Abstract
BACKGROUND: Involutive skin changes are an urgent problem in the modern world, which leads to the need to find a comprehensive and effective treatment method aimed at reducing the activity of matrix metalloproteinases (MMPs) and transforming growth factor-2 (TGF-2), which are responsible for the degradation of extracellular matrix proteins.
 AIMS: Determination of the degree of influence of microneedling monotherapy, fractional laser, as well as a combination of these methods on the content of MMP-2, MMP-3, MMP-12, TGF-2 in the skin of patients with involutive signs.
 MATERIAL AND METHODS: In a single-center, prospective, parallel, non-randomized study, 82 patients with involutive changes in the facial skin took part, which were divided into 3 groups. 26 patients (Group 1) received microneedling monotherapy (3 treatments every 3 weeks), 27 patients (Group 2) received fractional laser monotherapy (3 treatments every 4 weeks) and 29 patients (Group 3) combined therapy of microneedling and fractional laser (3 procedures every 4 weeks). The study lasted 10 weeks, before and after the start of the study, a biopsy of the skin behind the ear was taken to determine the level of MMP-2, -3, -12 and TGF-2.
 RESULTS: Comparative data of enzyme immunoassay with biotin monoclonal conjugates between the groups revealed a difference in the content of matrix metalloproteinases and TGF-: in group 1, there was less significant dynamics in all studied parameters compared to group 3: MMP-2 (p=0.0390), MMP-3 (p=0.0466), MMP-12 (p=0.0104) and TGF- (p=0.0080) and 2 group MMP-12 (p=0.0484) and TGF- (p=0.0367). When comparing groups 2 and 3, more significant dynamics was observed in group 3 in terms of MMP-2 (p=0.0290), MMP-12 (p=0.0511) and TGF- (p=0.0241). Thus, the most significant results were obtained in group 3.
 CONCLUSION: Combined treatment using microneedling and fractional laser leads to a significant decrease in the level of MMP-2, -3, -12 and TGF-2, which allows us to consider this therapeutic complex as a promising way to correct involutive skin changes.
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