RESUMO
Abstract Improving vaccine immunity and reducing antigen usage are major challenges in the clinical application of vaccines. Microneedles have been proven to be painless, minimally invasive, highly efficient, and have good patient compliance. Compared with traditional transdermal drug delivery, it can effectively deliver a large-molecular-weight drug into the skin, resulting in a corresponding immune response. However, few studies have examined the relationship between microneedle loading dose and immune effects. In this study, the hyaluronic acid (HA) conical and pyramidal dissolving microneedles were prepared by the two-step vacuum drying method, respectively. The model drug ovalbumin (OVA) was added to HA to prepare dissolving microneedles with different loading amounts. The mass ratios of HA to OVA were 5:1, 5:3, and 5:5. The mechanical properties of the dissolving microneedles were characterized using nanoindentation and in vitro puncture studies. The immune effects of the matrix and drug content were studied in Sprague-Dawley (SD) rats. Finally, the diffusion behavior of OVA and the binding mode of HA and OVA in the microneedles were simulated using Materials Studio and Autodocking software. The experimental results showed that the conical microneedles exhibited better mechanical properties. When the mass ratio of HA to OVA was 5:3, the immune effect can be improved by 37.01% compared to subcutaneous injection, and achieved a better immune effect with relatively fewer drugs. This conclusion is consistent with molecular simulations. This study provides theoretical and experimental support for the drug loading and efficacy of microneedles with different drug loadings
Assuntos
Injeções Subcutâneas/efeitos adversos , Preparações Farmacêuticas/análise , Vacinas/análise , Imunização/classificação , Testes Mecânicos/instrumentação , Ácido Hialurônico/agonistas , Antígenos/efeitos adversosAssuntos
Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/administração & dosagem , Reação no Local da Injeção/epidemiologia , Poliésteres/administração & dosagem , Adulto , Face/diagnóstico por imagem , Feminino , Humanos , Incidência , Reação no Local da Injeção/etiologia , Injeções Subcutâneas/efeitos adversos , Injeções Subcutâneas/métodos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Fotografação , Pele/diagnóstico por imagem , Resultado do TratamentoRESUMO
BACKGROUND: Calcium hydroxylapatite (CaHA) is effective for dorsal hand rejuvenation. Higher dilutions are used for biostimulation with fewer side effects. OBJECTIVE: To evaluate the efficacy and safety of 2 techniques of diluted CaHA injection for dorsal hand treatment. METHODS: A prospective, evaluator-blinded study was performed to compare (side-to-side) techniques for treating the dorsum of the hands with diluted CaHA: deep fat lamina or subdermal injection. Fifteen women with aging grades between 1 and 3 on the MHGS (Merz hand grading scale) were enrolled and followed up for 24 weeks. The outcomes were a histological analysis of collagen, skin viscoelasticity, high-frequency ultrasound parameters, MHGS score, and the global aesthetic improvement scale (GAIS) score. RESULTS: Improvement in the MHGS and GAIS scores (p < .01) was observed, with no difference between techniques (p > .05). Skin viscoelasticity measures and ultrasonography for dermal parameters improved for both treatments (p < .01). The mean total collagen density increased from the baseline for both techniques (p < .01). Pain during the procedure as well as adverse effects within the follow-up did not differ between treatments (p > .4). The overall satisfaction was 12% greater for the subdermal technique (p < .05). CONCLUSION: Diluted CaHA improves the skin quality of aging hands with a safe profile, without substantial differences between the techniques.
