Association between collagen production and mechanical stretching in dermal extracellular matrix: In vivo effect of cross-linked hyaluronic acid filler. A randomised, placebo-controlled study

• Published in: Journal of dermatological science Vol. 69; no. 3; pp. 187 - 194
• Main Authors: Turlier, Virginie, Delalleau, Alexandre, Casas, Christiane, Rouquier, Amandine, Bianchi, Pascale, Alvarez, Sandrine, Josse, Gwendal, Briant, Alain, Dahan, Serge, Saint-Martory, Christine, Theunis, Jennifer, Bensafi-Benaouda, Amel, Degouy, Arnaud, Schmitt, Anne-Marie, Redoulès, Daniel
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ireland Ltd 01.03.2013
• Subjects: Adult; Aged; Biopsy; Collagen - metabolism; Cross-Linking Reagents - pharmacology; Dermatology; Extracellular matrix; Extracellular Matrix - physiology; Female; Fibroblasts; Finite Element Analysis; Gene Expression Regulation; Humans; Hyaluronic Acid - therapeutic use; Hyaluronic acid fillers; Matrix Metalloproteinases - metabolism; Mechanical stretching; Middle Aged; Neocollagenesis; Procollagen - metabolism; Skin - drug effects; Skin - metabolism; Skin - pathology; Skin Physiological Phenomena; Stress, Mechanical; Time Factors; Tissue Inhibitor of Metalloproteinase-1 - metabolism; Fibroblasts; Extracellular matrix; Hyaluronic acid fillers; Mechanical stretching; Neocollagenesis
• ISSN: 0923-1811; 1873-569X; 1873-569X
• DOI: 10.1016/j.jdermsci.2012.12.006

The effects of hyaluronic acid (HA) injection on tissue collagen anabolism are suggested to be related to the induction of mechanical stress, causing biochemical changes in skin physiology. To ascertain the association between dermal mechanics modulated by a hyaluronic acid-based filler effect and metabolism. Sixty females were randomised to receive a 0.5mL injection of HA gel or isotonic sodium chloride (control) in the arm. Skin biopsies were taken at baseline and after 1, 3 and 6 months. Protein and gene expression of procollagen, matrix metalloproteinases (MMP) and MMP tissue inhibitors (TIMP1) were measured blind by ELISA and qPCR, respectively. Injected volumes were measured by high-frequency ultrasound and radiofrequency analysis. Skin layer effects of injections were analysed by finite element digital modelling. One month after injection, the filler induced an increase in procollagen (p=0.0016) and TIMP-1 (p=0.0485) levels and relative gene expression of procollagen III and I isoforms compared with the controls. After 3 months, procollagen levels remained greater than in the controls (p=0.0005), whereas procollagen expression and TIMP-1 and MMP content were no longer different. Forty-three percent of the injected filler volume was found at 1 month, 26% after 3 months and 20% after 6 months. The ultrasound imaging technique limited the scope of the investigation and precluded an evaluation of the action of the filler at the hypodermic level. Integrating both mechanical and biological aspects, our results suggest that mechanical stress generated by cross-linked HA plays a role in dermal cell biochemical response.