Skin bioengineering in the noninvasive assessment of cutaneous aging

Development and Evaluation of a Novel Anti-Ageing Cream Based on Hyaluronic Acid and Other Innovative Cosmetic Actives

The importance of incorporating hyaluronic acid (HA) as a cosmetic ingredient in skin care formulations emerged lately because the amount of HA naturally found in the epidermis decreases with age, and when applied to the skin through cosmetic products, it confers hydration and reduces the appearance of wrinkles. Currently, the diversity of cosmetic products for mature skin and the use of various and innovative active ingredients supporting their anti-ageing effect represent ample proof that the cosmetic industry is currently relying on these actives. The main objective of this study was the development of an anti-ageing formulation, incorporating HA and different other active ingredients. The developed formulation contains a novel complex of natural waxes, with an essential role in the restoration of the skin's hydro-lipid barrier, in combination with innovative active ingredients-like low-molecular hyaluronic acid (LMW-HA), sodium hyaluronate (NaHA), ectoin, gold, and an anti-ageing botanical complex-contributing to optimal skin hydration specifically designed to reduce the visible signs of ageing. An important objective was represented by the skin compatibility and topography assessment after 28 days (D28) of regular application of the developed cream. Stability testing, physicochemical characteristics, and microbiological control, including efficacy testing of the used preservative (challenge test) were performed for the cosmetic formulation. In silico approaches were applied to demonstrate the safety of cosmetic-related substances and the risk assessment of the cosmetic formulation. Safety and instrumental evaluation were performed to demonstrate the skin tolerance-the compatibility and the efficacy, respectively-of the developed anti-ageing cream. As result, quality control of the developed cosmetic formulation evidenced an appropriate cosmetic preparation with desirable aspect and adequate physicochemical characteristics. The concentrations of restricted ingredients like preservatives and UV filters were in accordance with those recommended by the Regulation (EC) No. 1223/2009 and so were considered to be safe. Additionally, according to the margin of safety (MoS) calculation, cosmetic ingredients incorporated in the developed formulation could be considered safe. The developed formulation was very well tolerated, and wrinkle depth and length in the periorbital area were significantly reduced after 28-day cosmetic treatment. Subjects' assessment questionnaires revealed self-perceived benefits referring to the cosmetic qualities and efficacy of the anti-ageing cream. This study confirmed the skin tolerance and efficacy of the new complex anti-ageing cream incorporating HA, microencapsulated sodium hyaluronate, ectoin, and a botanical extract. The formulated cosmetic product could serve as a daily care for mature skin to alleviate the effects of skin ageing.

The CSIESA: A Novel Score for the Assessment of Intrinsic and Extrinsic Skin Aging Based on Reflectance Confocal Microscopy Imaging

Skin aging is an intricate physiological process governed by intrinsic and extrinsic factors. Increasing life expectancy has turned skin aging into a growing concern for the general population. Clinical examination of the skin does not fully describe the skin aging process. This study aims to evaluate the healthy skin of five different age groups in order to develop an easy-to-use confocal score for quantifying signs of skin aging and test the correlation between this new score and the already described clinical score, SCINEXA (score of intrinsic and extrinsic skin aging). Thirty-five subjects split into five age groups: <35; 36−45; 46−55; 56−65, and >65 years old were enrolled. Clinical signs were quantified using the SCINEXA score, and known confocal variables of skin aging were evaluated. Three different semi-quantitative scores were calculated: epidermal disarrangement score (EDS), epidermal hyperplasia score (EHS), and dermal score (DS). The EDS showed a stable trend up to the age of 65 and a dramatic increase in older subjects. EHS was characterized by an ascending trend from younger subjects to middle-aged ones. The DS was progressive with age, with a different proportion of distinct collagen types. The confocal CSIESA (confocal score for the assessment of intrinsic and extrinsic skin aging) score correlated well with the SCINEXA score. Reflectance confocal microscopy is a powerful, non-invasive technique for microscopically quantifying aging signs.

