Exosomes and Signaling Nanovesicles from the Nanofiltration of Preconditioned Adipose Tissue with Skin-B® in Tissue Regeneration and Antiaging: A Clinical Study and Case Report

Background and Objectives: This three-year clinical trial aimed to demonstrate that only the signaling vesicles produced by ADSCa, containing mRNA, microRNA, growth factors (GFs), and bioactive peptides, provide an advantage over classical therapy with adipose disaggregate to make the tissue regeneration technique safer due to the absence of interfering materials and cells, while being extremely minimally invasive. The infiltration of disaggregated adipose nanofat, defined by the Tonnard method, for the regeneration of the dermis and epidermis during physiological or pathological aging continues to be successfully used for the presence of numerous adult stem cells in suspension (ADSCa). An improvement in this method is the exclusion of fibrous shots and cellular debris from the nanofat to avoid inflammatory phenomena by microfiltration. Materials and Methods: A small amount of adipose tissue was extracted after surface anesthesia and disaggregated according to the Tonnard method. An initial microfiltration at 20/40 microns was performed to remove fibrous shots and cellular debris. The microfiltration was stabilized with a sterile solution containing hyaluronic acid and immediately ultrafiltered to a final size of 0.20 microns to exclude the cellular component and hyaluronic acid chains of different molecular weights. The suspension was then injected into the dermis using a mesotherapy technique with microinjections. Results: This study found that it is possible to extract signaling microvesicles using a simple ultrafiltration system. The Berardesca Scale, Numeric Rating Scale (NRS), and Modified Vancouver Scale (MVS) showed that it is possible to obtain excellent results with this technique. The ultrafiltrate can validly be used in a therapy involving injection into target tissues affected by chronic and photoaging with excellent results. Conclusions: This retrospective clinical evaluation study allowed us to consider the results obtained with this method for the treatment of dermal wrinkles and facial tissue furrows as excellent. The method is safe and an innovative regenerative therapy as a powerful and viable alternative to skin regeneration therapies, antiaging therapies, and chronic inflammatory diseases because it lacks the inflammatory component produced by cellular debris and fibrous sprouts and because it can exclude the mesenchymal cellular component by reducing multiple inflammatory cytokine levels.

CGRP Antagonism and Ketogenic Diet in the Treatment of Migraine

The study of migraine is based on the complexity of the pathology, both at the pathophysiological and epidemiological levels. Although it affects more than a billion people worldwide, it is often underestimated and underreported by patients. Migraine must not be confused with a simple headache; it is a serious and disabling disease that causes considerable limitations in the daily life of afflicted people, including social, work, and emotional effects. Therefore, it causes a daily state of suffering and discomfort. It is important to point out that this pathology not only has a decisive impact on the quality of life of those who suffer from it but also on their families and, more generally, on society as a whole. The clinical picture of migraine is complex, with debilitating unilateral or bilateral head pain, and is often associated with characteristic symptoms such as nausea, vomiting, photophobia, and phonophobia. Hormonal, environmental, psychological, dietary, or other factors can trigger it. The present review focuses on the analysis of the physiopathological and pharmacological aspects of migraine, up to the correct dietary approach, with specific nutritional interventions aimed at modulating the symptoms. Based on the symptoms that the patient experiences, targeted and specific therapy is chosen to reduce the frequency and severity of migraine attacks. Specifically, the role of calcitonin gene-related peptide (CGRP) in the pathogenesis of migraine is analyzed, along with the drugs that effectively target the corresponding receptor. Particularly, CGRP receptor antagonists (gepants) are very effective drugs in the treatment of migraine, given their high diffusion in the brain. Moreover, following a ketogenic diet for only one or two months has been demonstrated to reduce migraine attacks. In this review, we highlight the diverse facets of migraine, from its physiopathological and pharmacological aspects to prevention and therapy.

