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Paradigmenwechsel im Verständnis der Wirkung von Hyaluronsäurefillern

Paradigm shift in understanding hyaluronic acid filler effects

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Zusammenfassung

Hyaluronsäure (Hyaluron; HA) ist eine wichtige Komponente der extrazellulären Matrix, die einen altersabhängigen Konzentrationsabfall zeigt. Während unvernetzte HA rasch abgebaut wird, zeigen Filler mit vernetzter HA Halbwertszeiten von 6 bis 12 Monaten. Diese Filler erfreuen sich zunehmender Beliebtheit in der ästhetischen Medizin und erlauben einen vielfältigen Einsatz. Obwohl HA-Filler Fibroblasten aktivieren können, ist dies für die langfristigen Effekte von untergeordneter Relevanz. Durch die Platzierung der Filler im subkutanen Fettgewebe kommt der Wechselwirkung mit somatischen Stammzellen und reifen Adipozyten eine größere Bedeutung zu. Tatsächlich führt vernetzte HA zur Proliferation von Präadipozyten, fördert die Differenzierung in reife Adipozyten und vermindert Seneszenz, Apoptose und Lipolyse reifer Adipozyten. Hieraus ergeben sich neue Perspektiven für die Entwicklung von Fillern für die ästhetische Medizin in der Zukunft.

Abstract

Hyaluronic acid (hyaluron; HA) is an important constituent of the extracellular matrix and has an age-dependent decrease in tissue concentration. While natural HA is rapidly degraded, filler cross-linked HA achieve a half-life of 6–12 months. Such fillers enjoy increasing popularity in esthetic medicine and are versatile tools. Although HA fillers can activate fibroblasts it is of minor importance for long-term results. Fillers are injected into subcutaneous adipose tissue. Their interaction with somatic stem cells and mature adipocytes has gained increasing interest. Cross-linked HA can indeed support proliferation of pre-adipocytes, stimulate their differentiation into mature adipocytes and protect the mature cells from senescence, apoptosis and lipolysis. This view offers a new perspective on the development of future fillers for esthetic medicine.

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Authors and Affiliations

  1. Klinik für Dermatologie und Allergologie, Städtisches Klinikum Dresden, Friedrichstr. 41, 01067, Dresden, Deutschland

    U. Wollina

  2. Department of Plastic Surgery, Hospital São Lucas da PUCS, Porto Alegre, Brasilien

    A. Goldman

Authors
  1. U. Wollina
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  2. A. Goldman
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Correspondence to U. Wollina.

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Interessenkonflikt

U. Wollina und A. Goldman geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien. Für Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts, über die Patienten zu identifizieren sind, liegt von ihnen und/oder ihren gesetzlichen Vertretern eine schriftliche Einwilligung vor.

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Wollina, U., Goldman, A. Paradigmenwechsel im Verständnis der Wirkung von Hyaluronsäurefillern. Hautarzt 72, 403–407 (2021). https://doi.org/10.1007/s00105-021-04780-x

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