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Long chain polynucleotides gel and skin biorevitalization
Abstract
Nowadays dermatological aesthetic treatments requires the use of well tolerated, tested, low invasive procedures, allowing the patients a prompt return to normal social life. This is why skin biorevitalization is a very frequent treatment, also because it can be used as an antiaging therapy by itself, as well as to prepare the skin for other aesthetic procedures. Authors describe the clinical experience on skin biorevitalization with long chain polynucleotide gel (Plinest®) for intradermal infiltration - a class III medical device, biocompatible, natural, entirely resorbable and not requiring allergy test. 143 patients of both sexes were submitted to 3 or 4 sessions of intradermal infiltration with the product in study according to the type of skin. The evaluations were performed before and 30 days after the last treatment. Results: The physician global assessment was positive in 91% of the cases, with a clinical improvement due to the reduction of superficial tine wrinkles and to a best appearance of the skin mainly pronounced in the cheeks, in the periocular area and in the neck. A digital skin measurement system for hydration, sebometry, pH and elasticity was performed in 14 patients. Data showed increase in hydration, and improvement of elasticity (21,8%). The product was very well tolerated and the injections did not cause much pain. There were no cases of severe side effects due to the product used in the study. The data obtained till now are in accord with the action of stimulous of secretion of collagenic and non collagenic proteins by fibroblasts, due to the activity of long polynucleotides molecules, but a greater number of cases are suitable to confirm these clinical results.
... Crow's feet are the rhytids spreading from the lateral canthus to the temple and may caused by aging, habitual squinting, or sunlight exposure. On histological examination, crow's feet show a configurational change in the skin that deteriorates the elastic tissue network (3). In addition, areas of crow's feet show epidermal thinning, a more compact stratum corneum, increased perifollicular fibrosis and granular layer thickness, and increased solar elastosis, compared with skin with less sun exposure (4). ...
... While previously existing filler products simply fill a contracted or depressed space, the polynucleotide-containing products not only fill the space, but also improve the regeneration environment of damaged tissue, resulting in more natural tissue regeneration (5). It has been reported that polynucleotides promote the growth of human corneal fibroblasts and increase reparation on ultraviolet B (UVB)-damaged dermal fibroblasts (3). They also appear to promote proliferation of human pre-adipocytes (6). ...
... They also appear to promote proliferation of human pre-adipocytes (6). In vivo studies have demonstrated therapeutic effects of polynucleotides on patients undergoing skin explants (7), and polynucleotides also promote fast corneal epithelization after photorefractive keratotomy (3). Polynucleotides have also been associated with an increase in the healing process in bone repair (6,8) and have been shown to stimulate angiogenesis and wound healing via increased vascular endothelial growth factor production during pathologic conditions of low tissue perfusion such as diabetes mellitus and thermal injury (9). ...
The Rejuran® is a new filler product made from purified polynucleotides. Here we present data from an animal study and a clinical trial to examine the durability, efficacy and safety of the Rejuran® on crow's feet. For the animal study, 25 mice were divided into three groups: Group 1 received phosphate buffered saline (PBS); Group 2 were treated with Yvoire®; and Group 3 were treated with Rejuran®. The durability and efficacy of each treatment were assessed by microscopy and staining. In the clinical trial, 72 patients were randomized to receive Rejuran® treatment for crow's feet on one side and Yvoire-Hydro® on the contralateral side, at a ratio of 1:1. Repeated treatments were performed every two weeks for a total of three times, over a total of 12 weeks' observation. All injections and observations of efficacy and safety were performed by the same two investigators. In the animal study, the Rejuran® group showed similar durability and inflammatory response to the Yvoire® group. Upon efficacy assessment, the Rejuran® group showed the greatest elasticity and collagen composition, and a significant difference in skin surface roughness and wrinkle depth. In the clinical trial, the primary and secondary objective efficacy outcome measure showed no statistical significance between the two groups, and in safety outcomes there were no unexpected adverse effects. Our data suggest that the Rejuran®, as a new regenerative filler, can be useful to reduce wrinkles, by showing evidence for its efficacy and safety.
