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Wiinberg M, Andresen TL, Haedersdal M, Olesen UH. Ablative fractional CO 2 laser treatment promotes wound healing phenotype in skin macrophages. Lasers Surg Med 2024; 56:270-278. [PMID: 38409449 DOI: 10.1002/lsm.23772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/12/2024] [Accepted: 02/13/2024] [Indexed: 02/28/2024]
Abstract
OBJECTIVES Ablative fractional laser (AFL) treatment is a well-established method for reducing signs of skin photoaging. However, the biological mechanisms underlying AFL-induced healing responses and skin rejuvenation remain largely unknown. It is known that macrophages play an important role in orchestrating healing, normalization, and remodeling processes in skin. Macrophage phenotypes are characterized by inflammatory markers, including arginase-1 (Arg1), major histocompatibility class II molecules (MHC II), and CD206. This study aims to explore AFL's effect on macrophage phenotype by evaluating changes in inflammatory markers and the potential concurrent accumulation of Arg1 in the skin. METHODS Mice (n = 9) received a single AFL treatment on the left side of the back skin (100 mJ/microbeam, 5% density) while the right side of the back remained untreated as control. Treated and untreated skin from each mouse were collected Day 5 posttreatment for flow cytometry and histology analysis. Flow cytometry evaluated the immune infiltration of macrophages and the expression of macrophage inflammatory markers (Arg1, MHC II, and CD206). In addition, Arg1 presence in the skin was evaluated through antibody staining of histology samples and quantification was performed using QuPath image analysis software. RESULTS Following AFL, the number of macrophages increased 11-fold (p = 0.0053). Phenotype analysis of AFL-treated skin revealed an increase in the percentage of macrophages positive for Arg1 (p < 0.0001) and a decrease in the percentage of macrophages positive for MHC II (p < 0.0001) compared to untreated skin. No significant differences were observed in percentage of CD206-positive macrophages (p = 0.8952). Visualization of AFL-treated skin demonstrated a distinct pattern of Arg1 accumulation that correlated with the microscopic treatment zones (MTZ). Quantification of the percentage of Arg1-positive area in epidermis and dermis showed a significant increase from 3.5% ± 1.2% to 5.2% ± 1.7 (p = 0.0232) and an increase from 2.2% ± 1.2% to 9.6% ± 3.3 (p < 0.0001) in whole skin samples. CONCLUSION AFL treatment polarizes macrophages toward a wound healing phenotype and induces Arg1 accumulation in the MTZ. We propose that the polarized wound healing macrophages are a major source for the increased Arg1 levels observed in the skin following treatment.
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Affiliation(s)
- Martin Wiinberg
- Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Thomas L Andresen
- Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Merete Haedersdal
- Department of Dermatology, Copenhagen University Hospital-Bispebjerg, Copenhagen, Denmark
| | - Uffe H Olesen
- Department of Dermatology, Copenhagen University Hospital-Bispebjerg, Copenhagen, Denmark
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Pedersen KK, Granborg JR, Lerche CM, Litman T, Olesen UH, Hædersdal M. Ablative fractional laser treatment reduces hedgehog pathway gene expression in murine basal cell carcinomas. Lasers Med Sci 2024; 39:55. [PMID: 38308119 PMCID: PMC10837214 DOI: 10.1007/s10103-024-03997-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/18/2024] [Indexed: 02/04/2024]
Abstract
This study aimed to investigate the impact of ablative fractional laser (AFL) on hedgehog pathway gene expression in murine microscopic basal cell carcinomas (BCCs) and compare these results to the effect of topical treatment with vismodegib, an FDA-approved hedgehog inhibitor. In 25 mice, 1 cm2 skin test sites (n = 44) containing microscopic BCCs were exposed to one of three interventions: a single CO2 AFL treatment (1 pulse, 40 mJ/microbeam, wavelength 10.6 μm, 5% density, pulse rate 250 Hz, n = 12), eight topical vismodegib treatments (3.8 mg/mL, n = 8), or combination of AFL and vismodegib treatments (n = 9). Untreated controls were included for comparison (n = 15). After 4 days, skin samples were analyzed for hedgehog gene expression (Gli1, Gli2, and Ptch1) by qPCR and vismodegib concentrations by liquid chromatography mass spectrometry (data analyzed with two-tailed t-tests and linear regression). A single treatment with AFL monotherapy significantly reduced hedgehog gene expression compared to untreated controls (Gli1 72.4% reduction, p = 0.003; Gli2 55.2%, p = 0.010; Ptch1 70.9%, p < 0.001). Vismodegib treatment also reduced hedgehog gene expression (Gli1 91.6%; Gli2 83.3%; Ptch1 83.0%), significantly surpassing AFL monotherapy for two out of three genes (Gli1, p = 0.017; Gli2, p = 0.007; Ptch1, p = 0.15). AFL and vismodegib combination mirrored the effects of vismodegib monotherapy (Gli1, p = 0.424; Gli2, p = 0.289; Ptch1, p = 0.593), possibly due to comparable cutaneous vismodegib concentrations (mean ± SD, vismodegib monotherapy 850 ± 475 µmol/L; combination 1036 ± 824 µmol/L; p = 0.573). In conclusion, a single AFL treatment significantly reduced hedgehog gene expression in murine BCCs mimicking the effects of eight topical applications of vismodegib. Further studies are needed to assess whether AFL can be utilized for BCC treatment, either as monotherapy or in combination with other drugs.
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Affiliation(s)
- Kristian Kåber Pedersen
- Department of Dermatology, Copenhagen University Hospital Bispebjerg, 2400, Copenhagen, Denmark
| | - Jonatan Riber Granborg
- Department of Dermatology, Copenhagen University Hospital Bispebjerg, 2400, Copenhagen, Denmark
| | - Catharina Margrethe Lerche
- Department of Dermatology, Copenhagen University Hospital Bispebjerg, 2400, Copenhagen, Denmark
- Department of Pharmacy, University of Copenhagen, 2100, Copenhagen, Denmark
| | - Thomas Litman
- Department of Immunology and Microbiology, University of Copenhagen, 2200, Copenhagen, Denmark
- Molecular Biomedicine, LEO Pharma A/S, 2750, Ballerup, Denmark
| | - Uffe Høgh Olesen
- Department of Dermatology, Copenhagen University Hospital Bispebjerg, 2400, Copenhagen, Denmark.
| | - Merete Hædersdal
- Department of Dermatology, Copenhagen University Hospital Bispebjerg, 2400, Copenhagen, Denmark
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3
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Blackstone BN, Malara MM, Baumann ME, McFarland KL, Supp DM, Powell HM. Laser Micropatterning Promotes Rete Ridge Formation and Enhanced Engineered Skin Strength without Increased Inflammation. Bioengineering (Basel) 2023; 10:861. [PMID: 37508888 PMCID: PMC10376754 DOI: 10.3390/bioengineering10070861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/11/2023] [Accepted: 07/15/2023] [Indexed: 07/30/2023] Open
Abstract
Rete ridges play multiple important roles in native skin tissue function, including enhancing skin strength, but they are largely absent from engineered tissue models and skin substitutes. Laser micropatterning of fibroblast-containing dermal templates prior to seeding of keratinocytes was shown to facilitate rete ridge development in engineered skin (ES) both in vitro and in vivo. However, it is unknown whether rete ridge development results exclusively from the microarchitectural features formed by ablative processing or whether laser treatment causes an inflammatory response that contributes to rete ridge formation. In this study, laser-micropatterned and non-laser- treated ES grafts were developed and assessed during culture and for four weeks post grafting onto full-thickness wounds in immunodeficient mice. Decreases in inflammatory cytokine secretion were initially observed in vitro in laser-treated grafts compared to non-treated controls, although cytokine levels were similar in both groups five days after laser treatment. Post grafting, rete ridge-containing ES showed a significant increase in vascularization at week 2, and in collagen deposition and biomechanics at weeks 2 and 4, compared with controls. No differences in inflammatory cytokine expression after grafting were observed between groups. The results suggest that laser micropatterning of ES to create rete ridges improves the mechanical properties of healed skin grafts without increasing inflammation.
