Abstract
Filler injection demand is increasing worldwide, but no ideal filler with safety and longevity currently exists. Sodium alginate (SA) is the sodium salt of alginic acid, which is a polymeric polysaccharide obtained by linear polymerization of two types of uronic acid, d-mannuronic acid (M) and l-guluronic acid (G). This study aimed to evaluate the therapeutic value of SA. Nine SA types with different M/G ratios and viscosities were tested and compared with a commercially available sodium hyaluronate (SH) filler. Three injection modes (onto the periosteum, intradermally, or subcutaneously) were used in six rats for each substance, and the animals were sacrificed at 4 or 24 weeks. Changes in the diameter and volume were measured macroscopically and by computed tomography, and histopathological evaluations were performed. SA with a low M/G ratio generally maintained skin uplift. The bulge gradually decreased over time but slightly increased at 4 weeks in some samples. No capsule formation was observed around SA. However, granulomatous reactions, including macrophage recruitment, were observed 4 weeks after SA implantation, although fewer macrophages and granulomatous reactions were observed at 24 weeks. The long-term volumizing effects and degree of granulomatous reactions differed depending on the M/G ratio and viscosity. By contrast, SH showed capsule formation but with minimal granulomatous reactions. The beneficial and adverse effects of SA as a filler differed according to the viscosity or M/G ratio, suggesting a better long-term volumizing effect than SH with relatively low immunogenicity
Highlights
Many types of fillers are widely used for cosmetic and reconstructive purposes but there is no ideal filler yet [1]
The principal aim of this study was to evaluate the potential of Sodium alginate (SA) as a filler
The cause may be due to cell infiltration and the construction of collagen fibers inside the SA substance, as observed in Elastica van Gieson staining
Summary
Many types of fillers are widely used for cosmetic and reconstructive purposes but there is no ideal filler yet [1]. An ideal filler should be effective in shaping and volumizing, long-lasting, biocompatible, safe, and low in cost. Hyaluronic acid (sodium hyaluronate, SH), which is currently the most widely used filler, is effective and safe [2], but it is expensive per volume and not long-lasting [3]. Sodium alginate (SA) is a highly biocompatible substance [4] that is used in a wide range of fields, from food additives [5] to pharmaceuticals [6]. SA is the sodium salt of alginic acid extracted from brown algae [7], and is inexpensive compared with other medical materials.
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