Graphical Abstract
... 7 Many studies demonstrate that intradermal PN HPT immediately counteracts the signs of ageing and damaged skin through its filling and moisturising effects; at the same time, it helps to restore the dermis physiology -firmness, hydration, elasticity, and brightness -in the face, neck, and décolleté areas. 8,9 After intradermal injection, the biocompatible PN HPT physiologically release water molecules and smaller-sized oligonucleotides, prolonging the PN HPT moisturising and viscoelastic properties over time, allowing a more natural and in-depth tissue regeneration and leading to a healthier skin look. 8,9 Intradermal PN HPT injections are increasingly popular in aesthetic medicine because they are a rapid outpatient procedure, usually lasting no more than 20-30 minutes and suited to all levels of ageing skin. ...
... 8,9 After intradermal injection, the biocompatible PN HPT physiologically release water molecules and smaller-sized oligonucleotides, prolonging the PN HPT moisturising and viscoelastic properties over time, allowing a more natural and in-depth tissue regeneration and leading to a healthier skin look. 8,9 Intradermal PN HPT injections are increasingly popular in aesthetic medicine because they are a rapid outpatient procedure, usually lasting no more than 20-30 minutes and suited to all levels of ageing skin. Moreover, the treatment allows for returning to daily activities without interruptions. ...
Introduction
Even lightly compromised skin may impact self-esteem and social behaviour. After intradermal infiltration, natural-origin Polynucleotides High Purification Technology (PN HPT) promote new collagen and extracellular matrix production, translating into a physiological correction of the ageing skin. The study aimed to explore the benefits of intradermal PN HPT on the four perceptual skin quality categories “Skin Tone Evenness”, “Skin Surface Evenness”, “Skin Firmness”, and “Skin Glow” in a representative sample of 30 Asian subjects (mean age 40.2± 11.4 years old).
Methods
Study protocol: three intradermal injections of a PN HPT-based Class III CE-marked medical device at T0 (baseline assessment and first treatment session), T1 (four weeks after baseline), and T2 (eight weeks after baseline), with efficacy and safety evaluations at T1, T2, T3 (four months after baseline) and T4 (six months after baseline). Quantitative and qualitative assessments: 3D skin analysis system QuantifiCare and Global Aesthetic Improvement Scale (GAIS, Investigator and Patient subscales).
Results
PN HPT treatment led to a meaningful and statistically significant improvement of the skin surface, firmness, pigmentation, and radiance, with no early- or late-onset adverse events and benefits persisting up to the sixth-month visit in all subjects. At T4, 33% and 43% of treated subjects felt “Much Improved” and “Very Much Improved” (optimal result); 56% and 44% of treated subjects felt “Satisfied” or “Very Satisfied”. At T4, the mean Investigator GAIS scores were 3.33 out of 5.0 for the “Skin Tone Evenness” skin quality perceptual category, 3.46 for the “Skin Surface Evenness” category, 3.61 for “Skin Firmness”, and 3.45 per for the radiance determinant of the “Skin Glow” category.
Conclusion
Intradermal treatment with the PN HPT-based medical device led to a meaningful improvement of the skin surface, firmness, pigmentation, and radiance with complete safety. The aesthetic benefits persisted up to the sixth-month visit in all subjects.
... Fibroblast activation accelerates skin and mucosal healing, ignited by local hypoxia and damaged or dying cells, by priming fibroblasts to produce new collagen and elastin fibers and new matrix glycosaminoglycans. [20][21][22] The increase in elastin fibers is distinctive, e.g., +21.8% of skin elasticity under stress in one study. [21] Polynucleotides also mitigate radiation-related erythema by acting as free radical scavengers and antioxidants, as shown in subjects exposed to ultraviolet A and B radiation (290-400 nm). ...
... [20][21][22] The increase in elastin fibers is distinctive, e.g., +21.8% of skin elasticity under stress in one study. [21] Polynucleotides also mitigate radiation-related erythema by acting as free radical scavengers and antioxidants, as shown in subjects exposed to ultraviolet A and B radiation (290-400 nm). [23] These properties associate with high safety and compliance of treated subjects, without significant side effects other than occasional transient erythema. ...
Seventy to 90 percent of patients who have received radiation treatment struggle with radiation skin and mucosal toxicity. The inflicted damage to progenitor cells and local microcirculation makes it more likely that wounds, infections, and fibrosis may occur; lesions of variable severity often co-exist. Acute erythema, hyperpigmentation, and mild desquamation usually wane in weeks and require only minor treatment. Conversely, the management of persistent radiation dermatitis and telangiectasia remains unsatisfactory; chronic lesions may progress to tissue atrophy and disfiguring fibrosis.