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Affiliation(s)
- Britani N Blackstone
- Department of Materials Science and Engineering, The Ohio State University, 140 W 19th Avenue, Columbus, OH 43210, USA
| | - Megan M Malara
- Department of Materials Science and Engineering, The Ohio State University, 140 W 19th Avenue, Columbus, OH 43210, USA
| | - Molly E Baumann
- Department of Biomedical Engineering, The Ohio State University, 140 W 19th Avenue, Columbus, OH 43210, USA
| | - Kevin L McFarland
- Department of Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH 45267, USA
| | - Dorothy M Supp
- Department of Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH 45267, USA
- Center for Stem Cell & Organoid Medicine (CuSTOM), Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
- Shriners Children's Ohio, 1 Children's Plaza, Dayton, OH 45404, USA
| | - Heather M Powell
- Department of Materials Science and Engineering, The Ohio State University, 140 W 19th Avenue, Columbus, OH 43210, USA
- Department of Biomedical Engineering, The Ohio State University, 140 W 19th Avenue, Columbus, OH 43210, USA
- Shriners Children's Ohio, 1 Children's Plaza, Dayton, OH 45404, USA
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4
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Abed K, Foucher A, Bernard D, Tancrède-Bohin E, Cavusoglu N. One-year longitudinal study of the stratum corneum proteome of retinol and all-trans-retinoic acid treated human skin: an orchestrated molecular event. Sci Rep 2023; 13:11196. [PMID: 37433822 DOI: 10.1038/s41598-023-37750-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/27/2023] [Indexed: 07/13/2023] Open
Abstract
Topically applied all-trans-retinoic acid (RA) is a gold-standard anti-aging molecule used in dermatology. As its cosmetic counterpart used in anti-aging, Retinol (ROL) is also a known metabolic precursor of RA. Despite this metabolic link, they haven't been compared exhaustively in vivo at a mechanistic level. Therefore, to highlight the effect of a topical application of both molecules on in vivo skin, we undertook a longitudinal 1-year study and performed an untargeted proteomic analysis to get a more holistic view on the underlying biological mechanisms of action. The generation of the temporal proteomics signatures of retinol and all-trans-retinoic acid reveals the impact of these molecules on biological functions related to the aging of skin. New biological functions impacted by retinoids were discovered: glycan metabolism and protein biosynthesis. In addition, the temporal analysis reveals highest modulations at early time points while the physical measures, such as epidermal thickening, was mostly observed at the latest time point, demonstrating a strong time lapse between molecular and morphological impacts. Finally, these global temporal signatures could be used to identify new cosmetic compounds of interest.
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Affiliation(s)
- Kahina Abed
- L'Oréal Research and Innovation, Aulnay-Sous-Bois, France.
| | - Aude Foucher
- L'Oréal Research and Innovation, Aulnay-Sous-Bois, France
| | | | - Emmanuelle Tancrède-Bohin
- L'Oréal Research and Innovation, Aulnay-Sous-Bois, France
- Service de Dermatologie, Hôpital Saint-Louis, Paris, France
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5
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Garza LA, Sheu M, Kim N, Tsai J, Alessi Cesar SS, Lee J, Hawkins SS, Chien AL, Kang S. Association of Early Clinical Response to Laser Rejuvenation of Photoaged Skin with Increased Lipid Metabolism and Restoration of Skin Barrier Function. J Invest Dermatol 2023; 143:374-385.e7. [PMID: 36055399 PMCID: PMC9971340 DOI: 10.1016/j.jid.2022.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 06/25/2022] [Accepted: 07/18/2022] [Indexed: 10/14/2022]
Abstract
Laser resurfacing treatments for photoaged skin have improved dramatically over the past decades, but few studies have examined the molecular mechanisms underlying differences in clinical response. Seventeen white female participants with moderate-to-severe photoaging received nonablative fractional laser treatment on the face and forearm once monthly for 6 months. Biopsies for microarray analysis were performed at baseline and 7 days after facial treatment and at baseline and 1, 7, 14, and 29 days after forearm treatment in each participant, resulting in 119 total samples. Participants were stratified into fast (n = 11) and slow (n = 6) responders on the basis of the presence of clinical improvement after the first treatment. Microarray analysis revealed the upregulation of genes associated with matrix metalloproteinases, collagen and extracellular components, TGF-β signaling, double-stranded RNA signaling, and retinoic acid synthesis after treatment that did not differ significantly between fast and slow responders. Cluster and enrichment analyses suggested significantly greater activation of lipid metabolism and keratinocyte differentiation in fast responders, who showed greater upregulation of acyltransferases, fatty acid elongases, fatty acid 2-hydroxylase, fatty acid desaturases, and specific keratins that may contribute to epidermal barrier function. These results create, to our knowledge, a previously unreported atlas of molecular changes that correlate with improvements in photoaging after laser therapy.
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Affiliation(s)
- Luis A Garza
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mary Sheu
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Noori Kim
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jerry Tsai
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Sabrina S Alessi Cesar
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jianming Lee
- Unilever Human Biology Science and Technology, Trumbull, Connecticut, USA
| | - Stacy S Hawkins
- Unilever Human Biology Science and Technology, Trumbull, Connecticut, USA
| | - Anna L Chien
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Sewon Kang
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
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Klimek P, Placek W, Owczarczyk-Saczonek A. Fractional Ablative Carbon Dioxide Lasers for the Treatment of Morphea: A Case Series and Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138133. [PMID: 35805793 PMCID: PMC9266234 DOI: 10.3390/ijerph19138133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/17/2022] [Accepted: 06/30/2022] [Indexed: 02/01/2023]
Abstract
Morphea is an inflammatory, immune-mediated disease of unknown aetiology. It is characterised by excessive collagen deposition, which leads to the hardening of the dermis and subcutaneous tissues. The disease is associated with cosmetic and functional impairment, which can affect the patients’ quality of life. Fractional ablative lasers (FALs) are currently used for the treatment of many skin diseases that are connected to tissue fibrosis due to the low risk of side effects and their great effectiveness. This study aimed to improve the aesthetic defects that are caused by morphea lesions and assess the efficacy and safety of FAL use in this indication. We also reviewed the literature on the subject. We present four women with biopsy-proven morphea, manifesting as hyperpigmented plaques and patches. One of the patients additionally had morphea-related knee joint contracture. Four fractional CO2 laser sessions, separated by one-month intervals, were performed and produced significant improvements in dyspigmentation and induration. An improved elasticity and a decrease in dermal thickness were also obtained, as proven by measurements using DermaLab Combo. No severe adverse effects occurred. Based on these cases presented by the authors, fractional CO2 lasers appear to be an effective, well-tolerated, and safe therapeutic option for patients suffering from morphea.
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7
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Caliskan E, Botsali A. Combination of Full-Field and Fractional Erbium: YAG Laser for Nonhealing Wounds. Dermatol Surg 2022; 48:114-119. [PMID: 34772834 DOI: 10.1097/dss.0000000000003292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND To evaluate the outcomes of a heterogeneous group of patients with chronic ulcer receiving a combination regimen of full-field and fractional erbium-doped yttrium aluminum garnet (erbium: YAG) laser applications. METHODS Enrolled in this study were patients with chronic ulcer who had received at least 2 erbium: YAG laser sessions. Fractional applications followed the initial full-field application for debridement. The therapeutic outcomes were evaluated by serial photographs. The primary outcome measure was the proportion of patients achieving complete re-epithelialization at the first year. RESULTS Forty-three treatment regions from 23 patients between 40 and 90 years (F: M = 11:12; age: 60.3 ± 15.5 years, mean ± SD) were eligible. The ulcers' median duration was 24 months (min-max: 2-240 months). The median number of laser sessions was 5 (min-max: 2-12). Of arterial (n = 13), immunologic (n = 9), venous (n = 8), diabetic (n = 8), and mechanical ulcers (n = 5), the primary outcome measure was achieved in 69%, 77.7%, 75%, 88.8%, and 100% of the groups, respectively. CONCLUSION Full-field erbium: YAG laser applications preserve the vascular architecture and enable delicate debridement. Ongoing maintenance fractional laser sessions promote wound healing. Similar to the previous reports of erbium: YAG laser in venous and diabetic ulcers, arterial ulcers, and ulcers of immunologic origin demonstrated an objective treatment response along with different adjuvant approaches.
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Affiliation(s)
- Ercan Caliskan
- Both authors are affiliated with the Department of Dermatology, Gülhane Faculty of Medicine, University of Health Sciences, Keçiören, Turkey
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Transcriptomic analysis of human skin wound healing and rejuvenation following ablative fractional laser treatment. PLoS One 2021; 16:e0260095. [PMID: 34843523 PMCID: PMC8629261 DOI: 10.1371/journal.pone.0260095] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 11/02/2021] [Indexed: 11/19/2022] Open
Abstract
Ablative fractional laser treatment is considered the gold standard for skin rejuvenation. In order to understand how fractional laser works to rejuvenate skin, we performed microarray profiling on skin biopsies to identify temporal and dose-response changes in gene expression following fractional laser treatment. The backs of 14 women were treated with ablative fractional laser (Fraxel®) and 4 mm punch biopsies were collected from an untreated site and at the treated sites 1, 3, 7, 14, 21 and 28 days after the single treatment. In addition, in order to understand the effect that multiple fractional laser treatments have on skin rejuvenation, several sites were treated sequentially with either 1, 2, 3, or 4 treatments (with 28 days between treatments) followed by the collection of 4 mm punch biopsies. RNA was extracted from the biopsies, analyzed using Affymetrix U219 chips and gene expression was compared between untreated and treated sites. We observed dramatic changes in gene expression as early as 1 day after fractional laser treatment with changes remaining elevated even after 1 month. Analysis of individual genes demonstrated significant and time related changes in inflammatory, epidermal, and dermal genes, with dermal genes linked to extracellular matrix formation changing at later time points following fractional laser treatment. When comparing the age-related changes in skin gene expression to those induced by fractional laser, it was observed that fractional laser treatment reverses many of the changes in the aging gene expression. Finally, multiple fractional laser treatments, which cover different regions of a treatment area, resulted in a sustained or increased dermal remodeling response, with many genes either differentially regulated or continuously upregulated, supporting previous observations that maximal skin rejuvenation requires multiple fractional laser treatments. In conclusion, fractional laser treatment of human skin activates a number of biological processes involved in wound healing and tissue regeneration.