Assuntos
Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/administração & dosagem , Durapatita/administração & dosagem , Dor Processual/diagnóstico , Pele/efeitos dos fármacos , Colágeno/análise , Preenchedores Dérmicos/efeitos adversos , Durapatita/efeitos adversos , Estética , Feminino , Seguimentos , Mãos , Humanos , Injeções Subcutâneas/efeitos adversos , Injeções Subcutâneas/métodos , Pessoa de Meia-Idade , Medição da Dor , Dor Processual/etiologia , Satisfação do Paciente , Estudos Prospectivos , Rejuvenescimento , Pele/química , Envelhecimento da Pele/efeitos dos fármacos , Envelhecimento da Pele/fisiologia , Resultado do TratamentoRESUMO
Vascular compromise is a rare but serious complication of dermal filler injection. Vessel occlusion tends to have a more immediate onset of symptoms. We report a case of skin necrosis that started with pain, erythema and edema two days after hyaluronic acid filler on the forehead of a 57-year-old woman. The patient was treated with less than 24 hours the onset of symptoms, leaving discreet scar. The current theories that explain skin necrosis caused by HA fillers include angiospasm and embolization. The frontal region has many anastomoses, the embolized proximal vessel initially did not lead to symptoms. However, the HA inside the artery may have traveled over time and reached a terminal distal branch, which generated localized skin damage and pain. The urgent treatment of arterial occlusion and thromboembolism caused by HA injection is intralesional high-dose hyaluronidase.
Assuntos
Cicatriz/etiologia , Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/efeitos adversos , Ácido Hialurônico/efeitos adversos , Pele/patologia , Cicatriz/prevenção & controle , Preenchedores Dérmicos/administração & dosagem , Feminino , Testa , Humanos , Ácido Hialurônico/administração & dosagem , Hialuronoglucosaminidase/administração & dosagem , Injeções Intralesionais , Injeções Subcutâneas/efeitos adversos , Pessoa de Meia-Idade , Necrose/induzido quimicamente , Necrose/complicações , Necrose/tratamento farmacológico , Pele/efeitos dos fármacos , Resultado do TratamentoRESUMO
We present a case report of a hyaluronic acid filler-induced complication documented using high-frequency ultrasound. We regard the scientific value of the case as indicating the benefit that ultrasound provides for the management and documentation of this complication. This technology has been becoming increasingly widespread in the care of patients who experience unwanted effects of hyaluronic acid filler because it can be used for the high-resolution visualization of skin layers as well as the differentiation of filler types and their relationships with adjacent tissues (via gray scale or B-mode ultrasound) and blood vessels (via color Doppler ultrasound). In addition, it was possible to conclude that external vascular compression causes clinical repercussions, a fact that is often questioned by some dermatologists. This questioning is based on the vast vascularization and anastomosis of arteries of the face, which should permit compensation for vascular compression. However, in this case, there was no doubt that compression caused a region of low output with the clinical manifestation of peri-oral pallor. Ultrasound was used to document the compression of a vessel by the filler; after application of hyaluronidase, increased vessel lumen and clinical reversal of hypoperfusion in the affected area were observed.
Assuntos
Arteriopatias Oclusivas/diagnóstico , Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/efeitos adversos , Ácido Hialurônico/efeitos adversos , Ultrassonografia Doppler em Cores , Adulto , Arteriopatias Oclusivas/tratamento farmacológico , Arteriopatias Oclusivas/etiologia , Artérias/diagnóstico por imagem , Bochecha/diagnóstico por imagem , Preenchedores Dérmicos/administração & dosagem , Feminino , Humanos , Ácido Hialurônico/administração & dosagem , Hialuronoglucosaminidase/uso terapêutico , Injeções Subcutâneas/efeitos adversos , Rejuvenescimento , Pele/irrigação sanguínea , Resultado do Tratamento , Grau de Desobstrução VascularAssuntos
Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Heparina/efeitos adversos , Dermatopatias Vesiculobolhosas/induzido quimicamente , Dermatopatias Vesiculobolhosas/patologia , Toxidermias/etiologia , Toxidermias/patologia , Anticoagulantes/efeitos adversos , Fatores de Tempo , Biópsia , Hemorragia/induzido quimicamente , Injeções Subcutâneas/efeitos adversosRESUMO
Abstract Cutaneous reactions associated with interferons (IFNs) treatment are either localized or generalized. The most common presentation of localized reactions at IFNs injection site is usually an erythematous patch or plaque. Local leukocytoclastic vasculitis presenting with cutaneous necrosis is extremely rare. We report a 19-year-old man with hepatitis B who had local leukocytoclastic vasculitis induced by interferon-gama injection at the injection site. After changing the injection sites and using the combined treatment of prednisone and colchicine, the previous lesion healed and no other cutaneous lesion occurred. We also made a mini review of such cases.