Protrophic, natural-origin polynucleotides, formulated as Class III medical devices, have long shown to be a reliable topical option to stop the progression of radiation-related lesions. The present review illustrates the rationale of polynucleotides in skin and mucosal radiodermatitis management. It also illustrates the clinical results in a series of exploratory clinical studies carried out with polynucleotide devices over the last decade. The examined studies open the way to the high-level clinical research program, which will develop over the next years.
... PN-HPT® have been used in aesthetic medicine in monotherapy, in combination with HA, or associated with CO 2 laser for treating stretch marks. [11][12][13] PN-HPT® showed valuable in several clinical studies for treating lower limb venous ulcers, postmenopausal atrophic labia majora, and knee osteoarthritis by intra-articular infiltration. [14][15][16] In this pilot study, the authors explored the value, so far untested, of sequential PN-HPT® and HA dermal filler injections for correction of moderate to severe NLFs. ...
... -HPT® are a mixture of DNA polynucleotides of different lengths. Numerous studies have shown that PN-HPT® injections are helpful across several medical specialities[10][11][12][13][14][15] ; a recent expert report extensively discussed the PN-HPT® benefits, as monotherapy or combined with other agents, in aesthetic medicine.13 Such benefits include the enhanced deposition of the collagen and elastin fibers and restoration of collagen and elastin networks associated with exposure to PN-HPT®.13 ...
Introduction:
The mandibular profile undergoes progressive wasting with aging, and the deepening of nasolabial folds (NLFs) has a leading role. Hyaluronic acid (HA) efficiently controls tissue hydration and permeability to small and large molecules. NLFs are an acknowledged HA target; at the same time, another class of agents, PN-HPT® (Polynucleotides Highly Purified Technology), enjoy growing acknowledgement in aesthetic medicine. This exploratory, prospective study probed the rationale of sequentially associating PN-HPT® as a first priming agent acting in the skin followed by HA dermal filler injections for correcting moderate to severe NLFs.
Methods:
Following strict inclusion and exclusion criteria, the authors screened Caucasian ambulatory women aged 40 to 65 with moderate to severe NLFs and randomly selected two NLFs for each enrolled woman. Due to the purely explorative nature of the study, the authors initially planned to enroll no more than ten women. According to a split-face design, the selected right-side NLFs received 4 mL of PN-HPT® intradermally in the initial priming phase ("NLF Rx group"); the selected left-side NLFs received 4 mL of saline (placebo) ("NLF Lx group"). After three and six weeks, all patients received 2 mL of subdermal cross-linked HA over both NLF areas (4 mL overall). The total study follow-up was six months after the first injection, with objective assessments, based on the qualitative and quantitative Antera 3D® and Vectra H2® skin imaging technologies, after six weeks and 3 and 6 months.
Results:
Because of the favorable early outcomes, the authors let enrollment progress between January and June 2020 up to a total of 20 women and 40 NLFs. All treated women completed the six-month follow-up without reporting side effects, even clinically minor. The Antera 3D® device demonstrated that wrinkles and skin texture significantly improved in the NLF Rx after six weeks (monotherapy phase) and 3 and 6 months (PN-HPT® priming + HA phase) compared to baseline. HA levels, measured with the quantitative Vectra H2® assessment technology in the right NLFs, were significantly higher than contralaterally at both 3 and 6 months.
Conclusions:
Although conceived only as an exploratory investigation, the study confirmed that PN-HPT® monotherapy might be a valuable and effective option to rapidly improve the skin dermis texture and quality in individuals with moderate to severe NLFs. Acting as a priming agent in the skin, PN-HPT® prolong the clinical efficacy of cross-linked HA. Well-designed trials in larger treatment groups will hopefully confirm these early promising results.
... PN-HPT has been utilized in aesthetic medicine as biorevitalizer in monotherapy and associated with CO 2 laser for stretch marks, in dermatology for healing of venous ulcers of the lower limbs, in postmenopausal women as biorevitalizer for labia majora, and in orthopedy for intra-articular osteoarthropathy knee treatment. [33][34][35][36][37][38] The goal of this prospective and randomized study was to assess the safety and effectiveness of PN-HPT monotherapy for treating moderate-to-severe atrophic acne scars. ...