Solubilized eggshell membrane supplies a type III collagen-rich elastic dermal papilla

Signs of aging in facial skin correlate with lifespan and chronic disease; however, the health of aging skin has not been extensively studied. In healthy young skin, the dermis forms a type III collagen-rich dermal papilla, where capillary vessels supply oxygen and nutrients to basal epidermal cells. Chicken eggshell membranes (ESMs) have been used as traditional medicines to promote skin wound healing in Asian countries for many years. Previously, we designed an experimental system in which human dermal fibroblasts (HDFs) were cultured on a dish with a solubilized ESM (S-ESM) bound to an artificial phosphorylcholine polymer; we found that genes that promoted the health of the papillary dermis, such as those encoding type III collagen, were induced in the S-ESM environment. The present study found that a gel with a ratio of 20% type III/80% type I collagen, similar to that of the baby skin, resulted in a higher elasticity than 100% type I collagen (p < 0.05) and that HDFs in the gel showed high mitochondrial activity. Thus, we decided to perform further evaluations to identify the effects of S-ESM on gene expression in the skin of hairless mice and found a significant increase of type III collagen in S-ESM. Picrosirius Red staining showed that type III collagen significantly increased in the papillary dermis after S-ESM treatment. Moreover, S-ESM application significantly improved human arm elasticity and reduced facial wrinkles. ESMs may have applications in extending lifespan by reducing the loss of tissue elasticity through the increase of type III collagen.

Randomized, double-blinded, vehicle-controlled, split-face study to evaluate the effects of topical application of a Gold Silk Sericin/Niacinamide/Signaline complex on biophysical parameters related to skin ageing

OBJECTIVE

To investigate the effects of topical application of a Gold Silk Sericin (GSS) complex on biophysical parameters related to skin ageing.

METHODS

A range of non-invasive bioengineering methods were deployed in an 8-week randomized, double-blinded, vehicle-controlled, split-face study among 40 female subjects aged 40-70. Endpoints measured included expert grades of skin condition, stratum corneum (SC) hydration, SC barrier function, elasticity and surface topography.

RESULTS

The GSS complex produced significant single-variable (P < 0.05) improvements in SC hydration, barrier function, elasticity and surface topography compared with the Vehicle control.

CONCLUSION

The GSS complex examined in this study represents an interesting new cosmetic topical technology with which to address multiple aspects of aged/photoaged female facial skin.

Variability in coefficient of restitution in human facial skin

BACKGROUND

If particles rebound on human facial skin, they can be re-entrained into the airflow and subsequently inhaled, increasing aspiration efficiency estimates. A realistic estimate of facial skin coefficient of restitution (CoR) is necessary to accurately model particle bounce. This study investigated the effects of sampling location, temperature, humidity levels, age, gender, and BMI on facial skin CoR.

METHODS

A torsional ballistometer was used to measure facial CoR for 30 participants divided into three age groups (18-30, 31-40, and 41-65 years), at three temperatures and three humidity levels. The study was repeated twice: once in the late winter and once in the early summer to capture the seasonal variability.

RESULTS

The CoR significantly varied across five facial locations, with values ranging from 0.55 to 0.75. Gender, sampling season and the interaction between sampling location and age were found to be significant, but changes in values were relatively small (0.05 at most) and are not considered practically significant.

CONCLUSION

CoR was non-uniform across the face. The use of uniform CoR value as modeling input parameters or for mannequin facial surfaces in experimental wind tunnel studies may not be accurate due to the high variability in CoR between facial sampling locations.