Assuntos
Humanos , Masculino , Adulto Jovem , Pele/patologia , Interferon gama/efeitos adversos , Vasculite Leucocitoclástica Cutânea/induzido quimicamente , Pele/efeitos dos fármacos , Prednisona/uso terapêutico , Colchicina/uso terapêutico , Resultado do Tratamento , Vasculite Leucocitoclástica Cutânea/patologia , Vasculite Leucocitoclástica Cutânea/tratamento farmacológico , Eritema/induzido quimicamente , Eritema/patologia , Injeções Subcutâneas/efeitos adversos , Anti-Inflamatórios/uso terapêutico , Necrose/induzido quimicamente , Necrose/patologiaRESUMO
Cutaneous reactions associated with interferons (IFNs) treatment are either localized or generalized. The most common presentation of localized reactions at IFNs injection site is usually an erythematous patch or plaque. Local leukocytoclastic vasculitis presenting with cutaneous necrosis is extremely rare. We report a 19-year-old man with hepatitis B who had local leukocytoclastic vasculitis induced by interferon-gama injection at the injection site. After changing the injection sites and using the combined treatment of prednisone and colchicine, the previous lesion healed and no other cutaneous lesion occurred. We also made a mini review of such cases.
Assuntos
Interferon gama/efeitos adversos , Pele/patologia , Vasculite Leucocitoclástica Cutânea/induzido quimicamente , Anti-Inflamatórios/uso terapêutico , Colchicina/uso terapêutico , Eritema/induzido quimicamente , Eritema/patologia , Humanos , Injeções Subcutâneas/efeitos adversos , Masculino , Necrose/induzido quimicamente , Necrose/patologia , Prednisona/uso terapêutico , Pele/efeitos dos fármacos , Resultado do Tratamento , Vasculite Leucocitoclástica Cutânea/tratamento farmacológico , Vasculite Leucocitoclástica Cutânea/patologia , Adulto JovemAssuntos
Anticoagulantes/efeitos adversos , Toxidermias/etiologia , Toxidermias/patologia , Heparina/efeitos adversos , Dermatopatias Vesiculobolhosas/induzido quimicamente , Dermatopatias Vesiculobolhosas/patologia , Idoso , Idoso de 80 Anos ou mais , Biópsia , Hemorragia/induzido quimicamente , Humanos , Injeções Subcutâneas/efeitos adversos , Masculino , Pessoa de Meia-Idade , Fatores de TempoRESUMO
Immunogenicity and safety of a recombinant, live-attenuated, tetravalent dengue disease vaccine (CYD-TDV) was evaluated in children/adolescents in Brazil. In this observer-blind, placebo-controlled, phase II single-center study, children/adolescents (ages 9-16 years) were randomized to receive CYD-TDV or placebo at 0, 6, and 12 months. Immunogenicity was assessed using a 50% plaque neutralization test. Overall, 150 participants were enrolled (CYD-TDV: N = 100; placebo: N = 50). Injection site pain and headache were the most common solicited injection site and systemic reactions. Unsolicited adverse events (AEs) and serious AEs were similar between groups. No serious AEs were vaccine-related. Geometric mean titers against all dengue virus serotypes increased with CYD-TDV vaccination and were 267, 544, 741, and 432 1/dil for serotypes 1-4, respectively, after dose 3, representing a mean fold increase from baseline of 5, 6, 6, and 20, respectively. CYD-TDV vaccination elicited a neutralizing antibody response against serotypes 1-4 and was well-tolerated in children/adolescents in a dengue-endemic region.