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9
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Laser Therapy for the Treatment of Morphea: A Systematic Review of Literature. J Clin Med 2021; 10:jcm10153409. [PMID: 34362192 PMCID: PMC8347526 DOI: 10.3390/jcm10153409] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/23/2021] [Accepted: 07/27/2021] [Indexed: 02/07/2023] Open
Abstract
Morphea, also known as localized scleroderma (LoS), comprises a set of autoimmune sclerotic skin diseases. It is characterized by inflammation and limited thickening and induration of the skin; however, in some cases, deeper tissues might also be involved. Although morphea is not considered a life-threatening disease, the apparent cosmetic disfigurement, functional or psychosocial impairment affects multiple fields of patients’ quality of life. Therapy for LoS is often unsatisfactory with numerous treatments that have only limited effectiveness or considerable side effects. Due to the advances in the application of lasers and their possible beneficial effects, the aim of this study is to review the reported usage of laser in morphea. We present a systematic review of available literature, performed with MEDLINE, Cinahl, Central, Scopus, Web of Science, and Google Scholar databases. We identified a total of twenty relevant studies (MEDLINE n = 10, Cinahl n = 1, Central n = 0, Scopus n = 2, Web of Science n = 5, Google Scholar n = 2) using laser therapy for LoS. Eight studies were focused on the use of PDL, six on fractional lasers (CO2 and Er:YAG), four on excimer, and two on either alexandrite or Nd:YAG.
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Flagler MJ, Tamura M, Laughlin T, Hartman S, Ashe J, Adams R, Kozak K, Cresswell K, Mullins L, Jarrold BB, Isfort RJ, Sherrill JD. Combinations of peptides synergistically activate the regenerative capacity of skin cells in vitro. Int J Cosmet Sci 2021; 43:518-529. [PMID: 34272744 PMCID: PMC9291327 DOI: 10.1111/ics.12725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 07/02/2021] [Accepted: 07/15/2021] [Indexed: 11/28/2022]
Abstract
Objective To explore synergistic effects related to skin regeneration, peptides with distinct biological mechanisms of action were evaluated in combination with different skin cell lines in the presence or absence of niacinamide (Nam). Furthermore, the synergistic responses of peptide combinations on global gene expression were compared with the changes that occur with fractional laser resurfacing treatment, a gold standard approach for skin rejuvenation, to further define optimal peptide combinations. Methods Microarray profiling was used to characterize the biological responses of peptide combinations (+/− Nam) relative to the individual components in epidermal keratinocyte and dermal fibroblast cell lines. Cellular functional assays were utilized to confirm the synergistic effects of peptide combinations. Bioinformatics approaches were used to link the synergistic effects of peptide combinations on gene expression to the transcriptomics of the skin rejuvenation response from fractional laser treatment. Results Microarray analysis of skin cells treated with peptide combinations revealed synergistic changes in gene expression compared with individual peptide controls. Bioinformatic analysis of synergy genes in keratinocytes revealed the activation of NRF2‐mediated oxidative stress responses by a combination of Ac‐PPYL, Pal‐KTTKS and Nam. Additional analysis revealed direct downstream transcriptional targets of NRF2/ARE exhibiting synergistic regulation by this combination of materials, which was corroborated by a cellular reporter assay. NRF2‐mediated oxidative stress response pathways were also found to be activated in the transcriptomics of the early skin rejuvenation response to fractional laser treatment, suggesting the importance of this biology in the early stages of tissue repair. Additionally, the second combination of peptides (pal‐KT and Ac‐PPYL) was found to synergistically restore cellular ATP levels that had been depleted due to the presence of ROS, indicating an additional mechanism, whereby peptide synergies may accelerate skin repair. Conclusion Through combinatorial synergy studies, we have identified additional in vitro skin repair mechanisms beyond the previously described functions of individual peptides and correlated these to the transcriptomics of the skin rejuvenation response of fractional laser treatment. These findings suggest that specific peptides can act together, via complementary and synergistic mechanisms, to holistically enhance the regenerative capacity of in vitro skin cells.
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Affiliation(s)
| | - Makio Tamura
- The Procter & Gamble Company, Cincinnati, Ohio, USA
| | - Tim Laughlin
- The Procter & Gamble Company, Cincinnati, Ohio, USA
| | | | - Julie Ashe
- The Procter & Gamble Company, Cincinnati, Ohio, USA
| | - Rachel Adams
- The Procter & Gamble Company, Cincinnati, Ohio, USA
| | - Kim Kozak
- The Procter & Gamble Company, Cincinnati, Ohio, USA
| | | | - Lisa Mullins
- The Procter & Gamble Company, Cincinnati, Ohio, USA
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11
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Jordão JM, Stoliar MFF, Melo SS, de Campos GLM, de Forville Mesquita LA, Skare TL. Low-fluence and low-density CO2 laser: histological analysis of collagen fiber changes in skin and its clinical repercussions in photorejuvenation. Lasers Med Sci 2021; 37:905-911. [PMID: 34009520 DOI: 10.1007/s10103-021-03330-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 05/03/2021] [Indexed: 10/21/2022]
Abstract
This study refers to clinical and histologic analysis of effects on photorejuvenation after one single treatment of fractional CO2 laser with low fluence and low density. To analyze histologically the quantitative variation of collagen fibers type I and III, elastic fibers, and epidermal thickness on D84, besides clinical evaluation of amount, length, thickness, and depth of periocular wrinkles during the same period. This is an open, prospective, interventional study. There were 40 healthy female with age between 35 and 65 years. Twenty-six participants were randomly selected for D0 and D84 biopsy. A single session of fractional CO2 laser was done in the hole face, using a 800-µm tip, 5% density, and 10 mJ fluence with a single pass. On D0, D42, and D84, a clinical comparative analysis of amount, length, depth, and thickness of periocular wrinkles has been done. On histological analysis, a comparative quantitative evaluation of collagen fibers type I and III, elastic fibers, and epidermal thickness has been done on D0 and D84. The results of this study denoted a significant clinical improvement of amount (- 32.17%; p < 0.0001), thickness (- 33%; p < 0.0001), lenght (- 35.84%; p < 0.0001), and depth of periocular wrinkles (- 32.46%; p < 0.0001). A significant increase in the amount of collagen fibers type III was observed on D84 (+ 60.67%; p = 0.0013). Collagen fibers type I and elastic fibers did not have the same result, with a nonsignificant increase (+ 8.31%; p = 0.3820) and a decrease (- 12.4%; p = 0.0585) respectively. Epidermal thickness has a tendency to significant variation (p = 0.05553). The results demonstrate that fractional CO2 laser with low fluence and low density is a safe and efficient option for photorejuvenation of the face.
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Affiliation(s)
- Juliana Merheb Jordão
- Head of Laser Therapy Dermatology Department, Hospital Universitário Evangélico Mackenzie, Curitiba, PR, Brazil.
| | | | - Sarah Sanches Melo
- Dermatology Department, Hospital Universitário Evangélico Mackenzie, Curitiba, PR, Brazil
| | | | | | - Thelma Larocca Skare
- Rheumatology Department, Hospital Universitário Evangélico Mackenzie, Curitiba, PR, Brazil
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12
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Elgarhy LH, El-Tatawy RA, Abdelaziz D, Dogheim NN. Pulsed dye laser versus ablative fractional CO 2 laser in treatment of old hypertrophic scars: Clinicopathological study. Wound Repair Regen 2021; 29:417-424. [PMID: 33599018 DOI: 10.1111/wrr.12904] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/29/2021] [Accepted: 02/04/2021] [Indexed: 12/14/2022]
Abstract
There is a continuous need to find out the best treatment for old hypertrophic scars (OHSs). Thirty patients with OHSs were included. Each scar was divided into right half treated with PDL (handpiece with a 7-mm spot, pulse duration of 1.5 ms and fluence of 6 J/cm2 ) and left half treated with FrCo2 laser (15 W, spacing 800 μm, dwelling time 600 μs and stack 3) once every month for three sessions. Scars were assessed before and after treatment clinically by Vancouver Scar Scale (VSS) and histologically using hematoxylin and eosin (H&E), Masson trichrome and orcein stains. Both halves showed statistically significant improvement after treatment. However, there was no statistically significant difference in VSS between them (P = 0.176). FrCo2 laser showed more significant improvement in pliability and height (Pp = 0.017, Ph = 0,011), while, PDL showed more significant improvement in vascularity (P = 0.039) of OHSs. Both PDL and ablative FrCo2 laser were effective in the treatment of OHSs, however, FrCo2 laser was more effective in improving OHSs pliability, and height which are the main concern in OHSs.
