Mixture Of Hyaluronic Acid Research Articles

Supraperiosteal technique protocol for forehead filling with a mixture of calcium hydroxyapatite and hyaluronic acid: Double-blind, randomized controlled clinical trial.

The current study aims to investigate the safety and efficacy of using calcium hydroxyapatite (CaHA) versus CaHA associated with hyaluronic acid (HA) for forehead volume replacement and contour restoration without forehead irregularities. This interventional study involved 132 participants in a two-arm, parallel, double-blind trial for forehead treatment using the supraperiosteal technique. Group A received CaHA, and Group B received a combination of CaHA and HA as filler materials. Follow-up assessments occurred at 30 and 180 days, incorporating the 5-point Global Aesthetic Improvement Scale (GAIS) and photographic analysis for forehead volume replacement, contour restoration, and without forehead irregularities. Safety assessments included monitoring adverse events, particularly nodules. The study included all 132 enrolled patients who completed the trial. Applying CaHA in combination with HA resulted in a statistically significant improvement in both GAIS scale scores and the reduction of forehead irregularities. The total incidence of nodules was 3.7%. Group A had four times more occurrences of nodules than Group B. Furthermore, Group B exhibited lower rates of forehead irregularities following the treatment compared to Group A. The supraperiosteal application of CaHA and HA for forehead treatment demonstrates superior efficacy in addressing signs of aging compared to the isolated use of CaHA.

Update on Evidence and Directions in Temporomandibular Joint Injection Techniques: A Rapid Review of Primary Research.

This rapid review summarizes the latest primary research in temporomandibular joint (TMJ) injection treatment. The final literature searches were conducted on 4 January 2024. Selection was performed systematically following predefined eligibility criteria. Randomized control trials concerning the treatment of TMJ disorders with intra-articular injections were included. Studies on more invasive interventions were excluded. Quality of life, joint pain and range of mandibular mobility were assessed. Ultimately, 12 studies covering a total of 603 patients qualified. They concerned: (1) arthrocentesis (AC) and the administration of, (2) injectable platelet-rich fibrin (I-PRF), (3) platelet-rich plasma (PRP), (4) hyaluronic acid (HA), (5) non-steroidal anti-inflammatory drugs (NSAIDs), and (6) hypertonic dextrose (HD) with a local anesthetic. The dominant approach was to perform arthrocentesis before administering the appropriate injection substance (I-PRF, PRP, HA, or NSAID). Two current studies on the intra-articular administration of NSAIDs, specifically tenoxicam and piroxicam, are noteworthy. A mixture of PRP and HA was injected in another two trials. These two innovative approaches may prove to be significant directions for further research on injection treatment of TMJs.

Characterization of two different alginate-based bioinks and the influence of melanoma growth within

Extrusion-based bioprinting is an established method in biofabrication. Suitable bioinks have fundamentally different compositions and characteristics, which should be examined, in order to find a perfect model system. Here, we investigate the effect of two alginate-based, yet unalike 3D-printed bioinks, pre-crosslinked alginate-dialdehyde gelatin (ADA-GEL) and a mixture of alginate, hyaluronic acid, and gelatin (Alg/HA/Gel), on the melanoma cell line Mel Im and vice versa in terms of stiffness, shrinkage, cellular behavior and colony formation over 15 days. Rheological stiffness measurements revealed two soft gels with similar storage moduli. The cells did not have a significant impact on the overall stiffness, whereas ADA-GEL (2.5/2.5%) was significantly stiffer than Alg/HA/Gel (0.5/0.1/3%). Regarding the shrinkage of printed constructs, cells had a significant influence, especially in ADA-GEL, which has covalent bonds between the oxidized alginate and gelatin. Multi-photon microscopy exhibited proliferation, cell spreading and migration in ADA-GEL with cell–cell and cell–matrix interaction, dissimilarly to Alg/HA/Gel, in which cells formed spherical, encapsulated colonies. Scanning electron microscopy and histology showed degradation and multi-layered growth on ADA-GEL and fewer examples of escaped cells on Alg/HA/Gel. Both gels serve as proliferation bioink for melanoma with more necrosis in deeper Alg/HA/Gel colonies and differences in spreading and matrix interaction. These findings show the importance of proper characterization of the bioinks for different applications.