... 36 PN-HPT has a consolidated utilization in the aesthetic field from skin rejuvenation to stretch marks and vulvo-vaginal biorevitalization; recently, specific guidelines in their utilization have been implemented. [33][34][35]37 To the best of our knowledge, no controlled study has yet investigated the efficacy and safety of PN-HPT in monotherapy for atrophic acne scars. We included in the study only young Caucasian women and excluded other groups to avoid ethnicity bias. ...
Background
Managing acne scars is a challenge and therapies are divided into nonsurgical and surgical. Highly Purified Technology Polynucleotides, PN-HPT™ are a compound which contains a mixture of DNA polymers of different lengths. Numerous studies have shown that PN-HPT™ also serves as an energy source, thus influencing cellular growth and cells vitality.
Objectives
We aimed assessed the improvement in dermal quality and acne scars after PN-HPT™ versus placebo according to Antera 3D® and the patient responses to PSQ after a comparison of pretreatment and posttreatment photographs at 1 and 3 months.
Methods
We Included women aged 30-50 years old with grade 3-4 moderate-to-severe atrophic scars according to the Goodman classification; nonsmokers; had not had active acne during the past 5 years. Ten patients (PN-HPT™ group) were treated with 4.0 ml of PN-HPT™, and ten patients (control) were treated with 4.0 ml of normal saline. All medical treatments were performed in a double blinded manner; neither the injection doctor nor the patient knew if the PN-HPT™ or the placebo was being administered.
Results
Twenty women fit the inclusion criteria were enrolled in this study. Only patients in PN-HPT™ group improved significantly at 1 and 3 months after treatment compared to baseline.
Conclusions
Our prospective and randomized study showed that PN-HPT™ in monotherapy was safe and effective treatment for atrophic scar acne when compared with placebo. Prospective and randomized studies will be necessary to investigate the clinical effectiveness in a larger cohort of patients and for a longer follow-up.
... 4 Purified PNs are derived from germinal cells of salmon and other fishes 5 ; unlike cross-linked hyaluronic acid fillers that act as a volumizer, the PN provides a natural tissue regeneration. Studies have shown that it promotes human corneal fibroblasts, 6 human preadipocytes, 7 and corneal epithelization after photorefractive keratotomy, 6 in addition to increasing the healing process in bone repair and stimulation of angiogenesis and wound healing. 7,8 On the other hand, non-crosslinked hyaluronic acid skin booster provides rejuvenation through collagen formation and improvement of the skin surface roughness; thus, it acts as a skin booster without volumization, 9 unlike cross-linked hyaluronic acid that provides volumization and filling of areas of volume loss. ...
Summary:
The new concept in aesthetic medicine is heading toward regenerative medicine and the use of skin boosters in our practice, so the present case report aimed to evaluate the efficacy of injecting a polynucleotide into the lips for lip rejuvenation. Five female Middle Eastern patients were included in the study who wanted to have a lip rejuvenation treatment aiming to provide a lip hydration effect without any volumization. All patients were injected with polynucleotide using a micro cannula. Standardized photographs were taken before and after the injection procedure for evaluation of the results. All patients reported a high degree of satisfaction immediately after the injection, and there was also a marked improvement in the lip texture and elasticity where this improvement lasted 6 months after the procedure. Using polynucleotide as a skin booster for lip rejuvenation can provide a hydrating effect for the lips without any volumization, along with improvement in the lip texture, where this improvement lasts for 6 months after the procedure.
... Most of those treatment strategies aim to stimulate the production of new collagen, reduce inflammation, and increase pigmentation [4,5]. PN HPT™ have similar properties, exploited to promote the healing of chronic wounds and other indications in dermatology, orthopaedics, and gynaecology [7][8][9][15][16][17][18]. In dermatology, PN HPT™ indications have long explored depressed scars and striae distensae, including striae albae [19][20][21]. Some small studies also investigated the striae albae indication [22]. ...
