The Potential of Topical and Injectable Growth Factors and Cytokines for Skin Rejuvenation
The Potential of Topical and Injectable Growth Factors and Cytokines for Skin Rejuvenation
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DOI：
10.1055/s-0034-1372423
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发表时间：
2014-04-01
影响因子：
1
通讯作者：
Sundaram, Hema
中科院分区：
文献类型：
--
作者：
Fabi, Sabrina;Sundaram, Hema
生长因子和细胞因子（以下统称为 GF）通过细胞间和细胞内信号通路网络控制细胞生长、增殖和分化。涉及皮肤伤口愈合的途径和涉及皮肤光老化的途径之间存在惊人的相似之处。近年来，局部和可注射的 GF 已成为一种有趣的治疗方式，可用于美容和医疗目的。本文综述了局部 GF 和自体富血小板血浆 (PRP) 中含有的可注射 GF 在皮肤再生中的作用的现有证据。它提供了最近 GF 研究的数据，讨论了它们作为抗衰老活性物质的潜力，并包括安全考虑因素。由于注射用 GF 的研究通常假设人们预先熟悉 PRP 方案及其背后的理论，因此提供了解释性说明。对目前 GF 的实验观察结果与其已证实的临床益处之间存在的证据差距进行了评估。 II 级和 III 级证据的数据支持局部 GF 用于皮肤再生，其来源包括人真皮成纤维细胞的分泌物或裂解物，以及蜗牛 Cryptomphalus aspersa 的分泌物。人类真皮成纤维细胞在缺氧应激下分泌的具有相关干细胞蛋白的GF可以加速激光换肤后的皮肤愈合。体外和动物研究、PRP 治疗患者的小病例系列研究以及对其变体富血小板纤维蛋白基质 (PRFM) 的一项前瞻性临床研究表明，可注射 GF 对于皮肤再生的价值。然而，需要更高功率的数据才能将这种概念证明扩展到基于证据的范式。局部和注射 GF 的临床应用前景广阔，但仍有待充分确定。通过持续的研究，可以积累更高证据水平的数据，并可以开发出提供最佳临床疗效、安全性、耐受性和稳定性的制剂。更好地了解 GF 的作用机制可能会增进我们对真皮信号通路的一般理解，从而促进对透明质酸和其他异质填充剂的一般理解；并允许开发 GF 与其他嫩肤方式协同组合的方案。
Growth factors and cytokines (referred to collectively hereafter as GFs) control cell growth, proliferation, and differentiation via a network of inter and intracellular signaling pathways. There are striking parallels between the pathways involved in skin wound healing and those implicated in photoaging of the skin. In recent years, topical and injectable GFs have emerged as an intriguing therapeutic modality that can be harnessed for aesthetic and medical purposes. This article provides a review of available evidence for the role in skin regeneration of topical GFs, and of injectable GFs contained in autologous platelet-rich plasma (PRP). It presents data from recent studies of GFs, offers a discussion of their potential to serve as antiaging actives, and includes safety considerations. As studies of injectable GFs typically assume preexisting familiarity with PRP protocols and the theory behind them, explanatory notes are provided. An assessment is provided of the evidence gaps that exist currently between experimental observations regarding GFs and their proven clinical benefits. Data of evidence levels II and III support the use for skin rejuvenation of topical GFs derived from sources including secretions or lysate of human dermal fibroblasts, and secretions of the snail Cryptomphalus aspersa. GFs with associated stem cell proteins, secreted by human dermal fibroblasts under hypoxic stress, can accelerate skin healing after laser resurfacing. In vitro and animal studies, small case series of PRP-treated patients and one prospective clinical study of its variant, platelet-rich fibrin matrix (PRFM), suggest the value of injectable GFs for skin rejuvenation. However, data of higher power are required to expand this proof of concept into an evidence-based paradigm. The clinical applications of topical and injectable GFs are promising, and remain to be fully defined. With continued study, data of higher evidence level can be accrued and formulations can be developed that offer optimal clinical efficacy, safety, tolerability, and stability. Better understanding of the mechanism of action of GFs can potentially advance our general understanding of dermal signaling pathways, and hence of hyaluronic acid and other alloplastic fillers; and allow the development of protocols for synergistic combination of GFs with other skin rejuvenation modalities.