Stretchable hydrogels of chitosan/hyaluronic acid induced by polyelectrolyte complexation around neutral pH

In this work, we propose the formation of stretchable hydrogels at neutral pH from the physical crosslinking of chitosan (CS) and hyaluronic acid (HA) by polyelectrolyte complexation. A mixture of CS (Mw ≈ 600 kg/mol, degree of acetylation ≈ 50 %) solution and HA (Mw ≈ 77 kg/mol) solution was prepared with an excess of salts screening the electrostatic interactions CS/HA. In a controlled manner, the polyelectrolyte complexation was induced through the progressive dialysis of the salted polymer mixture against a sodium acetate solution (AcONa, 0.01 M) for 7 days. Depending on [HA], various materials were obtained: viscous solutions at [HA] = 0.75 % (w/v); hydrogels at [HA] = 1.50–2.24 % (w/v) with Young modulus of 14 kPa and stretchable to 200 %. The small angle X-ray scattering characterization of the hydrogels revealed a multiscale organization related to the conformation of the polymers induced by the physical interactions. The dialysis process with AcONa was optimized by adding a dialysis step against a zinc acetate solution containing Zn2+. The combination of polyelectrolyte complexation between CS/HA and metal complexation between Zn2+ and the polymers led to an enhancement of the hydrogel stretchability up to 400 %.

Topical application of hyaluronic acid and amino acids in hard-to-heal wounds: a cost-effectiveness analysis.

The aim of this cost-effectiveness analysis was to estimate the monetary cost required to achieve a gain in health benefit. An analytic model to evaluate the cost-effectiveness of a topical medical device comprising a mixture of hyaluronic acid and amino acids (HA+AA medical device) (Vulnamin, Professional Dietetics SpA, Italy) as compared to standard of care (SoC) for hard-to-heal (chronic) wounds is presented. Retrospective data was analysed from a cohort of patients as well as information from published literature. For each paper, the following information was extracted: number of patients enrolled in each treatment arm and the results of prespecified reviewed outcomes. A total of six studies involving 378 patients were included in this pooled analysis. Findings showed that treatment with the HA+AA medical device has the potential to lower consumption of resources. With regards to wound healing, in both superficial and deep wounds, treatment benefits of the HA+AA medical device included: rapid wound size reduction; faster healing; reduction of dressing changes; reduced infection risk; and reduced treatment costs. Results showed the HA+AA medical device to be 32% more cost-effective than comparators in the treatment of hard-to-heal wounds (time horizon selected=six months). The findings of this analysis showed that treatment with the HA+AA medical device is a valid alternative to SoC care because it is cheaper, and its utility and effectiveness are greater. In addition, the results of the analysis showed a direct relationship between the time to complete healing and the increase in costs (increasing the period of time to reach complete healing increases the costs associated with the treatment).

Low Molecular Weight Hyaluronic Acid Added to Six Specific Amino Acids in the Treatment of Striae Alba (SA): An Observational Study

Striae distensae or stretch marks are a common complaint among women and can be distressing. The present study aimed to assess the efficacy of a mixture of low molecular weight hyaluronic acid and six amino acids when applied with a specific intradermal injection technique known as intra-mural fluid technique. A clinical study was carried out in 32 patients (with a dropout rate by 9.4%) with striae distensae alba (SA) in one or more of the following anatomical areas: breast, abdomen, inner thigh, trochanteric area, gluteal area, posterior supra-iliac area, and lumbar area. Product efficacy was assessed by the investigator using the Global Aesthetic Improvement Scale, while a Likert scale was used to evaluate to score the treatment tolerability and a QoL stretch marks questionnaire was used to investigate the patients’ self-body image. The treatment was effective in improving the appearance of SA fifteen days after the second treatment and 6 months after the first treatment (and after a total of 4 treatments). The product efficacy and tolerability were also perceived by the patients during each treatment session. Our results suggest that the test treatment is a valid treatment option to decrease the appearance of SA.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors https://www.springer.com/00266

Polynucleotides and Hyaluronic Acid (PN-HA) Mixture With or Without Deproteinized Bovine Bone Mineral as a Novel Approach for the Treatment of Deep Infra-Bony Defects: A Retrospective Case-Series.

