years, growing importance has been afforded to assisting women in coping with the menopausal transition. Menopause is a normal stage of development and a woman's attitude toward this transition embodies biological, psychological and social influences. An enlarging body of conflicting data concerning menopausal hormone therapy (MHT) demands reassessment of established paradigms of disease prevention and menopausal health. Currently, a woman's decision to participate in or abstain from menopausal HT is personal. It involves not only consideration of risk stratification of potential harm and benefit, but also involves her expectations and attitudes toward perceived physical and emotional changes associated with this change. Through the use of extensive patient history, quality-of-life questionnaires and powerful biological profiling, we may be able to develop a rational approach to menopausal HT that safely guides our patients through this transition.
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Affiliation(s)
- Danielle Vitiello
- Division of Reproductive Endocrinology, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut, USA
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Sator PG, Sator MO, Schmidt JB, Nahavandi H, Radakovic S, Huber JC, Hönigsmann H. A prospective, randomized, double-blind, placebo-controlled study on the influence of a hormone replacement therapy on skin aging in postmenopausal women. Climacteric 2007; 10:320-34. [PMID: 17653959 DOI: 10.1080/13697130701444073] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND There is mounting evidence that menopause affects some functions of the skin. Hormone replacement therapy (HRT) appears to limit some of the climacteric aspects of cutaneous aging. OBJECTIVE In the light of a growing interest in the endocrinological influence of skin, we performed a study evaluating the effects of HRT on skin aging in postmenopausal women. METHODS Forty non-hysterectomized, postmenopausal women were included in this prospective, randomized, double-blind, placebo-controlled study on the influence of oral sequential treatment with a combination of 2 mg 17beta-estradiol/10 mg dydrogesterone (Femoston) for seven 28-day cycles. Skin elasticity, skin surface lipids, skin hydration and skin thickness were measured by non-invasive methods, and both adverse-event profile and clinical-dermatological status were evaluated. RESULTS After 7 months of HRT, skin elasticity increased significantly at the right ramus of the mandible, while skin hydration tended to improve significantly at the right upper arm (inner side); skin thickness improved significantly but skin surface lipids did not. Absolute effects did not differ significantly between HRT and placebo patients. A dermatological evaluation was largely consistent with measurement results. Safety and tolerability of HRT were positive. CONCLUSION The results showed improvements in the parameters involved in skin aging in the HRT group as compared to baseline. While skin aging is no indication for systemic hormone supplementation, a positive effect on aging skin can be observed.
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Affiliation(s)
- P-G Sator
- Division of Special and Environmental Dermatology, Department of Dermatology, Medical University of Vienna, General Hospital, Vienna, Austria
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37
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Bensaleh H, Belgnaoui FZ, Douira L, Berbiche L, Senouci K, Hassam B. Peau et ménopause. ANNALES D'ENDOCRINOLOGIE 2006; 67:575-80. [PMID: 17194967 DOI: 10.1016/s0003-4266(06)73009-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Important changes related to declining level of several hormones occur during menopause: vasomotor instability, bone loss, anxiety, sexual dysfunction, skin aging... Our objective was a review of the literature concerning the histological and clinical changes seen in post menopausal skin, and also an analysis of the effect of hormonal replacement therapy in slowing down the aging process. Decline in progesterone increases the impact of androgen on the sebaceous glands and hair. Decreased estrogen slows down mitotic activity in the epidermal basal layer, reduces the synthesis of collagen and contributes to thickening of the dermo-epidermal junction. This hypoestrogenemia may be spontaneously attenuated by local synthesis of oestradiol in peripheral target tissues according to the intracrine process. This new hormonal pattern is associated with skin atrophy, hyperseborrhea, increased pilosity on the cheeks and upper lip, loss of scalp hair, increase in degeneration of elastic tissue, atrophy and dryness of the vaginal mucosa. Estrogen treatment in post menopausal women has been shown to increase collagen content, dermal thickness and elasticity. Biophysical properties are also significantly improved for the parameters reflecting hydration and sebum secretion. However, numerous side effects such as increased incidence of cancer and cardiovascular morbidity limit the use of this treatment. So non hormonal alternatives are proposed. Laser and lifting remain the most important options.
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Affiliation(s)
- H Bensaleh
- Service de Dermatologie, CHU Ibn Sina Rabat, Morocco.
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38
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Qu L, Abe M, Yokoyama Y, Ishikawa O. Effects of 17beta-estradiol on matrix metalloproteinase-1 synthesis by human dermal fibroblasts. Maturitas 2005; 54:39-46. [PMID: 16280215 DOI: 10.1016/j.maturitas.2005.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2005] [Revised: 08/09/2005] [Accepted: 08/23/2005] [Indexed: 11/25/2022]
Abstract
BACKGROUND Hormone replacement therapy (HRT) has been used in treatment of various menopausal disorders. It has been well documented that HRT increases the amount of dermal collagen and skin thickness in vivo. However little is known about the effects of female sex hormones on dermal fibroblasts in vitro. OBJECTIVE The aim of this study is to determine whether or not 17beta-estradiol affects mRNA expression and production of type I collagen, matrix metalloproteinases-1 (MMP-1), tissue inhibitor metalloproteinases-1 (TIMP-1) or transforming growth factor-beta1 (TGF-beta1) by human dermal fibroblasts. METHODS Fibroblasts were cultured with and without 17beta-estradiol for 6h. We evaluated the changes of mRNA expressions and protein production of type I collagen, MMP-1, TIMP-1 and TGF-beta1. RESULTS The mRNA expressions of collagen alpha1(I), MMP-1, TIMP-1, TGF-beta1 were not changed by 17beta-estradiol stimulations at a concentration of 10(-12) to 10(-8) M. However, 17beta-estradiol at concentrations of 10(-12) and 10(-10) M exhibited inhibitory effects on proMMP-1, but not type I collagen or TIMP-1 synthesis. The synthesis of TGF-beta1 by fibroblasts stimulated with 10(-8) M of estradiol was significantly increased as compared with the control. However, the level of TGF-beta type II receptor phosphorylation was not elevated under the same conditions. CONCLUSION Suppressed synthesis of MMP-1 at a low concentration of 17beta-estradiol may be partly involved in the dermal tissue remodeling to inhibit the degradative change.