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Affiliation(s)
- Lamia Hamouda Elgarhy
- Department of Dermatology & Venereology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Rania Ahmed El-Tatawy
- Department of Dermatology & Venereology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Dareen Abdelaziz
- Department of Dermatology & Venereology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Noha Nabil Dogheim
- Department of Dermatology & Venereology, Faculty of Medicine, Tanta University, Tanta, Egypt
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Safety of Combined Fractional Microneedle Radiofrequency and CO2 as an Early Intervention for Inflammatory Acne and Scarring Treated With Concomitant Isotretinoin. Dermatol Surg 2021; 46:e71-e77. [PMID: 32187040 DOI: 10.1097/dss.0000000000002364] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Fractional microneedle radiofrequency (FMRF) systems are popular options for treating acne scars. However, treatment efficacy when used in combination with traditional ablative fractional laser (AFL) and the safety profile with concomitant use of isotretinoin remain unknown. OBJECTIVE The aim of this study was to assess the safety and efficacy of an early intervention combination treatment protocol for inflammatory acne and acne scars. MATERIALS AND METHODS The electronic records of 71 patients with inflammatory acne and acne scars were included in this retrospective observational study. Data were collected for all patients who received combination FMRF and AFL. Within the study group, 43 patients were receiving low-dose isotretinoin or had completed isotretinoin within the past 3 weeks. RESULTS The mean Scar Global Assessment score significantly decreased after 3 sessions of combination treatment (n = 71). Patients with inflammatory acne showed a significant decrease in the number of inflammatory lesions (n = 30). Patients with concomitant low-dose isotretinoin use reported a further decrease in Scar Global Assessment score (n = 43). There were no reported persistent side effects, including prolonged inflammatory reaction or scarring. CONCLUSION Combination treatment with FMRF and AFL is an effective and well-tolerated treatment modality for acne scars and inflammatory acne.
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High- Versus Low-Density Fractional Laser in the Treatment of Hypertrophic Postburn Scars: A Randomized Clinical Trial. Dermatol Surg 2021; 46:e38-e44. [PMID: 31851017 DOI: 10.1097/dss.0000000000002293] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Fractional CO2 laser has been shown effective in improving pigmentation, pruritus, and tightness of hypertrophic burn scars. However, there is no consensus on the optimal treatment parameters. OBJECTIVE To compare effectiveness of different densities of fractional CO2 laser in the treatment of mature hypertrophic burn scars. MATERIALS AND METHODS The study included 25 patients, each with 3 or more mature hypertrophic burn scars. Scars were randomly assigned to treatment with low-, medium-, and high-density fractional CO2 laser. Each scar received 3 sessions of laser at 1-month interval. The degree of improvement was assessed clinically using Vancouver Scar Scale (VSS) and Patient and Observer Scar Assessment Scale (POSAS) scores, and histologically through evaluation of collagen (Masson's Trichrome stain) before and 1 month after end of therapy. RESULTS High-density parameters showed significant higher improvement in VSS and POSAS assessment scores (p-value < .001). Pliability and relief are the most improved parameters. Histopathological evaluation revealed a significant drop in the mean area percent of collagen in the 3 used parameters, with highest improvement with high-density laser treatment (p-value < .001). CONCLUSION High-density fractional CO2 laser treatment provides more improvement in burn scars both clinically and histopathologically.
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Paasch U, Grunewald S. Update Dermatologische Lasertherapie II – Weiterentwicklung der photodynamischen Therapie durch Laser‐assistierte transkutane Applikation von Topika. J Dtsch Dermatol Ges 2020; 18:1370-1378. [PMID: 33373145 DOI: 10.1111/ddg.14339_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 11/19/2018] [Indexed: 11/27/2022]
Abstract
Die technische Fortentwicklung der jüngeren Vergangenheit bietet dem Dermatologen Zugriff auf neue Laser, Strahlquellen und Behandlungskonzepte. Seit langem eingeführte Wellenlängen zur Ablation sind nunmehr fraktioniert applizierend verfügbar und stehen nunmehr für eine wirksamere und effizientere Behandlung von zahlreichen Hautveränderungen zur Verfügung. Das gezielte Einbringung von Topika (laser assisted drug delivery; LADD) ist das wichtigste Beispiel. Die LADD erfordert eine spezifische Weiterbildung, um sicher und wirksam zur Therapie (prä-)maligner nichtmelanozytärer Neoplasien der Haut wie der Feldkanzerisierung in Form der Laser-assistierten photodynamischen Therapie angewandt werden zu können. Bisher verfügbare Daten weisen auf eine höhere Effektivität im Vergleich zu konventionell verwendeten Topika hin, wobei anhaltend über Weiterentwicklungen berichtet wird. Unter anderem wurde die Kombination mit Tageslicht oder alternativen tageslichtähnlichen Strahlquellen bekannt. Dieses Update basiert wie zitiert gekürzt und aktualisiert auf "Paasch, U. 2019. Laser-assistierte photodynamische Therapie. p. 226-239. In G. Kautz (ed.) Energie für die Haut. Springer Nature, Springer Nature.".
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Affiliation(s)
- Uwe Paasch
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig AöR und Medizinische Fakultät der Universität Leipzig
| | - Sonja Grunewald
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig AöR und Medizinische Fakultät der Universität Leipzig
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Paasch U, Grunewald S. Update on dermatologic laser therapy II - advances in photodynamic therapy using laser-assisted drug delivery. J Dtsch Dermatol Ges 2020; 18:1370-1377. [PMID: 33331083 DOI: 10.1111/ddg.14339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 11/19/2018] [Indexed: 11/28/2022]
Abstract
Technical advances in recent years have led to the development of new dermatologic laser systems, light sources, and treatment concepts. With the introduction of ablative fractional lasers (using common wavelengths) in the field of dermatology, it is now possible to more effectively and efficiently treat a variety of skin disorders. One important example of these advances is laser-assisted drug delivery (LADD). A type of LADD, laser-assisted photodynamic therapy has been successfully employed in the treatment of non-melanoma skin cancer including field cancerization. This treatment concept has been continually modified and today includes the use of daylight as well as artificial daylight systems. This update is based as cited, shortened and updated according to "Paasch,U. 2019. Laser-assistierte photodynamische Therapie. p. 226-239. In G.Kautz (ed.) Energie für die Haut. Springer Nature, Springer Nature".
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Affiliation(s)
- Uwe Paasch
- Department of Dermatology, Venereology and Allergology, Leipzig University Medical Center, and Medical Faculty, Leipzig University, Leipzig, Germany
| | - Sonja Grunewald
- Department of Dermatology, Venereology and Allergology, Leipzig University Medical Center, and Medical Faculty, Leipzig University, Leipzig, Germany
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Owczarczyk-Saczonek A, Kasprowicz-Furmańczyk M, Kruszewska A, Krajewska-Włodarczyk M, Bechtold A, Klimek P, Placek W. The Correction of Facial Morphea Lesions by Hyaluronic Acid: A Case Series and Literature Review. Dermatol Ther (Heidelb) 2020; 10:1423-1434. [PMID: 32876907 PMCID: PMC7649201 DOI: 10.1007/s13555-020-00438-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The aim of the study is to assess the long-term safety and efficacy of hyaluronic acid (HA) administration in correction of facial morphea lesions and to review the literature on the subject. Morphea is a chronic inflammatory disease of the connective tissue which may lead to serious deformations. The lesions located on the face particularly affect patients' quality of life and self-esteem; thus, there is a demand for safe and effective methods of treatment. CASE PRESENTATION The paper presents three female patients aged 16, 17 and 70 with facial morphea lesions who had HA preparation Juvéderm® Voluma or Volux, Vycross® technology, Allergan, injected. One of the patients had additionally fractional ablative CO2 laser (FAL) therapy. DISCUSSION The literature provides reports on successful use of HA, polymethylmethacrylate and poly-L-lactic acid for the correction of facial defects in localized scleroderma. HA is a natural component of the extracellular matrix and it therefore minimizes the probability of immunogenicity. The application technique also plays an important role. On the other hand, FAL therapy leads to the degradation of the abnormal collagen and the induction of normal collagen synthesis. CONCLUSIONS HA injection and combination of HA application with FAL are minimally invasive, effective and safe therapeutic options for patients suffering from morphea.