Polynucleotides and Hyaluronic Acid (PN-HA) mixture showed several effects in modulation of healing process. The aim of this study was to assess the safety and clinical performance of PN-HA alone or in association with Deproteinized Bovine Bone Mineral (DBBM) with papillary preservation flaps (PPF) in the treatment of residual pockets. A total of 43 patients with 55 infra-bony defects were recruited; 30% were smokers. The mean baseline Probing Depth (PD) was 7.7 ±1.9 mm with a corresponding mean recession (Rec) of 1.9± 1.3 mm. The depth of infra-bony defect at the surgical measurement was 5.2±2.1 mm. DBBM was applied at 56% of the defects considered as not-containing based on clinical judgment. Healing was uneventful at all sites. After one year, PD reduction was 4.4±1.8 mm with a Rec increase of 1.0 ±0.8 mm. Detected bone fill at x-ray was 3.5 ± 1.9mm. The multilevel analysis showed that absence of smoking habits was associated with improved PD reduction (P =0.026) and bone gain (P= 0.039). PN-HA mixture is a safe product for periodontal surgery and seems to promote clinical benefit in the treatment of residual pockets associated to infra-bony defects.

Xenograft Combined with a Mixture of Polynucleotides and Hyaluronic Acid (PNs-HA) for Horizontal Alveolar Bone Regeneration: Clinical and Histologic Assessments in a Case Series.

The present case series aims to investigate the use of polynucleotides mixed with hyaluronic acid (PNs-HA) in the form of gel to promote bone regeneration in horizontal alveolar defects. Overall, 6 adult patients underwent localized horizontal guided bone regeneration by means of xenogeneic bone substitute and a resorbable barrier with a staged approach. The graft consisted in a mixture of deproteinized bovine bone mineral (DBBM) particles and PNs-HA gel in a 3:1 ratio, respectively. The material was covered by a resorbable collagen membrane fixed with pins to the underlying bone. Implant placement was performed after 5 months. Healing proceeded uneventfully, and, upon re-entry, the graft appeared well vascularized and firmly attached to the recipient bone. Histologically, the regenerated bone appeared highly mineralized, well-organized in lamellae and totally embedding the residual granules of the biomaterial. Histomorphometric evaluations revealed that newly formed bone occupied on average 41.2% ± 12.4% of the analysed samples. Linear measurements performed on CBCT scans yielded an overall linear horizontal bone gain of 4.91 ± 0.88 mm. These data suggest that a mixture of DBBM and PNs-HA can be safely used to promote bone regeneration in case of horizontal alveolar defects.

Physical Properties and Release Profiles of Chitosan Mixture Films Containing Salicin, Glycerin and Hyaluronic Acid

Chitosan (CS) has gained considerable attention due to its distinctive properties and its broad spectrum of potential applications, spanning cosmetics, pharmaceuticals, and biomedical uses. In this study, we characterized thin films comprising chitosan mixtures containing salicin (SAL) and glycerin (GLY), both with and without hyaluronic acid (HA) as active ingredients. Characterization was achieved through release studies of SAL, infrared spectroscopy, microscopy techniques (AFM and SEM), and thermogravimetric analysis (TGA). CS/GLY/SAL and CS/GLY/SAL/HA mixture films were fabricated using the solvent evaporation technique. We probed interactions between the components in the chitosan mixtures via infrared analysis. The concentration of released salicin was monitored at various time intervals in a phosphate buffer (PBS) at pH 5.5 using HPLC. The linear regression analysis for the calibration graph showed a good linear relationship (R2 = 0.9996) in the working concentration range of 5–205 mg/dm3. Notably, the release of SAL reached its peak after 20 min. Furthermore, the introduction of HA caused changes in the films’ morphology, but their roughness remained largely unchanged. The results obtained were compared, indicating that the release of SAL in the CS mixture films is sufficient for diverse applications, including wound-healing materials and cosmetic beauty masks.