Introduction: The outcomes of striae albae remodelling are currently disappointing. Replenishing the fibroblast pool of nucleotide precursors through passive exposure to Polynucleotides Highly Purified Technology (PN HPT™) facilitates the dermal production of new fibres. The manuscript reports on the outcomes of a prospective study with an intradermal PN HPT™-based medical device. Methods: Intra-subject-controlled randomised real-world study to evaluate the efficacy and safety of a medical device containing 20 mg/mL of PN HPT™ (functional ingredient) intradermal gel as therapy for moderate-to-severe striae albae. Based on a preliminary sample size assessment, the study estimated the need to enrol at least 65 mature albae from 18-to-55-year-old male and female subjects seeking ambulatory treatment (mean age: 34.1 ± 10.65). Up to eight symmetrical striae albae in the target areas (breast, abdomen, buttocks, thighs) per enrolled subject underwent randomisation into the two parallel “PN HPT™ intradermal infiltration” active group and “no-treatment striae albae” intra-subject control group. Actively treated striae albae underwent a four-session intradermal therapy cycle with the PN HPT™ device. Comparative efficacy assessments, performed at the two final evaluation visits by independent evaluators: Width of actively treated and untreated control striae albae (digital calliper). Global Aesthetic Improvement Scale (GAIS) outcomes (by investigators and subjects, respectively; assessments on digital photographic documentation). Width and wrinkling of actively treated and control striae albae (quantitative Antera 3D CS skin imaging technology). Results: The digital-calliper-assessed width for the exploratory sample of the 44 actively treated striae albae (29 control striae) decreased, on average, from 4.6 ± 2.31 at the V1 baseline visit to 2.7 ± 1.42 at V5 (first follow-up visit) one month after the last PN HPT™ intradermal infiltration at V4 (–40.8% vs. baseline, p <0.01). In a subset of 17 striae (7 subjects), the mean digital-calliper-assessed width was still a significant 2.0 ± 0.94 at the final V6 follow-up visit, six months after V1 and three months after V4 (–54.5% vs control striae albae at V6, p <0.05). At the V5 assessment, three months after V1 and one month and a half after V4, investigators and treated subjects reported average GAIS scores of 3.8 ± 0.51 (median, 4.0) and 4.0 ± 0.66 (median, 4.0) out of 5.0 as GAIS maximum score for both. The occasional mild local pain and irritation at the injection site, expected and known in the previous PN HPT™ literature, were of no clinical significance and rapidly transitory. Discussion: PN HPT™ are an innovative option with a solid rationale for treating mature striae albae. The efficacy outcomes of PN HPT™ dermal infiltrations appear noteworthy, with excellent safety and ease of use, confirming the previous results. However, waiting for complete results and confirmation by other controlled studies is prudent.
... The main advantage of this natural-origin, highly purified long-chain polynucleotide is its trophic action on dermal fibroblasts 7,8 as well as the high-water binding capacity. 9 Such features enable the plumping of the extracellular matrix with a boost in skin elasticity and turgor making PN ideal for facial fine lines and uneven and dry skin texture. 5,6,10,11 Intradermal PN injection with a 33G needle, and the use of the serial puncture technique is favored for most indications ( Figure 4A substance into the superficial layer of the skin. ...
Background
Skin boosters denote injectables that promote global improvement of the skin which includes skin texture, elasticity, hydration, and overall appearance. Polynucleotide (PN) products have become popular, but there is surprisingly little guidance on their use. We aimed to maximize the safety and efficacy of injectable PN by providing information on their pattern of practice among board‐certified dermatologists.
Methods
A total of 235 Korean board‐certified dermatologists familiar with skin boosters participated in a survey which questioned the participant's years of practice, selection of skin boosters in one's clinic, and range of lasers and light sources as well as skin care devices that are available. For those who use PN, one was asked to check all its aesthetic indications, mode of delivery, injection depth, treatment interval as well as options for combined therapy.
Results
Seventy‐one percent of the survey participants had at least 5 years of professional experience as a board‐certified dermatologist, and among the different skin boosters, 88% replied that they practiced PN injection. The top six indications for PN were fine lines on the cheek followed by infraorbital fine lines, periorbital fine lines, uneven skin texture, dry skin, and fine lines on the forehead. Many opted for a 33G needle and the serial puncture technique targeting the dermis. A total of three sessions of PN injection spaced 4 weeks apart is most often recommended. 79 percent of PN users blended PN injection with lasers and light therapy with the most popular being radiofrequency (non‐invasive, needle RF) and high‐intensity focused ultrasound (HIFU).
