| Background&ObjectiveThe pollution of environment, social pressure, irregular diet, etc. enhance theexogenous ageing of skin, these factors induce the dry, rough, loose, wrinkled skinand other forms of “ageing”. This impacts on the quality of life seriously. Accompanied by skin aging, cellular structure has changed, including bothappearance and function of epidermis, dermis and cutaneous appendages. Epidermisthickness does not have obvious change during the aging process, while the functionof stratum corneum is weaker. The mutation of base layer cell makes the transitionwhich connects epidermis and dermis flater. That is the reason of being morevulnerable under the external force. Dermis will be thin along with aging process.The number of fibroblasts declines constantly, as well as that of collagen. That makescutis laxa, wrinkles and poor elasticity. The decrease of sweat glands and sebaceousglands induces the appearance which presents dry, rough and sensitive of skin.Mechanism of skin aging has been studied in various methods. The lack of growthfactors is one of reasons of skin aging, such as transforming growth factor-β1、β2,fibroblast growth factor, etc. The decay of fibroblast should be pointed out. Collagentype Ⅰ and Ⅲ ratio inverts gradually, the expression of mature collagen type Ⅰ reduces away. With the increase of fibroblast’s passage in vitro, mRNA’s expressionof collagen type Ⅰ and receptors of Ⅰ and Ⅱ of TGF-β has a sharp fall. It is PRPthat can provide so many growth factors that decay skin aging.Platelets are nonnuclear celluar fragments which are derived frommegakaryocytes (MKs), giant cells resident in the bone marrow. They containglycogen, dense granules, alpha granules and lysosomes, the last three granules arethe main types. Platelet lysosomes contain enzymes which have the ability ofinducing protein and degradating matrix. Dense granules release several activesubstances, such as adenosine adiphosphate (ADP), adenosine triphosphate (ATP),serotonin and calcium ion. Several platelet-secreted proteins, such as coagulationfactors, growth factors and other active proteins are stored in the alpha granules, thegrowth factors, however, play a significant role in the movement, proliferation ofcells and the repairation or regeneration of vessels. There are plenty of growth factorsin the platelet concentrates, such as platelet-derived growth factor(PDGF),transforming growth factor-β1、β2(TGF-β1、β2), fibroblast growth factor(FGF),vascular endothelial growth factor(VEGF), insulin-like growth factor(IGF), epidermalgrowth factor(EGF) and so on.So far, there has been30years’ research of the platelet-rich plasma (PRP), whichis the first generation of platelet concentrate. Adding calcium chloride (CaCl2) orthrombin is method to active platelets and the release of growth factors. PRP willbecome a solid clotted jelly mass which is named autologous platelet-rich gel (APG).Theoretically, APG induce the formation of blood capillary vessels and collagen,improve the overall appearance of face and the quality of people’s lives by theconcentration of various growth factors. These growth factors promote cellproliferation and migration including blood and vascular cell and stimulate thegrowth of fibroblasts and other source of mesenchymal tissue cells and synthesis ofextracellular matrix, such as collagen and fibrin which contribute to formation of newblood vessels and deposition of collagen. Nowadays, the technique of microneedles iswidly used. Its mechanism is stimulating skin regeneration through tiny damage.Importing APG has more powerful effect with it. It is painless, absorbable andoperable that we put much more attention on this technique. There are few reports about external use of APG on improvement of facial skinproperties. This study aims to find out whether APG contributes to the female skin bythe use of mirconeedle rollers through human clinical research. The attractive pointsof PRP/APG are as follows:(1) The ability of stabling internal environment disorder caused by tissuedamage via growth factors and the synthesis and decomposition of othercytokines;(2) The method of obtaining natural concentration of autologous growth factorsis simple, efficient and minimally invasive;(3) Autologous blood products decreased immune resistance and infectiousdiseases (such as acquired immunodeficiency disease, hepatitis, etc.)(4) It is easy-to-use technique which can minimize trauma and be helpful ofclinical work and is more acceptable.MethodsFrom September2013to December2013, a consecutive series of10healthyvolunteers were enrolled and treated free of charge(average age40.3±7.025, range30~49, female). Standards of enrollment: a. healthy, no infectious disease, blooddisorders, severe mental illness, active disease and skin disease; b. the platelet countof venous blood is above100000/μl before the trial; c. do not use druges which affectplatelet function before3months of trial; d. do not receive any facial treatmentrecently; e. not in pregnancy and lactation, no bad habits; f. no severe allergies. Toaddress the research purpose, the investigators implemented a single-blindedprospective trial. The volunteers underwent bilateral facial treatment. The methodinvolved the use of APG on one side and saline on the other side (APG side/left sidewas experimental group, saline side/right side was control group). A10mL wholeblood sample was drawn and collected in sterile vacuette tube. The tubes wereimmediately centrifuged in machine and activated by stimulator, then we can getabout1.5~2.0mL PRP/APG. Before the experiment, we used dermotoscope anddigital skin analyzers to record the raw pictures and data, the experiment usedmirconeedle technique, it was a three-month study, with one session of experiment every15days. The results were evaluated every month. The outcome variables werethe data of digital skin analyzers (moisture, elasticity, complexion, olein) between twosides, a patient’s satisfaction sore and pictures.Results(1) In cheek area, there is a significant improvement of moisture, elasticity,complexion, olein between the experimental group and control group, whilethe control group is better than blank group expect the olein index;(2) Beside the complexion and olein index, experimental group is much betterthan control group in T-zone, the improvement of moisture, complexion,olein in control group is more obvious than that of in blank group;(3) Questionnaire results that experimental group is more effective than controlgroup, meanwhile, the control group is better than blank group, there is nosignificant improvement of olein and sensitivity in the perspective ofsubjective evaluation;(4) The platelet ratio of PRP in this research is effective.ConclusionsUsing microneedles roller importing APG into facial skin has a positive role inimprovement of female facial skin properties. It is a promising and easy-to-usetechnique. It is a novel method of facial rejuvenation:(1) APG has obvious improvement of moisture, elasticity, complexion and oleinin cheek area;(2) APG has visible improvement of moisture and elasticity in T-zone(mainlyrefers to nose), while adjustment of complexion and olein is not as obviousas that of cheek area;(3) Volunteers are satisfied with results;(4) Microneedles roller importing autologous APG into skin has a positive rolein female facial skin properties. It provides a novel method. It is aeasy-to-use technique which can minimize trauma and be helpful of clinical work and are more acceptable. |
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