Hyaluronic acid drug conjugates for the treatment of skin hyperpigmentation

Drug combination therapy is commonly used to treat hyperpigmentation. However, treatment success is often limited due to the insufficient activity of combined drugs. To improve the therapeutic efficacy of drug combination treatment, we synthesized and investigated several conjugates comprising homo- and heterogeneous anti-pigmenting drugs bound to a hyaluronic acid (HA) carrier through distinct biodegradable linkers. These HA-drug conjugates demonstrated a measurable drug release profile in hydrolytic media. Most of the tested conjugates, administered by mesotherapy after UV-light-induced pigmentation in a swine model, presented superior depigmentation over corresponding controls. Among them, the dendron-like conjugate, NH2-TXA-Tris-TXA-(EtCMB)3, that contains only tranexamic acid (TXA), was most effective at depigmenting the swine skin compared to its equimolar mixture of HA and TXA (control). These results emphasize the importance of conjugation depigmenting agents to HA for augmenting the efficacy of treatment and motivate the use of HA as a delivery platform for treatment of various skin disorders.

Release of liposomes from hyaluronic acid-based hybrid systems: Effects of liposome surface and size

Mixtures of hyaluronic acid (HA, in the semi-dilute entangled regime) with liposomes (high lipid concentration) exhibit a great interest in drug delivery. Considering the difference of microstructures when varying the liposome surface, we aimed to determine if liposome characteristics (surface and size) also influenced their release from these hybrid systems and to explore the mechanisms involved. Small-angle neutron scattering, cryogenic electron microscopy, zetametry, and dynamic light scattering were used to characterize liposomes. The implemented Transwell® model (two compartments separated by a polycarbonate membrane) showed that both size and surface governed liposome release. At 150 nm, anionic liposomes with or without poly(ethylene glycol) chains (PEG) migrated from HA-liposome mixtures, while cationic and neutral ones did not. Furthermore, increasing the size of PEGylated liposomes up to 200 nm or more strongly hindered their migration. Below 200 nm, the smaller the liposome size, the faster the release. Multiple and complex mechanisms (interactions between HA and liposomes, water exchanges, liposome migration, swelling and erosion, and HA reptation) were involved. Their relative importance depended on liposome characteristics. The Transwell® model is a pertinent tool to assess in vitro the release of liposomes over several weeks and discriminate the formulations, depending on the foreseen therapeutic strategy.

Hyaluronic acid/cellulose acetate polymeric mixture containing binary metal oxide nano-hybrid as low biodegradable wound dressing

