Zerbinati Nicola, Calligaro Alberto
Department of Surgical and Morphological Sciences, University of Insubria (Varese) and Polyspecialist Medical Center, Pavia.
Department of Public Health, Experimental and Forensic Medicine, Unit of Histology and Embryology, University of Pavia, Pavia, Italy.
Clin Cosmet Investig Dermatol. 2018 Jan 15;11:29-35. doi: 10.2147/CCID.S143015. eCollection 2018.
Calcium hydroxylapatite (CaHA, Radiesse) is a biocompatible, injectable filler for facial soft-tissue augmentation that provides volume to tissues, followed by a process of neocollagenesis for improved skin quality.
To examine the effects of CaHA treatment on the molecular organization of collagen using a combination of picrosirius red staining and circularly polarized light microscopy.
Five subjects received subdermal injection of 0.3 mL of CaHA in tissues scheduled for removal during abdominoplasty 2 months later. Tissue specimens from the CaHA injection site and a control untreated area were obtained from excised skin at the time of surgery. Processed tissue sections were stained with picrosirius red solution 0.1% and visualized under circularly polarized light microscopy for identification of thick mature (type I) and thin newly formed (type III) collagen fibers. Pixel signals from both the control and CaHA-treated areas were extracted from the images, and morphometric computerized hue analysis was performed to provide a quantitative evaluation of mature and newly formed collagen fibers.
Under picrosirius red staining and circularly polarized light microscopy, green/yellow areas (thin newly formed collagen type III) were visible among the collagen fibers in tissue sections from the area of CaHA injection. In contrast, the majority of the collagen fibers appeared red (thick mature collagen type I) in control tissues. Morphometric analysis confirmed that, following CaHA treatment, the proportion of fibers represented by thin newly formed collagen type III increased significantly (<0.01) in comparison with the proportion of thick mature collagen type I fibers. In contrast, collagen content of control tissues consisted almost exclusively of thick mature collagen type I fibers.
The use of picrosirius red staining and circularly polarized light microscopy provides evidence that subdermal injection of CaHA stimulates the formation of new collagen and dermal remodeling.
羟基磷灰石钙（CaHA，瑞蓝）是一种生物相容性可注射填充剂，用于面部软组织填充，为组织提供容积，随后通过新胶原形成过程改善皮肤质量。
采用苦味酸天狼星红染色和圆偏振光显微镜相结合的方法，研究CaHA治疗对胶原分子结构的影响。
5名受试者在皮下注射0.3 mL CaHA，注射部位的组织计划在2个月后腹部整形手术时切除。手术时从切除的皮肤中获取CaHA注射部位和未治疗对照区域的组织标本。处理后的组织切片用0.1%苦味酸天狼星红溶液染色，在圆偏振光显微镜下观察，以识别粗大成熟（I型）和细小新形成（III型）胶原纤维。从图像中提取对照区和CaHA治疗区的像素信号，进行形态计量计算机色调分析，以定量评估成熟和新形成的胶原纤维。
在苦味酸天狼星红染色和圆偏振光显微镜下，CaHA注射区组织切片的胶原纤维中可见绿色/黄色区域（细小新形成的III型胶原）。相比之下，对照组织中的大多数胶原纤维呈红色（粗大成熟的I型胶原）。形态计量分析证实，与粗大成熟的I型胶原纤维比例相比，CaHA治疗后细小新形成的III型胶原纤维比例显著增加（<0.01）。相比之下，对照组织的胶原几乎完全由粗大成熟的I型胶原纤维组成。
苦味酸天狼星红染色和圆偏振光显微镜的应用提供了证据，表明皮下注射CaHA可刺激新胶原形成和真皮重塑。
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