Mesenchymal Stem Cells in Soft Tissue Regenerative Medicine: A Comprehensive Review

Soft tissue regeneration holds significant promise for addressing various clinical challenges, ranging from craniofacial and oral tissue defects to blood vessels, muscle, and fibrous tissue regeneration. Mesenchymal stem cells (MSCs) have emerged as a promising tool in regenerative medicine due to their unique characteristics and potential to differentiate into multiple cell lineages. This comprehensive review explores the role of MSCs in different aspects of soft tissue regeneration, including their application in craniofacial and oral soft tissue regeneration, nerve regeneration, blood vessel regeneration, muscle regeneration, and fibrous tissue regeneration. By examining the latest research findings and clinical advancements, this article aims to provide insights into the current state of MSC-based therapies in soft tissue regenerative medicine.

Natural Products for the Prevention, Treatment and Progression of Breast Cancer

In this review, we summarize the most used natural products as useful adjuvants in BC by clarifying how these products may play a critical role in the prevention, treatment and progression of this disease. BC is the leading cancer, in terms of incidence, that affects women. The epidemiology and pathophysiology of BC were widely reported. Inflammation and cancer are known to influence each other in several tumors. In the case of BC, the inflammatory component precedes the development of the neoplasm through a slowly increasing and prolonged inflammation that also favors its growth. BC therapy involves a multidisciplinary approach comprising surgery, radiotherapy and chemotherapy. There are numerous observations that showed that the effects of some natural substances, which, in integration with the classic protocols, can be used not only for prevention or integration in order to prevent recurrences and induce a state of chemoquiescence but also as chemo- and radiosensitizers during classic therapy.

Evaluation of the efficacy and safety of hyaluronic acid and supplemented with amino acids, and glutathione or colin, for the prevention and treatment of wrinkles on the face, neck, décolleté and hands

OBJECTIVE

Hyaluronic acid has been used for a long time as a biorevitalizer to treat skin aging both in single formulation and in association with other compounds such as amino acids or vitamins. The purpose of this study was to evaluate the efficacy and safety of class III medical devices SKIN B, SKIN R, SKIN OX, SKIN COLIN, for the treatment of wrinkles on the face, neck, décolleté and hands. These medical devices are all based on hyaluronic acid and supplemented with amino acids (SKIN B and SKIN R) and glutathione (SKIN OX) or colin (SKIN COLIN). This gives broader possibilities to the aesthetic surgeon for personalization and pharmacological diversification based on the patient's deficits to treat.

PATIENTS AND METHODS

A total of 60 subjects affected by skin damage such as rhytidids, dehydration, reduced sebum production and skin hypoxia were enrolled. The patients were treated with a session of mesotherapy every 7 days for 30 days, followed by other 2 sessions every 15 days for 30 days and the follow-up on day 90. The primary efficacy endpoint was evaluated by means of a 0-10 visual analog scale at day 60; the secondary efficacy endpoint was evaluated by means of a 0-10 visual analog scale at day 90.

RESULTS

All patients completed the 3-month follow-up. Treatment with SKIN B, SKIN OX, SKIN COLIN and SKIN R medical devices for the prevention and treatment of wrinkles on the face, neck, décolleté and hands were associated with favorable and positive results. A clear reduction of wrinkles has been clinically observed with improvement in the texture, brightness, and turgor of the skin. No adverse events were reported.

CONCLUSIONS

The medical devices SKIN B, SKIN SKIN OX, SKIN COLIN produce an aesthetic improvement in patients affected by skin defects, when administered by mesotherapy technique. This study confirms the safety and efficacy of the medical devices based on hyaluronic acid supplemented with amino acids and glutathione or colin.