Wound dressing from a polymeric mixture of cellulose acetate (CA) and hyaluronic acid (HA) embedded with copper oxide (CuO) and magnesium oxide (MgO) nanoparticles as a scaffold was successfully fabricated. Several methods, including X-Ray diffraction analysis (XRD), contact angle, Fourier-transform infrared spectroscopy (FTIR), and scanning electron microscopy (SEM), were employed to characterize the prepared nanocomposite samples. The data obtained from XRD showed that pure HA with diffraction peaks at 2θ = 20.8°, 46.7°, and 63.2° that assigned to the semi-crystalline nature of HA. At the same time, the XRD pattern of the CuO@CA nanocomposites revealed the presence of a sharp crystalline peak at 2θ = 36°, representing the presence of the CuO nanomaterial. In addition, the typical cubic MgO peaks in the MgO@CA showed the pattern at 2θ = 43.1° and 62.5°. Furthermore, the diffraction pattern of CuO/MgO@HA/CA film shows strong crystallinity since its diffraction peaks are stated at 2θ = 8.8°, 13.01°, 29.6°, and 53.5° which represents CuO nanoparticles and the polycrystalline cubic structure of MgO nanoparticles exhibit several peaks at 2θ = 29.4°, 31°, 38.7°, 42.2°, and 63°. FTIR spectra of CuO/MgO@HA/CA displayed bands at 657 cm−1 and 843 cm−1 which correspond to the broadening vibration mode for the Mg-O-Mg and the existence of Mg-O vibrations, while the single band for CuO was shown at 1556 cm−1. SEM analysis revealed that the nanoparticles of copper oxide and magnesium oxide are evenly distributed throughout the polymer mass with the clean surface of the polymer with the appearance of nanoparticles with rough size and distribution in regions of varied densities by adding binary metal oxide nanoparticles (CuO/MgO@HA/CA). Furthermore, swelling rate percent, contact angle, and degradation behavior studies showed that the swelling rate percent of the polymer mixture film decreased when adding nanometal oxide. Contact angle was increased by incorporating the metal oxide nanoparticles in the polymeric mixture structure. Moreover, the degradation behavior of prepared samples showed lower rates of deterioration and the sample containing a mixture of metal oxide nanoparticles (CuO/MgO@HA/CA) exhibits a lower weight loss value when compared to HA, HA/CA, and CA samples. Human osteosarcoma MG-63 cells were used in in-vitro cytotoxicity tests. CuO/MgO@HA/CA sample treatment on cells suggests a non-cytotoxic impact, in contrast to the MTT test, which yields cell viability values of between 70% and 80% (72 h).

Clinical Evaluation of a Novel Combination of Sodium Hypochlorite/Amino Acid and Cross-linked Hyaluronic Acid Adjunctive to Non-surgical Periodontal Treatment: A Case Series.

The adjunctive subgingival application of sodium hypochlorite/amino acid and a mixture of natural and cross-linked hyaluronic acid gels (high molecular weight) has been recently proposed as a novel modality to enhance the outcomes of non-surgical periodontal therapy. The aim of this prospective case series was to evaluate the clinical outcomes obtained following the subgingival application of a combination of sodium hypochlorite/amino acid and a mixture of natural and cross-linked hyaluronic acid (high molecular) gels in conjunction with non-surgical periodontal therapy. Twenty-one systemically healthy, non-smoking patients diagnosed with stage II-III, grade A/B periodontitis underwent full-mouth subgingival debridement (SD) performed with ultrasonic and hand instruments. All sites with probing depths (PD) ≥ 4 mm were treated with additional repeated (i.e., 2-3 times) instillation of sodium hypochlorite/amino acid gel in the periodontal pockets prior to and during SRP. Following mechanical debridement, a mixture of natural and cross-linked hyaluronic acid (high molecular) gel was applied in the pockets. The primary outcome variable was PD reduction; changes in clinical attachment level (CAL) and bleeding on probing (BOP) were the secondary outcomes. The clinical parameters were assessed at baseline, 3 and 6 months after therapy. Compared to baseline, a statistically significant mean reduction of PD values was obtained after 3 and 6 months, amounting to 2.6 ± 0.4 mm, and 2.9 ± 0.4 mm, respectively (p < 0.001). Mean CAL gain measured 2.3 ± 0.5 mm at 3 months and 2.6 ± 0.5 mm at 6 months in comparison to baseline (p < 0.001). Mean reduction of BOP values was 54.9 ± 16.9 % at 3 months and 65.6 ± 16.4 % at 6 months (p < 0.001). The number of moderate pockets (4-5 mm) decreased from 1808 at baseline to 274 at the 6-month evaluation, and the number of deep (≥ 6 mm) pockets dropped from 319 to 3, respectively. The combination of sodium hypochlorite/amino acid and a mixture of natural and cross-linked hyaluronic acid (high molecular) adjunctive to subgingival debridement may represent a valuable approach to improve the outcomes of non-surgical periodontal treatment.