Conclusion
PN is a skin booster which is widely practiced among Korean dermatologists. According to our survey, the best indication of PN is facial fine lines, and as such PN injection is often repeated and combined with a variety of non‐surgical rejuvenation procedures. We hope our data help dermatologists better understand and utilize PN injection.
... 9,10 Using specifically designed, low-concentration, single-agent PN-HPT ® formulations in delicate areas such as eyelids and the periocular district minimized the incidence of wheals occasionally occurring with more concentrated PN-HPT ® formulations with or without hyaluronic acid. 9,11 The unique low-dose PN-HPT ® formulations used in such delicate areas were Plinest ® fast (7.5 mg/ml of PN-HPT ® in 2-ml prefilled syringes) and Plinest ® Eye (7.5 mg/ml of PN-HPT ® intradermic gel designed explicitly for eye contour in 2-ml prefilled syringes). ...
Background
Wasting of soft tissues leads to flattening and deflation of the aging midface skin. Polynucleotides Highly Purified Technology (PN-HPT®) demonstrated dermal hydration and elasticity as well as fibroblasts vitality and activity.
Aims
To probe the value of PN-HPT® in middle third rejuvenation in an open-design, exploratory prospective cohort study in 40 real-life ambulatorily treated women.
Methods
Three treatment sessions—at baseline (2-ml prefilled syringe containing 10 mg/ml PN-HPT®, 10 mg/ml hyaluronic acid, 200 mM mannitol) as intradermic gel, and after 3 weeks (2-ml prefilled syringe containing 20 mg/ml PN-HPT® intradermic gel) and 6 weeks (same treatment as baseline). The protocol allowed supplemental treatment with specifically formulated PN-HPT® (7.5 mg/ml) when needed in periocular and eyelid areas. Assessments: sequential photographs of the facial middle third at baseline, third treatment session and 6–8 weeks after the third treatment session; scoring of overall skin quality and texture, skin quality determinants (wrinkles and skin roughness, skin elasticity, skin brightness), scar appearance, and subjective satisfaction with impromptu 10-cm Visual Analogue Scales.
Results
Significant improvement of overall skin quality and texture (from 7.0 ± 1.06 at baseline session to 7.8 ± 0.99 at follow-up), associated with highly significant improvements of wrinkles and skin roughness, elasticity, and brightness (–17.1%, +39.6%, and +51.1%, respectively). The severity scores of post-acne scars decreased from 7.6 ± 1.32 to 4.2 ± 2.13. Individual satisfaction score at the end of treatment: 0.8 ± 0.28.
Conclusions
PN-HPT® candidate as a valuable option for facial middle third rejuvenation. Further trials will hopefully confirm these early results.
... PN is also widely present in the extracellular environment of a human body and is used to mediate the remodeling phase of wound healing (19). High-molecular-weight PNs in the skin can easily bind to water molecules for skin hydration, and PN acts as a free radical scavenger that exerts antioxidant activities and protective effects against irradiated cells (20). High-molecular-weight PN chains also affect the metabolic activities of fibroblasts, the main cells that control the renewal of various dermal components. ...
Background: Filler injection has become an extremely popular method for facial skin rejuvenation, including the periorbital area. In the recent years, new polynucleotide (PN)-containing filler products have been used for esthetic purposes.
Aim: We aimed to investigate the efficacy and safety of PN filler injection in the periorbital area.
Patients/methods: A total of 27 subjects were enrolled in this randomized, pair-matched, and active-controlled study. Each subject received filler injections thrice with two-week intervals, with a PN filler injection on one side and a non-crosslinked hyaluronic acid (HA) filler injection on the contralateral side of the periorbital area.
Results: Improvements in the visual analog scale and global esthetic improvement scale scores were not significantly different between the PN and HA groups. The improvement rates of skin elasticity and hydration decreased over time in both groups, with the PN group showing a higher improvement rate. The improvement rates of roughness and pore volume were higher in the PN group than in the HA group. The improvement rate of dermal density was not significantly different between the groups. No serious adverse events were reported.
Conclusion: The PN filler injection is effective and safe for periorbital rejuvenation.