Galenic and Dermopharmaceutical Effectiveness Study of an Emulsified Pharmaceutical form with Retinoic Acid

Retinoic acid constitutes an active that is already being used extensively in the fight against cutaneous aging. After a period in which certain scientific publications questioned its use, today there is no doubt that retinoic acid continues to be an active with wide possibilities of use when it is formulated and administered correctly. In this work we propose a new formulation that, on the basis of a modern self-emulsifying excipient, incorporates retinoic acid in its composition. The work protocol is structured in the following points of study. Rheological assay: Shear rate, shear stress, viscosity, thixotropy, rheodestruction, and extensibility measurements were carried out. Other pharmacotechnical assays: External appearance, interposition type, and pH control were studied. Dermopharmaceutical effectiveness study: Biophysical non-invasive techniques were applied, according to a standardized work method. The following considerations can be made from the results: the layout of the rheograms could fit, in principle, inside a non-Newtonian-shear-thinning flow behavior, with similar rheodestruction profiles. The hysteresis values, as well as the extensibility indexes that were obtained, determined a good degree of applicability. From the whole of results, we could conclude that the formulation proposed is profiled like an emulsified pharmaceutical form with an excellent cosmetological adaptation, eudermic pH, and soft emollient action, which prohibits the loss of superficial water that maintains the retinoic acid action.

[Use of biophysical techniques to evaluate the physiologic effects of injected hyaluronic acid]

BACKGROUND

To evaluate the effects of intradermal injection of native hyaluronic acid on physiology of aged skin using bioengineering methods.

PATIENTS AND METHODS

10 female patients aged 44-69 were included. Study duration was 24 weeks. Each patient received 3 treatments (at week 0, 2 and 4) with native hyaluronic acid (Hyalsystem Merz Pharmaceuticals, Frankfurt/Main, Germany) and 4 examinations (week 0, 4, 12 and 24). Biophysical properties assessed were skin elasticity and surface roughness, as well as skin thickness and density.

RESULTS

Skin elasticity increased while skin surface roughness was reduced. High frequency ultrasound revealed an increase of skin thickness, whereas skin density decreased during treatment and slightly increased above baseline at week 24.

CONCLUSION

The evaluation of the effects of an intradermal injection of hyaluronic acid on aged skin showed an improvement of skin elasticity and skin surface roughness.

Fingertip skin conformance accounts, in part, for differences in tactile spatial acuity in young subjects, but not for the decline in spatial acuity with aging

The ability of the skin to conform to the spatial details of a surface or an object is an essential part of our ability to discriminate fine spatial features haptically. In this study, we examined the extent to which differences in tactual acuity between subjects of the same age and between younger and older subjects can be accounted for by differences in the properties of the skin. We did so by measuring skin conformance and tactile spatial acuity in the glabrous skin at the fingertip in 18 younger (19-36 years old) and 9 older (61-69 years old) subjects. Skin conformance was measured as the degree to which the skin invaded the spaces in the psychophysical stimuli. There were several findings. First, skin conformance accounted for 50% of the variance in our measure of tactile spatial acuity (the threshold for grating orientation discrimination) between the younger subjects. The subjects with more compliant skin had substantially lower thresholds than did the subjects with stiffer skin. Second, the skin of the younger subjects was more compliant across than along the skin ridges, and this translated into significantly greater performance when the gratings were oriented along than when oriented across the skin. Third, skin conformance was virtually identical in the younger and the older subjects. Consequently, skin conformance cannot account for the loss of spatial acuity reported in earlier studies and confirmed in this study. We infer that the loss must be neural in origin.

A pilot study of noninvasive methods to assess healed acute and chronic wounds

BACKGROUND

A variety of instruments are available that can objectively assess physical parameters of the skin such as strength, firmness, elasticity, hydration, and color, often undetected by clinical assessment.

OBJECTIVE

To assess the physical properties of healed acute and chronic wounds using several noninvasive instruments.

METHODS

Four patients with healed acute wounds and four patients with healed chronic wounds were studied using ballistometric, impedance, levarometric, and spectrophotometric measurements.

RESULTS

In general, scars were harder, less elastic, dryer, and more erythematous than control skin. These differences were more pronounced in healed chronic wounds.