Can We Do Anything Else before Removing a Button Battery from the Esophagus?-Hyaluronic Acid.

This article tests the protective effect of a commercially available mixture of hyaluronic acid, chondroitin sulfate, and poloxamer 407 on the damage caused by the exposure of esophageal mucosa to button batteries in an animal model. Experimental study. Sixty porcine esophageal samples were distributed in three groups: control (CG), exposure (EG), and exposure-protection (EPG). In EG and EPG, one CR2032 button battery per sample was inserted, both were subdivided into 2-, 4-, 6-, and 24-hour exposure subgroups, with subsequent battery removal. EPG samples were irrigated with the solution 1 hour after battery exposure. Esophageal pH and final voltage of the battery were measured. pH in CG remained stable. No significant differences in pH at 1 hour were found between EG and EPG. In EPG, the pH of the mucosa exposed to the anode was lower than in GE at 2 hours (12.44 vs. 11.89, p = 0.203) and 4 hours (13.78 vs. 11.77, p < 0.0001). In the cathode pH was significantly higher in EG at 2 hours (2.5 vs. 4.11, p < 0.0001), 4 hours (2.33 vs. 4.78, p < 0.0001), and 6 hours (2.17 vs. 2.91, p < 0.0001). Significant voltage reduction at 1 hour was found in EG compared to EPG (0.48 vs. 1.08 V, p = 0.004). Exposure to hyaluronic acid solution buffers the acidification on the side exposed to the cathode and basification on the anode. This effect can be maintained up to 3 to 5 hours, even after stopping its application. Our results suggest that a solution containing hyaluronic acid could be used as an esophageal protector after accidental ingestion of button batteries.

In vitro Cytotoxicity Evaluation of Flowable Hyaluronic Acid-Acellular Stromal Vascular Fraction (HA-aSVF) Mixture for Tissue Engineering Applications.

The stromal vascular fraction (SVF) is an aqueous fraction isolated from the adipose tissue that constitutes different kinds of cells and extracellular matrix components. Hyaluronic acid (HA) is a linear polysaccharide in vertebrate tissues and is considered a potential tissue engineering scaffold due to its biocompatible nature. In this study, we have evaluated the cytotoxicity of xenofree HA in combination with an acellular component of adipose SVF (HA-aSVF) to propose it as a candidate biomaterial for future applications. 3-(4,5-dimethyl thiazolyl-2)-2,5-diphenyltetrazolium bromide assay of L-929 cells treated with HA-aSVF was used in our study. Data were normalized to cell control (untreated) and extracts of copper and ultra-high molecular weight polyethylene were used as positive (PC) and negative controls (NC). Fibroblast cells retained the morphology after 24 h of treatment with HA-aSVF mixture and exhibited a similar percentage of cell activity compared to NC. PC showed a positive cytotoxic response as expected. The cells incubated with HA-aSVF showed a linear increase in cell activity indicating proliferation. The mixture of HA and acellular SVF in its flowable form is non-cytotoxic and showed improved cell proliferation. Hence the mixture can be proposed as a biomaterial and can be further explored for specific tissue engineering applications.

Protection against tuberculosis achieved by dissolving microneedle patches loaded with live Mycobacterium paragordonae in a BCG prime-boost strategy.