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Affiliation(s)
- Agnieszka Owczarczyk-Saczonek
- The Chair and Clinic of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, The Municipal Polyclinical Hospital in Olsztyn, Olsztyn, Poland
| | - Marta Kasprowicz-Furmańczyk
- The Chair and Clinic of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, The Municipal Polyclinical Hospital in Olsztyn, Olsztyn, Poland
| | - Anna Kruszewska
- The Chair and Clinic of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, The Municipal Polyclinical Hospital in Olsztyn, Olsztyn, Poland
| | - Magdalena Krajewska-Włodarczyk
- Department of Rheumatology, The Municipal Polyclinical Hospital in Olsztyn, Olsztyn, Poland
- Department of Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
| | - Agata Bechtold
- The Chair and Clinic of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, The Municipal Polyclinical Hospital in Olsztyn, Olsztyn, Poland.
- Psychodermatology Department, Medical University of Lodz, Łódź, Poland.
| | - Paulina Klimek
- The Chair and Clinic of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, The Municipal Polyclinical Hospital in Olsztyn, Olsztyn, Poland
| | - Waldemar Placek
- The Chair and Clinic of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, The Municipal Polyclinical Hospital in Olsztyn, Olsztyn, Poland
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Paasch U, Said T. Stimulation of collagen and elastin production in-vivo using 1,540 nm Er:Glass laser: assessment of safety and efficacy. J COSMET LASER THER 2020; 22:77-83. [PMID: 32079432 DOI: 10.1080/14764172.2020.1728339] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: Induction of collagen and elastin remodeling in the human skin can be achieved by non-ablative fractional laser (NAFXL) and ablative fractional laser (AFXL). Our objective was to compare the safety, efficacy, tolerability, and ability to induce collagen and elastin remodeling of NAFXL versus AFXL in a series of treatments over time.Materials and Methods: In this prospective, proof of principle, single-case study, the safety, tolerability and efficacy of the laser systems were assessed via histopathology and clinical evaluations including photographs. Optical biopsies by means of multiphoton tomography (MPT) were used to evaluate the induction of collagen and elastin remodeling.Results: Treatments by both NAFXL and AFXL were well tolerated. The NAFXL system was found to be less painful and resulted in a shorter down- and healing times. MPT findings showed the superior capability of the AFXL procedure to induce collagen; on the other hand, elastin induction was more pronounced after NAFXL treatments.Conclusions: While NAFXL is as effective and safe as the traditional AFXL, it is better tolerated and has a shorter downtime. Serial optical biopsies over time over time can be a useful tool to assess the induction of collagen and elastin remodeling in the human skin.
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Affiliation(s)
- Uwe Paasch
- Department of Dermatology, Venereology and Allergology, University of Leipzig, 04103 Leipzig, Saxony, Germany
| | - Tamer Said
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Scieglinska D, Krawczyk Z, Sojka DR, Gogler-Pigłowska A. Heat shock proteins in the physiology and pathophysiology of epidermal keratinocytes. Cell Stress Chaperones 2019; 24:1027-1044. [PMID: 31734893 PMCID: PMC6882751 DOI: 10.1007/s12192-019-01044-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 10/09/2019] [Accepted: 10/15/2019] [Indexed: 12/21/2022] Open
Abstract
Heat shock proteins (HSPs), a large group of highly evolutionary conserved proteins, are considered to be main elements of the cellular proteoprotection system. HSPs are encoded by genes activated during the exposure of cells to proteotoxic factors, as well as by genes that are expressed constitutively under physiological conditions. HSPs, having properties of molecular chaperones, are involved in controlling/modulation of multiple cellular and physiological processes. In the presented review, we summarize the current knowledge on HSPs in the biology of epidermis, the outer skin layer composed of stratified squamous epithelium. This tissue has a vital barrier function preventing from dehydratation due to passive diffusion of water out of the skin, and protecting from infection and other environmental insults. We focused on HSPB1 (HSP27), HSPA1 (HSP70), HSPA2, and HSPC (HSP90), because only these HSPs have been studied in the context of physiology and pathophysiology of the epidermis. The analysis of literature data shows that HSPB1 plays a role in the regulation of final steps of keratinization; HSPA1 is involved in the cytoprotection, HSPA2 contributes to the early steps of keratinocyte differentiation, while HSPC is essential in the re-epithelialization process. Since HSPs have diverse functions in various types of somatic tissues, in spite of multiple investigations, open questions still remain about detailed roles of a particular HSP isoform in the biology of epidermal keratinocytes.
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Affiliation(s)
- Dorota Scieglinska
- Center for Translational Research and Molecular Biology of Cancer, Maria Skłodowska-Curie Institute-Oncology Center Gliwice Branch, ul. Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland.
| | - Zdzisław Krawczyk
- Center for Translational Research and Molecular Biology of Cancer, Maria Skłodowska-Curie Institute-Oncology Center Gliwice Branch, ul. Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Damian Robert Sojka
- Center for Translational Research and Molecular Biology of Cancer, Maria Skłodowska-Curie Institute-Oncology Center Gliwice Branch, ul. Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Agnieszka Gogler-Pigłowska
- Center for Translational Research and Molecular Biology of Cancer, Maria Skłodowska-Curie Institute-Oncology Center Gliwice Branch, ul. Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland
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20
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Chacur R, Menezes HS, Chacur NMBDS, Alves DD, Mafaldo RC, Gomes LD, Matzenbacher G, Barreto GDS. Aesthetic correction of lesion by post-liposuction corticoid infiltration using subcision, PMMA filling, and CO 2 laser. Case Reports Plast Surg Hand Surg 2019; 6:140-144. [PMID: 32002462 PMCID: PMC6968505 DOI: 10.1080/23320885.2019.1602837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 03/30/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Post-liposuction fibrosis is a relatively common complication which can be repaired. CASE REPORT We report a case of cutaneous atrophy and diffuse irregularity of the abdominal region with achromia post-liposuction. She was treated with subcision, PMMA filler and fractioned CO2 laser. RESULTS Cutaneous colour and irregularities get improved.
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De Filippis A, Perfetto B, Guerrera LP, Oliviero G, Baroni A. Q-switched 1064 nm Nd-Yag nanosecond laser effects on skin barrier function and on molecular rejuvenation markers in keratinocyte-fibroblasts interaction. Lasers Med Sci 2018; 34:595-605. [PMID: 30276490 DOI: 10.1007/s10103-018-2635-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 09/04/2018] [Indexed: 01/01/2023]
Abstract
Skin represents an interface between internal and external environment; it protects human body by regulating the water loss and the maintenance of body temperature, defending against irritant and pathogen agents, and against physical, chemical, and UV damage. It provides to essential physiological functions, such as the important antioxidant defense capacity; its protective/defensive function is performed by a high number of proteins, and shows important functions in maintenance of skin barrier homeostasis. Keratinocytes and fibroblasts play a pivotal role to determine or prevent skin aging in response to intrinsic or extrinsic stimuli, modulating cytokines and several biochemical factors. Non-ablative technologies are playing an increasing role in the management of skin aging, inducing a dermal remodeling without a visible epidermal damage. The objective of this study was to evaluate the effect of Q-switched 1064 Nd-YAG laser (Medlite Conbio C6 Nd-YAG laser, Cynosure USA) in skin barrier function, analyzing the constituents which are strongly altered in aging skin. Particularly, we evaluated the expression of filaggrin, TGase, HSP70, and aquaporins, on HaCaT cells. The expression of proinflammatory cytokines has been investigated too.As a second step of the study, we analyzed the modulation of the rejuvenation molecular markers on human skin fibroblasts (HDFs) stimulated with keratinocytes conditioned medium (KCM).Our results demonstrated that Q-switched 1064 nm Nd:YAG laser acts on the skin barrier function, increasing the expression of aquaporins, filaggrin, TGase, and HSP70, modulating the proinflammatory cytokines. In fibroblasts stimulated with keratinocytes conditioned medium (KCM) and irradiated with Q-switched 1064 nm Nd:YAG laser, we can observe a reduction of MMP-1 and an increase in procollagen, collagen type I, and elastin. Our results highlight that Q-switched 1064 nm Nd:YAG laser treatment could represent an effective weapon to fight skin aging.
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Affiliation(s)
- Anna De Filippis
- Department of Experimental Medicine, Section of Microbiology and Clinical Microbiology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Brunella Perfetto
- Department of Experimental Medicine, Section of Microbiology and Clinical Microbiology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Luigi Pio Guerrera
- Department of Mental Health and Physics and Preventive Medicine, Unit of Dermatology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giovanni Oliviero
- Department of Mental Health and Physics and Preventive Medicine, Unit of Dermatology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Adone Baroni
- Department of Mental Health and Physics and Preventive Medicine, Unit of Dermatology, University of Campania "Luigi Vanvitelli", Naples, Italy.