... PN might also promote the proliferation of human pre-adipocytes, an effect that could help to counteract the loss of labial adiposity [13]. Extensively used in esthetic medicine for rejuvenation of skin, PN fillers replenish the contracted or depressed spaces and may help to improve the regeneration of several autologous skin fractions, e.g., glycosaminoglycans, proteins, and fibrils [15]. Beyond regenerative dermatology, PN have already shown benefits in gynecological surgery and orthopedics [16,17]. ...
Background and objectives: The genitourinary syndrome of menopause, with special reference to vulvovaginal atrophy, impacts on postmenopausal women's quality of life. There is a rationale for exploring the effectiveness of vulvovaginal bio-revitalization with techniques similar to those successful in cutaneous bio-revitalization (infiltration and topical application of polynucleotides and hyaluronic acid).
Background
Injective procedures using polynucleotides‐based products to promote dermal rejuvenation and revitalization are steadily evolving, yet no structured protocols are available that discuss and provide guidance in aesthetic treatments with highly purified polynucleotides.
The goal of this document is to provide consensus‐based recommendations for the safe and effective use of Polynucleotides Highly Purified Technology (PN‐HPT™) devices for skin rejuvenation.
Methods of consensus development
A team of eight experts with extensive experience in treatments for skin rejuvenation and revitalization integrated the best available evidence and clinical judgement and devised a series of practical guidance to support dermatologists, plastic surgeons and aesthetic physician in the use of PN‐HPT™ products, alone and in combination, in aesthetic medicine.
Results
For most items, the expert group achieved a majority consensus. “Recommendations” (consensus >80%) were reached for the face, periocular area, décolleté and neck, hands, scalp, and stretch marks. Recommendations include details of techniques, information on dosage, volumes to be injected, and the ideal number of required treatment sessions, as well as time intervals between them for different areas of face and body. A lower agreement level of 60% was reached on but one item related to the initial treatment cycle for the face, leading to a “Consensus statement” for that area instead of a full “Recommendation”.
Conclusions
The expert consensus illustrates the value of natural‐origin, highly purified polynucleotides (PN‐HPT™) as bio‐stimulatory booster strategy for skin priming and revitalization of face and body and provides a detailed guide for the use.
Background:
No data on the clinical results and safety profiles of the polycaprolactone (PCL) -based dermal filler for crow's feet correction have been published.
Aims:
This study was designed to compare the efficacy and safety of a novel PCL-based dermal filler, DLMR01, with that of RJR, a purified polynucleotide dermal filler.
Patients/methods:
A total of 30 subjects with symmetric crow's feet of 2-4 points on the Crow's Feet Grading Scale (CFGS) were enrolled in this randomized, patient/evaluator-blinded, split-face study. Each subject was randomized to receive injections of DLMR01 or RJR in their right or left crow's feet. At 4 and 12 weeks, all participants were evaluated via CFGS, Global Aesthetic Improvement Scale (GAIS), and PRIMOS software system.
Results:
No significant difference in CFGS, GAIS, and Ra value was detected between DLMR01 side and RJR at 12 weeks (improvement rate in CFGS from baseline at week 12-DLMR01: 48.28% [14/29], RJR: 41.38% [12/29]).
Conclusion:
The novel PCL-based dermal filler DLMR01 shows suitable efficacy and safety, widening the selection possibilities for clinicians and patients in the treatment crow's feet.
Cited By (since 1996): 4, Export Date: 3 April 2012, Source: Scopus
Polydeoxyribonucleotide (PDRN) is used in aesthetic medicine as a skin revitalyzing agent as well as to correct depressed scars and striae distansae. The purpose of this study is to evaluate the effect of PDRN in stimulating skin biorevitalization of the face in women who underwent to a complete face-lift or a mini lifting procedure, not only to improve the cosmetic appearance but also to create more suitable conditions to better tolerate surgery. 15 female patients with an age ranging from 28 and 58 years (mean age 46) who had to undergo to a mini lifting procedure (10 patients) and a complete face-lift (5 patients) were treated in four sessions preoperatively, once a week, with intradermal administration of PDRN. Four more sessions, again on a weekly basis, were carried out starting from day 15 post-operatively. During the week before surgery and the two weeks following it, a home therapy consisting of one i.m. PDRN vial a day was offered to the patients. In all treated patients scar healing was normal, with no evidence of diastase and/or delayed scarring. Morevover the skin showed a good eutrophication and the suture stitches were removed a few days earlier than in the case of the traditional protocol (on day 10 instead of day 12). The patients' subjective evaluation was positive in all cases and extremely positive in 35% of them. The results of the study reveal a trophic and revitalizing action of PDRN on the skin which is therefore useful to improve the cosmetic appearance of the face and to create those conditions that assure a better tolerability of the stress due to surgery, and to reduce the healing time.