Skin vaccination using dissolving microneedle patch (MNP) technology for transdermal delivery is a promising vaccine delivery strategy to overcome the limitations of the existing vaccine administration strategies using syringes. To improve the traditional microneedle mold fabrication technique, we introduced droplet extension (DEN) to reduce drug loss. Tuberculosis remains a major public health problem worldwide, and BCG revaccination had failed to increase the protective efficacy against tuberculosis. We developed an MNP with live Mycobacterium paragordonae (Mpg) (Mpg-MNP) as a candidate of tuberculosis booster vaccine in a heterologous prime-boost strategy to increase the BCG vaccine efficacy. The MNPs were fabricated by the DEN method on a polyvinyl alcohol mask film and hydrocolloid-adhesive sheet with microneedles composed of a mixture of mycobacteria and hyaluronic acid. We assessed the transdermal delivery efficiency by comparing the activation of the dermal immune system with that of subcutaneous injection. A BCG prime Mpg-MNP boost regimen was administered to a mouse model to evaluate the protective efficacy against M. tuberculosis. We demonstrated the successful transdermal delivery achieved by Mpg-MNP compared with that observed with BCG-MNP or subcutaneous vaccination via an increased abundance of MHCII-expressing Langerin+ cells within the dermis that could migrate into draining lymph nodes to induce T-cell activation. In a BCG prime-boost regimen, Mpg-MNP was more protective than BCG-only immunization or BCG-MNP boost, resulting in a lower bacterial burden in the lungs of mice infected with virulent M. tuberculosis. Mpg-MNP-boosted mice showed higher serum levels of IgG than BCG-MNP-boosted mice. Furthermore, Ag85B-specific T-cells were activated after BCG priming and Mpg-MNP boost, indicating increased production of Th1-related cytokines in response to M. tuberculosis challenge, which is correlated with enhanced protective efficacy. The MNP fabricated by the DEN method maintained the viability of Mpg and achieved effective release in the dermis. Our data demonstrate a potential application of Mpg-MNP as a booster vaccine to enhance the efficacy of BCG vaccination against M. tuberculosis. This study produced the first MNP loaded with nontuberculous mycobacteria (NTM) to be used as a heterologous booster vaccine with verified protective efficacy against M. tuberculosis.

Hyaluronic Acid and Platelet-Rich Plasma Mixture Versus Hyaluronic Acid and Corticosteroid in the Treatment of Temporomandibular Joint Internal Derangement: A Comparative Randomized Study.

This study aimed to compare the effects of different intra-articular injections using a mixture of hyaluronic acid (HA) and platelet-rich plasma (PRP) versus hyaluronic acid and corticosteroid in the management of TMJ internal derangement with reduction. Sixty patients were randomly divided into two equal groups. Group I was injected with hyaluronic acid and PRP, while group II was injected with hyaluronic acid and corticosteroid. Pain intensity according to the visual analogue scale, maximum inter-incisal opening (MIO), lateral movement, and joint sound were measured pre-operatively and at 1 week, 1 month, and 6 months post-operatively. MIO and lateral movements were improved in both groups, with a reduction in the number of patients suffering from clicking sounds along the follow-up periods with no significant difference between the studied groups. However, regarding pain, the group injected with HA and PRP achieved the best results after 6 months, while patients treated with HA and corticosteroids obtained the best results at the end of the 1st week. Hyaluronic acid and platelet-rich plasma mixture performed better than hyaluronic acid and corticosteroid in the treatment of TMJ internal derangement with reduction at the long-term follow-up regarding pain intensity.

Assessing the Rejuvenation Effectiveness of a Hyaluronic Acid and Amino Acid Mixture in the Periorbital Region.

We performed an assessment of the rejuvenation effect of an amino acid and hyaluronic acid mixture in the periorbital area. A total of 23 of the 35 participants completed all application sessions and measurements. These 23 women were aged 30-55 years. A hyaluronic acid and amino acid mixture was injected into the participants' periorbital area. Three sessions of application with 15-day intervals were undertaken. Subjects' age, height, weight, smoking status, and sport participation were recorded. A photonumeric dark circle scale and Fitzpatrick's periorbital wrinkling classification were used for evaluation of dark circles and wrinkles in the periorbital area. Anatomical measurements (height of upper and lower eyelids) were done using ImageJ and a skin-analysis system (Observ 520). The 23 women had a mean age of 42.46±9.33 years, mean height 164.46±4.96 cm, and mean weight 63.94±8.26 kg. Before the sessions, the mean heights of the upper eyelids were 1.24±013 cm (right) and 1.21±013 cm (left), while those of the lower eyelids were 0.98±014 cm (right) and 0.97±0.17 cm (left). One month after the third session, mean upper-eyelid heights were 1.30±0.09 cm (right) and 1.28±0.11 cm (left) and lower-eyelid ones 1.02±0.11 cm (right) and 1.02±0.13 cm (left). Dark-circle and wrinkle-scale scores showed significantly positive results between before the sessions and 1 month after the third session. A hyaluronic acid and amino acid mixture can be used to rejuvenation of the periorbital area in women aged 30-55 years.

