Zerbinati Nicola, d'Este Edoardo, Cornaglia Antonia Icaro, Riva Federica, Farina Aurora, Calligaro Alberto, Gallo Giovanni, Perrotta Emanuele Rosario, Protasoni Marina, Bonan Paolo, Vojvodic Aleksandra, Fioranelli Massimo, Thuong Nguyen Van, Lotti Torello, Tirant Michael, Vojvodic Petar
Department of Medicine and Surgery School of Medicine, University of Insubria (Varese), Italy.
Centro Medico Polispecialistico, Pavia, Italy.
Open Access Maced J Med Sci. 2019 Aug 30;7(18):2991-2997. doi: 10.3889/oamjms.2019.778. eCollection 2019 Sep 30.
Recently, it has been developed a new technology for the reduction of subcutaneous adipose tissue through a non-invasive treatment by microwaves. The main objective of the present study is to demonstrate the feasibility of utilising a non-invasive, localised microwaves (MW) device to induce thermal modifications into subcutaneous adipose tissue only by a controlled electromagnetic field that heats up fat preferentially. This device is provided with a special handpiece appropriately cooled, directly contacting the cutaneous surface of the body, which provides a calibrated energy transfer by microwaves.
In this paper, microscopic and ultrastructural modifications of subcutaneous adipose tissue induced by microwaves irradiation are evaluated.
Our experimental plan was designed for collecting biopsy samples, for each skin region treated with a single irradiation session, 1) before treatment (control), 2) immediately after treatment, 3) after 6 hrs, 4) after 1 month, 5) after 2 months. Bioptic samples from each step were processed for light microscopy and transmission electron microscopy. At the same time, each region where biopsies were collected was subjected to ultrasound examination. Recorded images permitted to evaluate the thickness of different layers as epidermis, dermis, hypodermis, connective fasciae, until to muscle layer, and related modifications induced by treatment.
In every biopsy collected at different time-steps, epidermis and superficial dermis appeared not modified compared to control. Differently, already in the short-term biopsies, in the deep dermis and superficial hypodermis, fibrillar connective tissue appeared modified, showing reduction and fragmentation of interlobular collagen septa. The most important adipose tissue modifications were detectable following 1 month from treatment, with a significant reduction of subcutaneous fat, participating both the lysis of many adipocytes and the related phagocytic action of monocytes/macrophages on residuals of compromised structures of adipocytes. In the samples collected two months following treatment, the remnants of adipose tissue appeared normal, and macrophages were completely absent.
Ultrasound, microscopic and ultrastructural evidence are supporting significant effectiveness of the new device treatment in the reduction of subcutaneous fat. In this paper, the possible mechanisms involved in the activation of the monocytes/macrophages system responsible for the removal of adipocytes residuals have also been discussed.
最近,已经开发出一种通过微波非侵入性治疗来减少皮下脂肪组织的新技术。本研究的主要目的是证明利用一种非侵入性的局部微波(MW)设备,仅通过优先加热脂肪的可控电磁场,在皮下脂肪组织中诱导热改变的可行性。该设备配备有一个经过适当冷却的特殊手持件,直接接触身体的皮肤表面,通过微波提供校准的能量传递。
本文评估了微波照射引起的皮下脂肪组织的微观和超微结构改变。
我们的实验方案设计用于收集活检样本,对于每个接受单次照射治疗的皮肤区域,在1)治疗前(对照)、2)治疗后立即、3)6小时后、4)1个月后、5)2个月后采集样本。对每个步骤的活检样本进行光学显微镜和透射电子显微镜检查。同时,对采集活检样本的每个区域进行超声检查。记录的图像允许评估表皮、真皮、皮下组织、结缔筋膜直至肌肉层等不同层的厚度,以及治疗引起的相关改变。
在不同时间点采集的每次活检中,与对照相比,表皮和浅表真皮未见改变。不同的是,在短期活检中,深层真皮和浅表皮下组织中的纤维结缔组织就出现了改变,表现为小叶间胶原间隔减少和断裂。治疗1个月后可检测到最重要的脂肪组织改变,皮下脂肪显著减少,这既涉及许多脂肪细胞的溶解,也涉及单核细胞/巨噬细胞对受损脂肪细胞结构残余物的相关吞噬作用。在治疗后两个月采集的样本中,脂肪组织残余物看起来正常,且巨噬细胞完全消失。
超声、微观和超微结构证据支持这种新设备治疗在减少皮下脂肪方面的显著有效性。本文还讨论了负责清除脂肪细胞残余物的单核细胞/巨噬细胞系统激活过程中可能涉及的机制。