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Affiliation(s)
- LuDan Qu
- Department of Dermatology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan.
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39
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Miga MI, Rothney MP, Ou JJ. Modality independent elastography (MIE): potential applications in dermoscopy. Med Phys 2005; 32:1308-20. [PMID: 15984683 DOI: 10.1118/1.1895795] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The use of palpation information for skin disease characterization is not as commonly used as in other soft tissues, although mechanical differences within lesions have been noted. For example, regions of hyperkeratosis have the potential to transform into cancerous lesions and likely feature different material properties from those of surrounding normal tissue due to varying cytoarchitecture. As a result, the spatial distribution of lesion mechanical properties may serve to assist a diagnosis or enhance visualization of the complete extent of a cancerous region, i.e., accurate information regarding the margins of disease for surgical therapy. In this work, a multiresolution extension to a novel elastographic imaging method called Modality Independent Elastography (MIE) is used to characterize the mechanical properties of a skin-like phantom embedded with a mock stiff lesion. Simulation studies were also performed to investigate the potential for characterizing realistic melanoma lesions. Elasticity image reconstructions from the phantom experiments localized the stiff inclusion and had good correlation between the Young's modulus contrast ratio and experimental measurements from material testing. In addition, multiresolution MIE was shown to be a more robust framework than its single-resolution version. Results from the melanoma simulation demonstrate the potential for using multiresolution MIE with dermoscopic images.
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Affiliation(s)
- Michael I Miga
- Vanderbilt University, Department of Biomedical Engineering, Nashville, Tennessee 37235, USA
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40
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Draelos ZD. Topical and oral estrogens revisited for antiaging purposes. Fertil Steril 2005; 84:291-2; discussion 295. [PMID: 16084864 DOI: 10.1016/j.fertnstert.2005.03.033] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2005] [Revised: 03/21/2005] [Accepted: 03/21/2005] [Indexed: 11/24/2022]
Abstract
Topical and oral estrogens are beneficial in maintaining skin firmness and elasticity in postmenopausal women. The positive cutaneous effects of estrogen were overlooked in the Women's Health Initiative trial.
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Affiliation(s)
- Zoe Diana Draelos
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
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Abstract
Oestrogens have significant effects on different cell types important in skin physiology, including the epidermal keratinocytes, dermal fibroblasts and melanocytes. In addition, they can also modulate skin appendages such as the hair follicle, the sebaceous gland and the apocrine glands. Oestrogens may also have important modulatory roles in events such as skin ageing, pigmentation, hair growth, sebum production and skin cancer. It is now recognised that oestrogens can modulate their actions via two distinct intracellular receptors (ERalpha and ERbeta) or via cell surface receptors, which activate specific second messenger signalling pathways. This paper highlights the effects of oestrogens on different components of the skin and reviews some of the more recent developments in terms of receptor expression and cell signalling pathways.
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Affiliation(s)
- M J Thornton
- Department of Biomedical Sciences, University of Bradford, Bradford, West Yorkshire, BD7 1DP, UK.
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Sell DR, Biemel KM, Reihl O, Lederer MO, Strauch CM, Monnier VM. Glucosepane Is a Major Protein Cross-link of the Senescent Human Extracellular Matrix. J Biol Chem 2005; 280:12310-5. [PMID: 15677467 DOI: 10.1074/jbc.m500733200] [Citation(s) in RCA: 160] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
The extracellular matrix in most tissues is characterized by progressive age-related stiffening and loss of proteolytic digestibility that are accelerated in diabetes and can be duplicated by the nonenzymatic reaction of reducing sugars and extracellular matrix proteins. However, most cross-links of the Maillard reaction described so far are present in quantities too low to account for these changes. Here we have determined in human skin and glomerular basement membrane (GBM) collagen the levels of the recently discovered lysine-arginine cross-links derived from glucose, methylglyoxal, glyoxal, and 3-deoxyglucosone, i.e. glucosepane, MODIC, GODIC, and DOGDIC, respectively. Insoluble preparations of skin collagen (n = 110) and glomerular basement membrane (GBM, n = 28) were enzymatically digested, and levels were measured by isotope dilution technique using liquid chromatography/mass spectrometry. In skin, all cross-links increased with age (p < 0.0001) except DOGDIC (p = 0.34). In nondiabetic controls, levels at 90 years were 2000, 30, and 15 pmol/mg for glucosepane, MODIC, and GODIC, respectively. Diabetes, but not renal failure, increased glucosepane to 5000 pmol/mg (p < 0.0001), and for all others, increased it to <60 pmol/mg (p < 0.01). In GBMs, glucosepane reached up to 500 pmol/mg of collagen and was increased in diabetes (p < 0.0001) but not old age. In conclusion, glucosepane is the single major cross-link of the senescent extracellular matrix discovered so far, accounting for up to >120 mole% of triple helical collagen modification in diabetes. Its presence in high quantities may contribute to a number of structural and cell matrix dysfunctions observed in aging and diabetes.
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Affiliation(s)
- David R Sell
- Institute of Pathology, School of Medicine, Case Western Reserve University, Cleveland, Ohio 44106, USA.
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