The efficacy and safety of an indocyanine green-hyaluronic acid mixture (LuminoMark™) for localization in patients with non-palpable breast lesions: A multicenter, randomized, open-label, parallel phase 3 clinical trial.

The incidence of early tumor detection is increasing due to popularization of breast cancer screening and the development of imaging techniques. Thus, suitable preoperative localization is required for proper diagnosis and treatment of non-palpable breast lesions. The purpose of this study was to evaluate the efficacy and safety of indocyanine green (ICG)-hyaluronic acid (HA) mixture for lesion localization compared to activated charcoal. This was a multicenter, randomized, open-label, parallel phase 3 clinical trial performed at four centers in Korea. Female patients scheduled for surgery to remove non-palpable breast lesions were enrolled. One hundred and nine patients were randomly assigned to a control group (activated charcoal: 0.3. - 1 mL) or a study group (ICG-HA mixture, 0.2 mL) for the localization of a breast lesion. The primary endpoint was the accuracy of resection. Secondary endpoints included the technical success rate, histopathological accuracy, skin pigmentation rate, and adverse event rate. A total of 104 patients were eligible for per-protocol analysis (control group, n = 51; study group, n = 53). The accuracy of resection in the study group was not inferior to that of the control group (90.57% vs. 98.04%, 95% confidence interval (CI): -2.31 - 18.91, p = 0.21). There was no statistically significant difference in technical success rate between the two groups (marking on breast skin: p = 0.11, marking on the excised specimen: p = 0.12). However, there were statistically significant differences in histopathological accuracy (0.26 ± 0.13 vs. 0.33 ± 0.17, p = 0.01) and skin pigmentation rate (0.00% vs. 30.77%, p< 0.01). Adverse events were not reported in either group. When localization was performed using ICG-HA, the accuracy of resection was not inferior to that of activated charcoal. However, skin pigmentation rate was significantly lower. In conclusion, ICG-HA is effective and safe for localizing of non-palpable breast lesions.

Effect of Hyaluronic Acid and Mesenchymal Stem Cells Secretome Combination in Promoting Alveolar Regeneration.

Pharmacological therapies in lung diseases are nowadays useful in reducing the symptomatology of lung injury. However, they have not yet been translated to effective treatment options able to restore the lung tissue damage. Cell-therapy based on Mesenchymal Stem Cells (MSCs) is an attractive, as well as new therapeutic approach, although some limitations can be ascribed for therapeutic use, such as tumorigenicity and immune rejection. However, MSCs have the capacity to secrete multiple paracrine factors, namely secretome, capable of regulating endothelial and epithelial permeability, decrease inflammation, enhancing tissue repair, and inhibiting bacterial growth. Furthermore, Hyaluronic acid (HA) has been demonstrated to have particularly efficacy in promoting the differentiation of MSCs in Alveolar type II (ATII) cells. In this frame, the combination of HA and secretome to achieve the lung tissue regeneration has been investigated for the first time in this work. Overall results showed how the combination of HA (low and medium molecular weight HA) plus secretome could enhance MSCs differentiation in ATII cells (SPC marker expression of about 5 ng/mL) compared to the only HA or secretome solutions alone (SPC about 3 ng/mL, respectively). Likewise, cell viability and cell rate of migration were reported to be improved for HA and secretome blends, indicating an interesting potentiality of such systems for lung tissue repair. Moreover, an anti-inflammatory profile has been revealed when dealing with HA and secretome mixtures. Therefore, these promising results can allow important advance in the accomplishment of the future therapeutic approach in respiratory diseases, up to date still missing.