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5-Aminolevulinic Acid-Hyaluronic Acid Complexes Enhance Skin Retention of 5-Aminolevulinic Acid and Therapeutic Efficacy in the Treatment of Hypertrophic Scar

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Abstract

Hypertrophic scar is a serious skin disorder, which reduces the patient’s quality of life. 5-aminolevulinic acid (5-ALA)-mediated photodynamic therapy has been used to treat patients with hypertrophic scar. However, the poor skin retention of 5-ALA limited the therapeutic effect. In this study, we constructed the 5-ALA-hyaluronic acid (HA) complex to potentially prolong the skin retention of 5-ALA for improving the therapeutic efficacy. HA is a polysaccharide with viscoelasticity and the carboxyl groups could conjugate with amino groups of 5-ALA via electrostatic interaction. The protoporphyrin IX (PpIX) assay revealed that 5-ALA-HA complexes markedly enhanced the skin retention, resulting in increased generation and accumulation of endogenous photosensitizer PpIX. Furthermore, 5-ALA-HA complexes allowed PpIX to be maintained at a high level for 12 h, much longer than the 3 h of 5-ALA alone. And then, the accumulative PpIX induced by 5-ALA-HA in human hypertrophic scar fibroblasts (HSF) was triggered by laser irradiation to produce sufficient reactive oxygen species, leading to efficient necrosis and apoptosis of HSF. In vivo therapeutic efficacy study indicated that 5-ALA-HA effectively reduced the appearance and scar thickness, and the scar elevation index with 5-ALA-HA treatment was significantly lower than other groups, suggesting that the 5-ALA-HA-treated scar became flattened and was closely matched to the unwounded tissues. Moreover, 5-ALA-HA treatment markedly downregulated the gene expression levels of α-SMA and TGF-β1, demonstrating attenuated the scar formation and growth. Therefore, the 5-ALA-HA complex enhancing skin retention and PpIX accumulation at the lesion site provide a promising therapeutic strategy for hypertrophic scar.

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Funding

This work was supported by the Fundamental Research Funds for the Central Universities, Sun Yat-sen University (Project No. 22qntd4504) and Guangdong Basic and Applied Basic Research Foundation (Project No. 2020A1515110147, 2021A1515011418, 2021A1515012025).

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  1. Liya Yang and Huihui Deng contributed equally to this work.

Authors and Affiliations

  1. School of Pharmaceutical Sciences, Sun Yat-sen University, University Town, Guangzhou, 510006, People’s Republic of China

    Liya Yang, Huihui Deng, Yiman Chen, Yuling Chen, Ling Guo & Min Feng

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  1. Liya Yang
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  2. Huihui Deng
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  3. Yiman Chen
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  4. Yuling Chen
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Contributions

Min Feng and Lin Guo planned and supervized the project. Huihui Deng, Liya Yang, and Yuling Chen formulated the systems and performed experimental work. Liya Yang and Yiman Chen contributed to writing the manuscript. All the authors contributed to editing the manuscript.

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Correspondence to Ling Guo or Min Feng.

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Yang, L., Deng, H., Chen, Y. et al. 5-Aminolevulinic Acid-Hyaluronic Acid Complexes Enhance Skin Retention of 5-Aminolevulinic Acid and Therapeutic Efficacy in the Treatment of Hypertrophic Scar. AAPS PharmSciTech 23, 216 (2022). https://doi.org/10.1208/s12249-022-02370-1

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