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Kim JH, Jeong JJ, Lee YI, Lee WJ, Lee C, Chung WY, Nam KH, Lee JH. Preventive effect of polynucleotide on post-thyroidectomy scars: A randomized, double-blinded, controlled trial. Lasers Surg Med 2018; 50:755-762. [PMID: 29574803 DOI: 10.1002/lsm.22812] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVE Polynucleotide (PN) provides a structural scaffold to induce anti-inflammatory and enhanced wound healing properties, and this study aimed to assess the efficacy of PN administration in the prevention of post-operative scars after conventional open total thyroidectomy. STUDY DESIGN MATERIALS AND METHODS Forty-two patients with thyroid carcinoma who underwent total thyroidectomy were randomly assigned to the study (PN administration) or control (normal saline) group. All patients underwent a single session of combined ablative and non-ablative fractional laser. The Vancouver Scar Scale (VSS), global photographic assessment, and objective scar were assessed using three-dimensional (3D) camera at baseline and at 2, 4, 8, and 16 weeks after surgery. RESULTS Patients who underwent PN injection demonstrated better surgical scar quality outcome. Participants in the PN administration group had lower VSS scores than the control group (2.09 ± 0.47 vs. 4.01 ± 0.55, respectively) and lower scar height (0.23 ± 0.03 vs. 0.29 ± 0.03, respectively), as measured using 3D imaging. Furthermore, in the PN injected group, the degree of erythema, and pigmentation of the scar were less prominent. No patient developed hypertrophic scar or keloids on the surgical site. No other adverse events, including post-inflammatory hyperpigmentation, scarring, or infection, were observed. CONCLUSION Adjuvant administration of PN along with conventional fractional laser treatment led to more favorable effect in wound healing and post-operative scar prevention after thyroidectomy. Lasers Surg. Med. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- Ji Hee Kim
- Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
- Scar Laser and Plastic Surgery Center, Yonsei University College of Medicine, Yonsei Cancer Hospital, Seoul, Korea
| | - Jong Ju Jeong
- Department of Surgery, Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea
| | - Young In Lee
- Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Won Jai Lee
- Scar Laser and Plastic Surgery Center, Yonsei University College of Medicine, Yonsei Cancer Hospital, Seoul, Korea
- Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, Korea
| | - Chorok Lee
- Department of Surgery, Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea
| | - Woong Youn Chung
- Department of Surgery, Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea
| | - Kee-Hyun Nam
- Department of Surgery, Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea
| | - Ju Hee Lee
- Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
- Scar Laser and Plastic Surgery Center, Yonsei University College of Medicine, Yonsei Cancer Hospital, Seoul, Korea
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Schmitt L, Huth S, Amann PM, Marquardt Y, Heise R, Fietkau K, Huth L, Steiner T, Hölzle F, Baron J. Direct biological effects of fractional ultrapulsed CO2 laser irradiation on keratinocytes and fibroblasts in human organotypic full-thickness 3D skin models. Lasers Med Sci 2017; 33:765-772. [DOI: 10.1007/s10103-017-2409-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 11/30/2017] [Indexed: 11/25/2022]
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Abstract
Scar formation is the consequence of trauma to the skin that affects the deep parts of the dermis. Different scar types like immature, mature, atrophic, hypertrophic, or keloid scars can develop depending on factors like age, anatomic localization, cause of trauma, the course of the healing process, and individual predispositions. Keloids and hypertrophic scars are often associated with itching, pain, tautness of the skin, and functional impairments, thus, leading to significantly reduced quality of life in some patients. However, even seemingly physiologically healed scars can cause tremendous psychological strain as is the case with self-harm scars. Despite increased research efforts, the exact pathomechanisms of excessive scarring are still scarcely understood, and dependably effective treatment options are often lacking. However, through continually improving scientific progress, scar treatment paradigms for a variety of scar types, thus far often dominated by conventional treatment methods, are increasingly complemented by new laser technologies and wavelengths.
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Affiliation(s)
- G G Gauglitz
- Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität München, Frauenlobstr. 9-11, 80337, München, Deutschland.
| | - J Pötschke
- Klinik für Plastische und Handchirurgie mit Schwerbrandverletztenzentrum, Klinikum St. Georg gGmbH, Delitzscher Straße 141, 04129, Leipzig, Deutschland
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Paasch U, Schwandt A, Seeber N, Kautz G, Grunewald S, Haedersdal M. New lasers and light sources - old and new risks? J Dtsch Dermatol Ges 2017; 15:487-496. [DOI: 10.1111/ddg.13238] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 12/29/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Uwe Paasch
- Department of Dermatology, Venereology and Allergology; University Hospital Leipzig and Medical Faculty; University of Leipzig; Germany
| | - Antje Schwandt
- Laser Medicine Center Rhein-Ruhr; Porschekanzel 3-5 45127 Essen Germany
| | | | - Gerd Kautz
- Dermatology Practice Peter/Seeber/Altheide; Wandsbeker Marktstr. 48-50 22041 Hamburg-Wandsbek Germany
| | - Sonja Grunewald
- Department of Dermatology, Venereology and Allergology; University Hospital Leipzig and Medical Faculty; University of Leipzig; Germany
| | - Merete Haedersdal
- Department of Dermatology, Bispebjerg Hospital; University of Copenhagen; Denmark
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Paasch U, Schwandt A, Seeber N, Kautz G, Grunewald S, Haedersdal M. Neue Laser und Strahlquellen - alte und neue Risiken? J Dtsch Dermatol Ges 2017; 15:487-497. [DOI: 10.1111/ddg.13238_g] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 12/29/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Uwe Paasch
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie; Universitätsklinikum Leipzig AöR und Medizinische Fakultät der Universität Leipzig; Deutschland
| | - Antje Schwandt
- Laser Medizin Zentrum Rhein-Ruhr; Porschekanzel 3-5 45127 Essen Deutschland
| | | | - Gerd Kautz
- Hautarztpraxis Peter/Seeber/Altheide; Wandsbeker Marktstr. 48-50 22041 Hamburg-Wandsbek Deutschland
| | - Sonja Grunewald
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie; Universitätsklinikum Leipzig AöR und Medizinische Fakultät der Universität Leipzig; Deutschland
| | - Merete Haedersdal
- Dermatologische Abteilung, Bispebjerg Hospital; Universität Kopenhagen; Dänemark
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Poetschke J, Dornseifer U, Clementoni MT, Reinholz M, Schwaiger H, Steckmeier S, Ruzicka T, Gauglitz GG. Ultrapulsed fractional ablative carbon dioxide laser treatment of hypertrophic burn scars: evaluation of an in-patient controlled, standardized treatment approach. Lasers Med Sci 2017; 32:1031-1040. [DOI: 10.1007/s10103-017-2204-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 03/29/2017] [Indexed: 10/19/2022]
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Schmitt L, Amann PM, Marquardt Y, Heise R, Czaja K, Gerber PA, Steiner T, Hölzle F, Baron JM. Molecular effects of fractional ablative erbium:YAG laser treatment with multiple stacked pulses on standardized human three-dimensional organotypic skin models. Lasers Med Sci 2017; 32:805-814. [PMID: 28299490 DOI: 10.1007/s10103-017-2175-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 02/20/2017] [Indexed: 11/25/2022]
Abstract
The molecular changes in gene expression following ablative laser treatment of skin lesions, such as atrophic scars and UV-damaged skin, are not completely understood. A standardized in vitro model of human skin, to study the effects of laser treatment on human skin, has been recently developed. Therefore, the aim of the investigation was to examine morphological and molecular changes caused by fractional ablative erbium:YAG laser treatment on an in vitro full-thickness 3D standardized organotypic model of human skin. A fractional ablative erbium:YAG laser was used to irradiate organotypic human 3D models. Laser treatments were performed at four different settings using a variety of stacked pulses with similar cumulative total energy fluence (60 J/cm2). Specimens were harvested at specified time points and real-time PCR (qRT-PCR) and microarray studies were performed. Frozen sections were examined histologically. Three days after erbium:YAG laser treatment, a significantly increased mRNA expression of matrix metalloproteinases and their inhibitors (MMP1, MMP2, MMP3, TIMP1, and TIMP2), chemokines (CXCL1, CXCL2, CXCL5, and CXCL6), and cytokines such as IL6, IL8, and IL24 could be detected. qRT-PCR studies confirmed the enhanced mRNA expression of IL6, IL8, IL24, CXCLs, and MMPs. In contrast, the mRNA expression of epidermal differentiation markers, such as keratin-associated protein 4, filaggrin, filaggrin 2, and loricrin, and antimicrobial peptides (S100A7A, S100A9, and S100A12) as well as CASP14, DSG2, IL18, and IL36β was reduced. Four different settings with similar cumulative doses have been tested (N10%, C10%, E10%, and W25%). These laser treatments resulted in different morphological changes and effects on gene regulations. Longer pulse durations (1000 μs) especially had the strongest impact on gene expression and resulted in an upregulation of genes, such as collagen-1A2, collagen-5A2, and collagen-6A2, as well as FGF2. Histologically, all treatment settings resulted in a complete regeneration of the epidermis 3 days after irradiation. Fractional ablative erbium:YAG laser treatment with a pulse stacking technique resulted in histological alterations and shifts in the expression of various genes related to epidermal differentiation, inflammation, and dermal remodeling depending on the treatment setting applied. A standardized in vitro 3D model of human skin proved to be a useful tool for exploring the effects of various laser settings both on skin morphology and gene expression during wound healing. It provides novel data on the gene expression and microscopic architecture of the exposed skin. This may enhance our understanding of laser treatment at a molecular level.