Ageing and ultimate death, when survival offers no reproductive advantages to the species, are essential to the evolutionary process. Yet the prolongation of youth has always been a human dream. The prevention of ageing in visible areas of skin is desirable not for physiological but for social reasons; the skin proclaims our sexuality and asserts our social image. Has the aspiration any hope of success?
Ageing of the skin involves changes in the dermis, epidermis, pigment cells, hair follicles, sebaceous and sweat glands, and sense organs. Some of these changes appear intrinsic to the organs concerned; some are dependent on hormonal and other systemic mechanisms; some involve environmental factors such as radiation. If changes of the first type appear to be inevitable, those of the second may be modifiable, and those of the third may, to some extent, be preventable.
L'histoire physiologique du vieillissement de la peau
Presumptive astrocytes isolated from 10-day white Leghorn chick embryos, Factor VIII-positive human brain capillary endothelial cells, meningeal fibroblasts from 10-day chick embryos, Swiss mouse 3T3 cells, and human astrocytoma cell lines, SKMG-1 and U373, were rendered quiescent when placed in culture medium that contained 0 or 0.2% serum for 48 h; their proliferation was markedly reduced and they incorporated [3H]thymidine at a low rate. [3H]Thymidine incorporation and cell proliferation were induced in all types of cells by addition of guanosine, GMP, GDP, GTP, and to a lesser extent, adenosine, AMP, ADP or ATP to the culture medium. The stimulation of proliferation by adenosine and guanosine was abolished by 1,3-dipropyl-7-methylxanthine (DPMX), an adenosine A2 receptor antagonist, but not by 1,3-dipropyl-8-(2-amino-4-chorophenyl)xanthine (PACPX), an A1 antagonist. Stimulation of proliferation by the nucleotides was not abolished by either DPMX or PACPX. The P2 receptor agonists, alpha, beta-methyleneATP and 2-methylthioATP, also stimulated [3H]thymidine incorporation into the cells with peak activity at approximately 3.5 and 0.03 nM, respectively. These data imply that adenosine and guanosine stimulate proliferation of these cell types through activation of an adenosine A2 receptor, and the stimulation of cell proliferation by the nucleotides may be due to the activation of purinergic P2y receptors. As the primary cultures grew older their growth rate slowed. The capacity of the purine nucleosides and nucleotides to stimulate their growth diminished concomitantly. The 3T3 cells showed neither decreased growth with increased passages nor reduced response to the purines. In contrast, although the doubling time of the immortalized human astrocytoma cell lines SKMG-1 and U373 remained constant, the responsiveness to purinergic stimulation of the U373 cells decreased but that of the SKMG-1 did not. These data are compatible with a decrease in the number, or the ligand-binding affinity of the purinergic receptors, or a decreased coupling of purinergic receptors to intracellular mediators in primary cells aged in tissue culture.
Extracellular purine nucleosides and nucleotides are ubiquitous, phylogenetically ancient, intercellular signals. Purines are released from hypoxic, damaged or dying cells. Purine nucleosides and nucleotides are potent mitogens for several types of cells such as fibroblasts, endothelial cells and neuroglia. They also induce other cell types to differentiate. For example, they act synergistically with nerve growth factor to stimulate neurite outgrowth from a pheochromocytoma cell line (PC12). We propose that after injury to tissues, including the central nervous system, purine nucleosides and nucleotides interact synergistically with other growth factors. They stimulate proliferation and morphological changes in the various cell types involved in the wound healing response. In the central nervous system this response includes glial proliferation, capillary endothelial cell proliferation, and sprouting of nerve axons. Since many actions of extracellular purines are mediated through specific cell surface receptors, this hypothesis has broad pharmacological implications.