Adipose tissue micrograft in a scaffold of plasma-gel combined with platelet-derived growth factors in dermal wrinkle regeneration

Background: The dermal aging process and the formation of deep wrinkles are a biological involution that also involves the regeneration system of cells immersed in the extracellular matrix and the papillary dermis. The progressive loss of niches of adult stem cells (MSCs) is more evident after the first third of life; it increases the phenotypic expression and the characteristics of the tissue senescence process. The purpose of this study was to clinically demonstrate that in viable micrograft there may be an improvement of deep wrinkles and surrounding tissues. Methods: This study involved 11 female patients who underwent the correction of deep dermal wrinkles through a suspension containing 0.8 mL of viable micrografts in a 5 mL plasma gel scaffold, obtained from the centrifugation of a 20 cc venous sample peripheral blood, gelled by heat in a dry steriliser and the buffy coat coming from the same venous sample, in order verify overtime the improvement of the interested anatomical area. Individual signs of wrinkles and the degree of correction obtained for each treatment and each area were objectively evaluated by using a 10-0 visual analog scale (VAS), Modified Vancouver scale and Berardesca's scale. Results: With this technique excellent results were obtained. In fact, wrinkles were improved, as well as surrounding tissues, even after 60 days, as shown by the Berardesca's, VAS and Modified Vancouver scales. Conclusion: This retrospective clinical evaluation allowed us to consider the excellent clinical results obtained with this method for the treatment of deep wrinkles and surrounding tissues, through a suspension of progenitors with MSCs derived from adipose tissue (ADSCa) in a not inflammatory plasma gel scaffold combined with buffy coat.

Use of microfiltered vs only disaggregated mesenchymal stem cells from adipose tissue in regenerative medicine

Background: Clinical use of adult mesenchymal stem cells (MSCa) in medicine and regenerative surgery is constantly evolving. Adipose tissue-derived stem cells (ADSc) are capable of inducing the production of new extracellular matrix (ECM), deposition of new collagen and early revascularisation. Methods: Flow cytometry was performed for 2 mL of cell colonies harvested from adipose tissue (AT). Comparation has been made of at disaggregated only and the same at disaggregated and microfiltered at 50 mm, 100 mm and 200 mm. Signs of inflammation after dermo-epidermal regeneration session through the mesotherapy method were observed and compared. Results: Even after filtration, significant number of ADSc was collected. An increase in the size of the filter did not always translate into an increase in the number of cells that were found in the microfiltrate. In the non-filtered at disaggregated in both cases, highest number of cells was found, as expected, but at the expense of more pronounced inflammation. Sampling with the 16 Gauge needle produces superior results compared to the cannula in all cases. Conclusion: With this method in medicine and regenerative surgery it will be easier to exploit the growth factors, mRNA, MicroRNA, lipids and bioactive peptides emitted in the MSCa signalling micro-vesicles as they are isolated from the inflammatory component.

Anatomical variations of the median nerve and of the vascular-nervous structures at the wrist

Three cases of anatomical variation of the median nerve at the wrist found during our surgical activity led us to take the opportunity to expose anatomical variations by reviewing already published reviews. Consequently, on the basis of anatomical studies, clinical reports and imaging, as a result of careful examination of the published literature, it has been observed that the interventions in such anatomical area must take into account these variations. In particular, the most performed procedure is the lysis of the transverse carpal ligament (TCL), which is not free from complications. In our opinion it is therefore necessary, in order to avoid the complications of the nervous, vascular and tendinous sections, to use some specific technical procedures.

A phosphatidylcholine hyaluronic acid chitin-nanofibrils complex for a fast skin remodeling and a rejuvenating look

Background

The reduction of mortality worldwide has led older individuals to seek intervention modalities to improve their appearance and reverse signs of aging.

Objective

We formulated a medical device as innovative block-polymer nanoparticles based on phosphatidylcholine, hyaluronan, and chitin nanofibrils entrapping amino acids, vitamins, and melatonin.

Methods

Viability and collagen synthesis were controlled on fibroblasts ex vivo culture while adenosine triphosphate production was evaluated on keratinocytes culture. Subjective and objective evaluations were performed in vivo on selected volunteer patients.

Results

In accordance with our previous studies, both the in vitro and in vivo obtained results demonstrate the efficacy of the injected block-polymer nanoparticles in reducing skin wrinkling and ameliorating the signs of aging.