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Affiliation(s)
- Laurenz Schmitt
- Department of Dermatology and Allergology, Medical Faculty, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany.
| | - P M Amann
- Department of Dermatology and Allergology, Medical Faculty, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - Y Marquardt
- Department of Dermatology and Allergology, Medical Faculty, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - R Heise
- Department of Dermatology and Allergology, Medical Faculty, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - K Czaja
- Department of Dermatology and Allergology, Medical Faculty, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - P A Gerber
- Department of Dermatology and Allergology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - T Steiner
- Department of Oral and Maxillofacial Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany
- Interdisciplinary Center for Laser Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - F Hölzle
- Department of Oral and Maxillofacial Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany
- Interdisciplinary Center for Laser Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Jens Malte Baron
- Department of Dermatology and Allergology, Medical Faculty, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany.
- Interdisciplinary Center for Laser Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany.
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Fractional carbon dioxide laser versus low-dose UVA-1 phototherapy for treatment of localized scleroderma: a clinical and immunohistochemical randomized controlled study. Lasers Med Sci 2016; 31:1707-1715. [PMID: 27510285 DOI: 10.1007/s10103-016-2041-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 07/25/2016] [Indexed: 12/26/2022]
Abstract
Morphea is a rare fibrosing skin disorder that occurs as a result of abnormal homogenized collagen synthesis. Fractional ablative laser resurfacing has been used effectively in scar treatment via abnormal collagen degradation and induction of healthy collagen synthesis. Therefore, fractional ablative laser can provide an effective modality in treatment of morphea. The study aimed at evaluating the efficacy of fractional carbon dioxide laser as a new modality for the treatment of localized scleroderma and to compare its results with the well-established method of UVA-1 phototherapy. Seventeen patients with plaque and linear morphea were included in this parallel intra-individual comparative randomized controlled clinical trial. Each with two comparable morphea lesions that were randomly assigned to either 30 sessions of low-dose (30 J/cm2) UVA-1 phototherapy (340-400 nm) or 3 sessions of fractional CO2 laser (10,600 nm-power 25 W). The response to therapy was then evaluated clinically and histopathologically via validated scoring systems. Immunohistochemical analysis of TGF-ß1 and MMP1 was done. Patient satisfaction was also assessed. Wilcoxon signed rank test for paired (matched) samples and Spearman rank correlation equation were used as indicated. Comparing the two groups, there was an obvious improvement with fractional CO2 laser that was superior to that of low-dose UVA-1 phototherapy. Statistically, there was a significant difference in the clinical scores (p = 0.001), collagen homogenization scores (p = 0.012), and patient satisfaction scores (p = 0.001). In conclusion, fractional carbon dioxide laser is a promising treatment modality for cases of localized morphea, with proved efficacy of this treatment on clinical and histopathological levels.
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Amann PM, Marquardt Y, Steiner T, Hölzle F, Skazik-Voogt C, Heise R, Baron JM. Effects of non-ablative fractional erbium glass laser treatment on gene regulation in human three-dimensional skin models. Lasers Med Sci 2016; 31:397-404. [PMID: 26796701 DOI: 10.1007/s10103-015-1863-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 12/28/2015] [Indexed: 11/27/2022]
Abstract
Clinical experiences with non-ablative fractional erbium glass laser therapy have demonstrated promising results for dermal remodelling and for the indications of striae, surgical scars and acne scars. So far, molecular effects on human skin following treatment with these laser systems have not been elucidated. Our aim was to investigate laser-induced effects on skin morphology and to analyse molecular effects on gene regulation. Therefore, human three-dimensional (3D) organotypic skin models were irradiated with non-ablative fractional erbium glass laser systems enabling qRT-PCR, microarray and histological studies at same and different time points. A decreased mRNA expression of matrix metalloproteinases (MMPs) 3 and 9 was observed 3 days after treatment. MMP3 also remained downregulated on protein level, whereas the expression of other MMPs like MMP9 was recovered or even upregulated 5 days after irradiation. Inflammatory gene regulatory responses measured by the expression of chemokine (C-X-C motif) ligands (CXCL1, 2, 5, 6) and interleukin expression (IL8) were predominantly reduced. Epidermal differentiation markers such as loricrin, filaggrin-1 and filaggrin-2 were upregulated by both tested laser optics, indicating a potential epidermal involvement. These effects were also shown on protein level in the immunofluorescence analysis. This novel standardised laser-treated human 3D skin model proves useful for monitoring time-dependent ex vivo effects of various laser systems on gene expression and human skin morphology. Our study reveals erbium glass laser-induced regulations of MMP and interleukin expression. We speculate that these alterations on gene expression level could play a role for dermal remodelling, anti-inflammatory effects and increased epidermal differentiation. Our finding may have implications for further understanding of the molecular mechanism of erbium glass laser-induced effects on human skin.
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Affiliation(s)
- Philipp M Amann
- Department of Dermatology and Allergology, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany.
| | - Yvonne Marquardt
- Department of Dermatology and Allergology, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - Timm Steiner
- Department of Oral and Maxillofacial Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany.,Interdisciplinary Center for Laser Medicine, RWTH Aachen University, Aachen, Germany
| | - Frank Hölzle
- Department of Oral and Maxillofacial Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany.,Interdisciplinary Center for Laser Medicine, RWTH Aachen University, Aachen, Germany
| | - Claudia Skazik-Voogt
- Department of Dermatology and Allergology, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - Ruth Heise
- Department of Dermatology and Allergology, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - Jens M Baron
- Department of Dermatology and Allergology, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany. .,Interdisciplinary Center for Laser Medicine, RWTH Aachen University, Aachen, Germany.
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31
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Borges J, Cuzzi T, Mandarim-de-Lacerda CA, Manela-Azulay M. Fractional Erbium laser in the treatment of photoaging: randomized comparative, clinical and histopathological study of ablative (2940nm) vs. non-ablative (1540nm) methods after 3 months. An Bras Dermatol 2014; 89:250-8. [PMID: 24770501 PMCID: PMC4008055 DOI: 10.1590/abd1806-4841.20142370] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Accepted: 03/08/2013] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Fractional non-ablative lasers keep the epidermis intact, while fractional ablative lasers remove it, making them theoretically more effective. OBJECTIVES To evaluate the clinical and histological alterations induced by fractional photothermolysis for treating photoaging, comparing the possible equivalence of multiple sessions of 1540nm Erbium, to one session of 2940nm Erbium. METHODS Eighteen patients (mean age 55.9) completed the treatment with three sessions of 1540nm fractional Erbium laser on one side of the face (50 mJ/mB, 15ms, 2 passes), and one session of 2940nm on the other side (5mJ/mB, 0.25ms, 2 passes). Biopsies were performed before and 3 months after treatment. Clinical, histological and morphometric evaluations were carried out. RESULTS All patients presented clinical improvement with no statistically significant difference (p> 0.05) between the treated sides. Histopathology revealed a new organization of collagen and elastic fibers, accompanied by edema, which was more evident with the 2940nm laser. This finding was confirmed by morphometry, which showed a decrease in collagen density for both treatments, with a statistical significance for the 2940nm laser (p > 0.001). CONCLUSIONS Three 1540nm sessions were clinically equivalent to one 2940nm session. The edema probably contributed to the positive results after three months, togheter with the new collagen and elastic fibers organization. The greater edema after the 2940nm session indicates that dermal remodeling takes longer than with 1540nm. It is possible that this histological superiority relates to a more prolonged effect, but a cohort longer than three months is needed to confirm that supposition.