CONCLUSION

A scar from an acute surgical wound becomes softer, more elastic, dryer, less erythematous, and less pigmented as it ages. In contrast, chronic wound scars become harder as they age. These different properties of healed acute wounds and healed chronic wounds may be a result of the different healing processes in each wound type.

Perineal dermatitis in the elderly. A critical review of the literature

The review of literature revealed a significant lack of research on the pathogenesis of perineal dermatitis in the elderly. The majority of what is known about this condition stems from the pediatric population. The differences between TEWL and skin surface pH levels in pediatric and geriatric skin raises questions about the further generalizability of the pediatric studies. There appears to be some controversy in the literature regarding whether baseline TEWL is increased or decreased in cutaneous aging. The literature did reveal some data indicating that skin surface pH increases with age; however, no data on the perineum was found. No studies examining the role of TEWL and skin surface pH and its association in the development of perineal dermatitis in the elderly were found. Additionally, no studies were found that examine the nursing variables identified in the literature search. The paucity of scientific data on this serious and costly condition warrants additional research in this area.

Interleukin-4 and interleukin-5 are rarely co-expressed by human T cells

Interleukin (IL)-4 and IL-5 are two cytokines which synergize in the induction of several biological effector functions. They are produced by mouse and human T helper 2 (Th2) and T helper 0 (Th0) cells. Little is known about the regulation of the two cytokines at the single-cell level. Here we show, using a flow cytometric intracellular staining technique, that IL-4 and IL-5 are predominantly produced by different human peripheral CD4+ and CD8+ T cells, whereas interferon (IFN)-gamma and IL-2 are produced by the same cells. In contrast, cloned human Th0 and Th2 cells were able to produce IL-4 and IL-5 simultaneously. The segregation of IL-4 and IL-5 in activated peripheral T cells was found within 72 h of activation upon anti-CD3 or phorbol ester + ionomycin stimulation. The kinetics of IL-4 and IL-5 production were different at the mRNA and the intra- and extracellular protein level, indicating that the cytokines are regulated differently. T cells from three patients with hyper-IgE syndrome did not display a substantial proportion of IL-4/IL-5 double-positive cells. However, simultaneous production could be induced in normal human T cells after prolonged stimulation with a minimum of two restimulation cycles. We conclude that the simultaneous production of IL-4 and IL-5 is a feature of repetitively activated human T cells.

Observations on human tactile directional sensibility

1. The ability to tell the direction of a motion across the skin deserve attention for being an easily observed function which provides a sensitive test for disturbances of the peripheral and central nervous systems. The mode of operation, on the other hand, of this tactile directional sensibility is still uncertain. 2. The dependence of directional sensibility on the contact load and distance of movement of a blunt metal tip, has now been determined for the skin of the forearm of normal subjects with the two-alternative forced-choice method. The testing was done under two conditions: elbow bent or straight. Straightening of the arm always reduced the accuracy of the directional sensibility. It also caused measurable changes of cutaneous mechanical properties, which presumably decreased the reliability of afferent information about lateral distension. 3. The average accuracy of the directional sensibility was found to be correlated linearly to the logarithm of the contact load, and straightening of the arm decreased the accuracy for each load by corresponding amounts. Similar relationships were found between the accuracy and the distance of movement. 4. Straightening of the arm did not cause any significant average reduction of the contact threshold for point stimulation of the same receptive field. A consistently lowered contact sensitivity, however, was observed for some of the subjects, which may have contributed to the reduction of the directional sensibility in these cases. 5. Correct directional estimations of the movement of the metal tip were obtained for a distance which was a fifth of the shortest distance for a corresponding estimation of the movement of a frictionless stimulus. The findings thus indicated that the friction between a moving object and the underlying skin, which can be mediated via stretch-sensitive cutaneous receptors, is critical for the determination of its direction of motion. 6. The present observations and previous observations by various authors are suggested to indicate that typical tactile directional sensibility depends on parallel processing of direction-selective data, and spatial data expressed as a function of time.