Evaluation of the In Vivo Kinetics and Biostimulatory Effects of Subcutaneously Injected Hyaluronic Acid Filler
Evaluation of the In Vivo Kinetics and Biostimulatory Effects of Subcutaneously Injected Hyaluronic Acid Filler
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DOI：
10.1097/prs.0000000000004496
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发表时间：
2018-07-01
影响因子：
3.6
通讯作者：
Komuro, Yuzo
中科院分区：
文献类型：
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作者：
Mochizuki, Masato;Aoi, Noriyuki;Komuro, Yuzo
背景：由于皮下注射透明质酸填充剂在面部皱纹治疗后6个月至1年内被吸收，因此可能需要频繁地重新治疗。然而，临床上经常观察到当注射透明质酸填充剂作为面部隆起的丸剂时，持续的长期效果。因此，随着时间的推移，作者研究了皮下注射透明质酸的体积和组织学特征的变化。方法：6周龄大鼠背部皮下注射透明质酸填充物。分别于注射后即刻、注射后4、8、16、32周及注射后4周、8周、16周、32周和周进行磁共振成像，观察形态变化并测量体积。结果：注射后4周内平均体积增大，然后逐渐减小，周后剩余体积为74.8%，与注射前相比无统计学差异。组织学分析表明，成纤维细胞和胶原纤维形成了晶格结构，填充物中也产生了血管和脂肪细胞。结论：尽管皮下注射透明质酸填充物呈现扁平化，但即使在周后，总体积仍保持不变。组织学上，透明质酸填充物通过成纤维细胞的迁移和增殖、胶原的诱导和血管生成，作为自体组织替代的支架，继而促进脂肪细胞的增殖。这项研究表明，通过用自体组织替换部分注射的透明质酸填充物，总容量可以长期保持。
Background: Because subcutaneously injected hyaluronic acid filler is absorbed over 6 months to 1 year after the treatment of facial wrinkles, frequent retreatment may be required. However, persistent long-term effects are often clinically observed when hyaluronic acid filler is injected as a bolus for facial augmentation. Therefore, the authors investigated, over time, the changes in volume and histologic features of subcutaneous bolus injections of hyaluronic acid.Methods: Hyaluronic acid filler was subcutaneously injected as a bolus into the dorsum of 6-week-old rats. At several time points (immediately after injection and 4, 8, 16, 32, and 64 weeks thereafter), magnetic resonance imaging was introduced to observe morphologic changes and to measure volume. Histologic examination of sectioned tissues was also performed.Results: The average volume increased for up to 4 weeks after injection and then gradually decreased, with 74.8 percent of the injected volume remaining after 64 weeks, with no statistical difference compared to the initial volume. Histologic analysis revealed that lattice structures were created by fibroblasts and collagen fibers, and blood vessels and adipocytes were also generated in the filler.Conclusions: Although subcutaneous bolus injections of hyaluronic acid filler exhibited flattening, the total volume was maintained even after 64 weeks. Histologically, hyaluronic acid filler acted as a scaffold for autogenous tissue replacement by means of fibroblast migration and proliferation, collagen induction, and angiogenesis, followed by proliferation of adipocytes. This study demonstrates that the total volume is maintained long-term by replacing part of the injected hyaluronic acid filler with autologous tissues.