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Affiliation(s)
- Juliano Borges
- Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Tullia Cuzzi
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Paasch U, Sonja G, Haedersdal M. Synergistic skin heat shock protein expression in response to combined laser treatment with a diode laser and ablative fractional lasers. Int J Hyperthermia 2014; 30:245-9. [DOI: 10.3109/02656736.2014.925590] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kohl E, Meierhöfer J, Koller M, Zeman F, Klein A, Hohenleutner U, Landthaler M, Hohenleutner S. Fractional carbon dioxide laser resurfacing of rhytides and photoageing: a prospective study using profilometric analysis. Br J Dermatol 2014; 170:858-65. [DOI: 10.1111/bjd.12807] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2013] [Indexed: 11/27/2022]
Affiliation(s)
- E. Kohl
- Department of Dermatology; University Hospital Regensburg; Franz-Josef-Strauss-Allee 11 93053 Regensburg Germany
| | - J. Meierhöfer
- Department of Dermatology; University Hospital Regensburg; Franz-Josef-Strauss-Allee 11 93053 Regensburg Germany
| | - M. Koller
- Centre for Clinical Trials; University Hospital Regensburg; Franz-Josef-Strauss-Allee 11 93053 Regensburg Germany
| | - F. Zeman
- Centre for Clinical Trials; University Hospital Regensburg; Franz-Josef-Strauss-Allee 11 93053 Regensburg Germany
| | - A. Klein
- Department of Dermatology; University Hospital Regensburg; Franz-Josef-Strauss-Allee 11 93053 Regensburg Germany
| | - U. Hohenleutner
- Department of Dermatology; University Hospital Regensburg; Franz-Josef-Strauss-Allee 11 93053 Regensburg Germany
| | - M. Landthaler
- Department of Dermatology; University Hospital Regensburg; Franz-Josef-Strauss-Allee 11 93053 Regensburg Germany
| | - S. Hohenleutner
- Department of Dermatology; University Hospital Regensburg; Franz-Josef-Strauss-Allee 11 93053 Regensburg Germany
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Krakowski AC, Admani S, Shumaker PR, Uebelhoer NS. Fractionated Carbon Dioxide Laser as a Novel, Noninvasive Treatment Approach to Burn Scar-Related Nail Dystrophy. Dermatol Surg 2014; 40:351-4. [DOI: 10.1111/dsu.12418] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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35
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Oliveira G, Leverett JC, Emamzadeh M, Lane ME. The effects of heat on skin barrier function and in vivo dermal absorption. Int J Pharm 2014; 464:145-51. [PMID: 24445121 DOI: 10.1016/j.ijpharm.2014.01.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 01/07/2014] [Accepted: 01/09/2014] [Indexed: 11/25/2022]
Abstract
Enhanced delivery of ingredients across the stratum corneum (SC) is of great interest for improving the efficacy of topically applied formulations. Various methods for improving dermal penetration have been reported including galvanic devices and micro-needles. From a safety perspective it is important that such approaches do not compromise SC barrier function. This study investigates the influence of topically applied heat in vivo on the dermal uptake and penetration of a model active, allantoin from gel and lotion formulations. A custom designed device was used to deliver 42°C for 30s daily to human subjects after application of two formulations containing allantoin. The results were compared with sites treated with formulations containing no active and no heat, and a control site. In addition to penetration of allantoin, the integrity of the SC was monitored using trans-epidermal water loss (TEWL) measurements. The results showed that just 30s of 42°C topically applied heat was enough to cause significantly more penetration of allantoin from the lotion formulation compared with no application of heat. TEWL data indicated that the integrity of the skin was not compromised by the treatment. However, the application of heat did not promote enhanced penetration of the active from the gel formulation. Vehicle composition is therefore an important factor when considering thermal enhancement strategies for targeting actives to the skin.
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Affiliation(s)
- Gabriela Oliveira
- Department of Pharmaceutics, UCL School of Pharmacy, 29-39 Brunswick Square, London WC1N 1AX, United Kingdom
| | - Jesse C Leverett
- New Technology R&D, Amway Corporation, 7575 Fulton Street East, Ada, MI 49355, USA
| | - Mandana Emamzadeh
- Department of Pharmaceutics, UCL School of Pharmacy, 29-39 Brunswick Square, London WC1N 1AX, United Kingdom
| | - Majella E Lane
- Department of Pharmaceutics, UCL School of Pharmacy, 29-39 Brunswick Square, London WC1N 1AX, United Kingdom.
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Sardana K, Garg VK, Arora P, Khurana N. Histological validity and clinical evidence for use of fractional lasers for acne scars. J Cutan Aesthet Surg 2012; 5:75-90. [PMID: 23060702 PMCID: PMC3461801 DOI: 10.4103/0974-2077.99431] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Though fractional lasers are widely used for acne scars, very little clinical or histological data based on the objective clinical assessment or the depth of penetration of lasers on in vivo facial tissue are available. The depth probably is the most important aspect that predicts the improvement in acne scars but the studies on histology have little uniformity in terms of substrate (tissue) used, processing and stains used. The variability of the laser setting (dose, pulses and density) makes comparison of the studies difficult. It is easier to compare the end results, histological depth and clinical results. We analysed all the published clinical and histological studies on fractional lasers in acne scars and analysed the data, both clinical and histological, by statistical software to decipher their significance. On statistical analysis, the depth was found to be variable with the 1550-nm lasers achieving a depth of 679 μm versus 10,600 nm (895 μm) and 2940 nm (837 μm) lasers. The mean depth of penetration (in μm) in relation to the energy used, in millijoules (mj), varies depending on the laser studied. This was statistically found to be 12.9–28.5 for Er:glass, 3–54.38 for Er:YAG and 6.28–53.66 for CO2. The subjective clinical improvement was a modest 46%. The lack of objective evaluation of clinical improvement and scar-specific assessment with the lack of appropriate in vivo studies is a case for combining conventional modalities like subcision, punch excision and needling with fractional lasers to achieve optimal results.
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Affiliation(s)
- Kabir Sardana
- Department of Dermatology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
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Hsiao FC, Bock GN, Eisen DB. Recent Advances in Fractional Laser Resurfacing: New Paradigm in Optimal Parameters and Post-Treatment Wound Care. Adv Wound Care (New Rochelle) 2012; 1:207-212. [PMID: 24527307 DOI: 10.1089/wound.2011.0323] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Laser plays an increasingly prominent role in skin rejuvenation. The advent of fractional photothermolysis revolutionizes its application. Microcolumns of skin are focally injured, leaving intervening normal skin to facilitate rapid wound healing and orderly tissue remodeling. THE PROBLEM Even with the popularity of fractional laser devices, we still have limited knowledge about the ideal treatment parameters and postlaser wound care. BASIC/CLINICAL SCIENCE ADVANCES Many clinicians believe that higher microbream energy in fractional laser devices results in better clinical outcome. Two recent studies argue against this assumption. One article demonstrates that lower fluence can induce comparable molecular changes with fewer side effects. Another study corroborates this by showing that lower-density settings produce similar clinical outcome in scar remodeling as higher-density ones, but with fewer side effects. To shed light on the optimal post-treatment wound care regimen from fractional ablative resurfacing, another paper shows that platelet-rich plasma (PRP) can reduce transepidermal water loss and skin color changes within 1 month after treatment. CLINICAL CARE RELEVANCE For fractional nonablative resurfacing, lower settings in fluence or density may produce similar dermal remodeling as higher settings and with a better side-effect profile. Moreover, autologous PRP appears to expedite wound healing after fractional ablative resurfacing. CONCLUSION Lower microbeam energy in fractional laser resurfacing produces similar molecular changes and clinical outcome with fewer side effects. The findings might portend a shift in the paradigm of treatment parameters. Autologous PRP can facilitate better wound healing, albeit modestly. Long-term follow-ups and larger studies are necessary to confirm these findings.
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Affiliation(s)
- Francis C. Hsiao
- Department of Dermatology, University of California, Davis Medical Center, Sacramento, California
| | | | - Daniel B. Eisen
- Department of Dermatology, University of California, Davis Medical Center, Sacramento, California
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Ganceviciene R, Liakou AI, Theodoridis A, Makrantonaki E, Zouboulis CC. Skin anti-aging strategies. DERMATO-ENDOCRINOLOGY 2012; 4:308-19. [PMID: 23467476 PMCID: PMC3583892 DOI: 10.4161/derm.22804] [Citation(s) in RCA: 376] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Skin aging is a complex biological process influenced by a combination of endogenous or intrinsic and exogenous or extrinsic factors. Because of the fact that skin health and beauty is considered one of the principal factors representing overall "well-being" and the perception of "health" in humans, several anti-aging strategies have been developed during the last years. It is the intention of this article to review the most important anti-aging strategies that dermatologists have nowadays in hand, including including preventive measurements, cosmetological strategies, topical and systemic therapeutic agents and invasive procedures.
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Affiliation(s)
- Ruta Ganceviciene
- Centre of Dermatovenereology; Vilnius University Hospital Santariskiu Klinikos; Vilnius, Lithuania
| | - Aikaterini I. Liakou
- Departments of Dermatology, Venereology, Allergology and Immunology; Dessau Medical Center; Dessau, Germany
| | - Athanasios Theodoridis
- Departments of Dermatology, Venereology, Allergology and Immunology; Dessau Medical Center; Dessau, Germany
| | - Evgenia Makrantonaki
- Departments of Dermatology, Venereology, Allergology and Immunology; Dessau Medical Center; Dessau, Germany
| | - Christos C. Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology; Dessau Medical Center; Dessau, Germany
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