AI Article Synopsis
- The study investigates granulomatous reactions to poly-L-lactic acid (PLLA)- fillers, focusing on the biological mechanisms behind their augmenting effects.
- It characterizes the types of cells and collagen present in PLLA-treated tissues, revealing significant macrophage and fibroblast presence, as well as increased collagen types I and III.
- The findings suggest that PLLA's augmentation is driven by the formation of a capsule involving immune cells and fibroblasts, with PLLA showing slower degradation than previously reported, remaining detectable for up to 28 months post-application.
Article Abstract
Background: Granulomatous reactions to poly-L-lactic acid (PLLA)-based filler have been described previously. Neither the biological background of these partly late-onset reactions or the desired augmenting effect of PLLA has been studied to date. Histological studies have revealed foreign body reactions and foreign body giant cell formation.
Objective: The aim of this study was to increase our knowledge about the biological mechanisms behind the augmenting effect of PLLA-based filler.
Methods: We characterised the cell infiltrate and collagen type of PLLA-treated tissue by immunofluorescence staining. The expression of genes related to collagen metabolism was determined.
Results: CD68(+) macrophages were found next to PLLA. CD90(+) fibroblasts were found alongside. αSMA-positive structures indicated myofibroblasts and neovascularisation. Substantial collagen type III deposition was detected next to PLLA particles and collagen type I was found at the periphery of PLLA encapsulations. mRNA expression for collagen type I and III transcripts, as well as for TGFβ1 and TIMP1, was upregulated significantly.
Conclusion: PLLA-induced augmentation is most likely based on capsule formation orchestrating macrophages, (myo-)fibroblasts, and collagen type I and III fibres. We observed considerably slower degradation of PLLA particles than described previously. Thus PLLA particles were still retrievable 28 months after subcutaneous application.
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| http://dx.doi.org/10.1016/j.jdermsci.2015.01.012 | DOI Listing |
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