Departments of Dermatology, Medical Faculty, Research Laboratory for Dermatology and Immunology, Heinrich-Heine-University Duesseldorf, University Hospital Duesseldorf, Duesseldorf, Germany.
Departments of Radiation Oncology, Medical Faculty, Research Laboratory for Dermatology and Immunology, Heinrich-Heine-University Duesseldorf, University Hospital Duesseldorf, Duesseldorf, Germany.
Eur J Med Res. 2018 Aug 20;23(1):37. doi: 10.1186/s40001-018-0334-9.
Hyaluronidase is a hyaluronic acid (HA) metabolizing enzyme, which is approved as an adjuvant for infiltration anesthesia. The "off-label" use of hyaluronidase is regarded as gold standard for the management of HA-filler-associated complications. Yet, up to date there are only few studies that have systematically assessed the degradability of different HA-fillers by hyaluronidase.
To analyze the interactions of HA-fillers and hyaluronidase in a time-dependent manner using a novel standardized in vitro approach.
Comparable HA-fillers, Belotero Balance Lidocaine (BEL; Merz), Emervel classic (EMV; Galderma) and Juvederm Ultra 3 (JUV; Allergan), were incubated with a fluorescent dye and bovine hyaluronidase (HYAL; Hylase "Dessau", Riemser) or control (NaCl) and monitored by time-lapse videomicroscopy. The degradation of HA-fillers was assessed as decrease in fluorescence intensity of HA-filler plus hyaluronidase vs. HA-filler plus control, quantified by computer-assisted image analysis (ImageJ).
Hyaluronidase showed a significant degradation of the HA-fillers BEL and EMV. Degradation was measurable at 5 h (BEL) and 7 h (EMV), respectively; significance was reached at 14 h (BEL) and 13 h (EMV). No effect of hyaluronidase was observed for JUV.
Time-lapse microscopy enables systematically, standardized, comparative in vitro analyses of the interactions of hyaluronidase and HA-fillers.
透明质酸酶是一种透明质酸（HA）代谢酶，已被批准作为浸润麻醉的辅助剂。透明质酸酶的“超适应证”使用被视为管理 HA 填充剂相关并发症的金标准。然而，迄今为止，只有少数研究系统评估了不同 HA 填充剂的可降解性。
采用新的标准化体外方法，分析透明质酸酶与 HA 填充剂的时间依赖性相互作用。
采用荧光染料和牛透明质酸酶（HYAL；Hylase“Dessau”，Riemser）或对照（NaCl）孵育可比 HA 填充剂 Belotero Balance Lidocaine（BEL；Merz）、Emervel classic（EMV；Galderma）和 Juvederm Ultra 3（JUV；Allergan），并用延时视频显微镜进行监测。通过计算机辅助图像分析（ImageJ）评估 HA 填充剂的降解情况，即 HA 填充剂加透明质酸酶与 HA 填充剂加对照的荧光强度降低。
透明质酸酶对 BEL 和 EMV 两种 HA 填充剂均有显著的降解作用。分别在 5 小时（BEL）和 7 小时（EMV）时可测量到降解；在 14 小时（BEL）和 13 小时（EMV）时达到显著水平。JUV 无透明质酸酶作用。
延时显微镜可用于系统、标准化、比较透明质酸酶与 HA 填充剂相互作用的体外分析。
