Impact Of Injection Layer,Mixed Injection And Anxiety On Inflammatory Reaction After Dermal Filler Injection In Mice

Background:The popularity of cosmetic injection has grown rapidly in recent years,but the number of complications will likely also increase.Foreign body granuloma is one of the most severe condition of delayed complications.According to clinical experience and former research,granulomas are more frequent when implantation is too superficial.Granulomatous reactions after injections of multiple dermal fillers in temporal combinations are also reported.Anxiety condition is very common among modern people,and psychocutaneous diseases are also common.The skin is an organ that strongly reactive to psychiatric and psychological conditions and this interaction is significant in the pathogenesis of several skin diseases.Objective:To observe the influence of injection layer,mixed injection and anxiety on inflammatory reaction after dermal filler injection in miceMaterials:Hyaluronic Acid(HA),Poly Methy-Methacrylate(PMMA)Methods:Twenty-four mice were randomly divided into four groups,every group had six mice.1)Injection methods and observation time:three of the four groups were injected as the same way.For every mouse,we injected 0.1ml PMMA on periosteum of its head,0.1ml PMMA subdermal on the left side of its back,and 0.05ml HA mixed with 0.05ml PMMA subdermal on the right side of its back.After one week,six weeks and twelve weeks of injection,we obtained the skin and the dermal filler for observation.The forth group of mice were used for anxiety model,were injected 0.1ml PMMA subdermal on the left side of its back and after six weeks of injection we obtained the materials.2)Anxiety model:The uncertainty bottles of drinking water method combined with single feeding was used to establish anxiety models.In the first 14 days,give water to mice exactly at the same two period of 08:30-08:50 and 16:30-16:50,and for next 14 days randomly chose one of the period for water fasting.For the last 14 days,put every mouse in a single cage and consisting on water fasting program.3)Histological observation:we observed the tissue by HE staining and Masson staining,used a semi-quantitative scale to evaluate the degree of inflammatory infiltration.Immunohistochemistry were performed for CD3 and CD68 to observe change of lymphocyte and macrophage.Results:1)The difference of inflammatory infiltration among the first week,sixth week and twelfth week was statistically significant(p<0.05).The level of inflammatory infiltration in subdermal group and mixed group were not statistically different.The score of dermal filler inside the capsule was significantly lower than that in the capsule(p<0.05).2)As to the periosteal injection group,the inflammatory infiltration score was statistically lower than subdermal injection group after one week(p<0.05),but had no difference after six weeks and twelve weeks.CD3 positive cells were more than subdermal injection after six and twelve weeks(p<0.05).3)Mixed injection had no inflammatory infiltration difference with single PMMA injection at each time point.4)The percent of open arm entries(OE%)and open arm time(OT%)were significantly less than the control group(p<0.05).The inflammatory infiltration was more severe of the anxiety group(p<0.05),CD3 positive cells increased and CD68 positive cells decreased in comparison with control group(p<0.05).Conclusion:1)Periosteal injection can reduce inflammatory infiltration during early period after injection,and can speed up its extinction.2)Mixed injection does not increase inflammatory infiltration than single injection.3)Local inflammatory infiltration is more severe in anxiety group.