Department of Plastic Surgery, Jichi Medical University, Tochigi 329-0498, Japan.
Mar Drugs. 2020 Oct 19;18(10):520. doi: 10.3390/md18100520.
Filler injection demand is increasing worldwide, but no ideal filler with safety and longevity currently exists. Sodium alginate (SA) is the sodium salt of alginic acid, which is a polymeric polysaccharide obtained by linear polymerization of two types of uronic acid, d-mannuronic acid (M) and l-guluronic acid (G). This study aimed to evaluate the therapeutic value of SA. Nine SA types with different M/G ratios and viscosities were tested and compared with a commercially available sodium hyaluronate (SH) filler. Three injection modes (onto the periosteum, intradermally, or subcutaneously) were used in six rats for each substance, and the animals were sacrificed at 4 or 24 weeks. Changes in the diameter and volume were measured macroscopically and by computed tomography, and histopathological evaluations were performed. SA with a low M/G ratio generally maintained skin uplift. The bulge gradually decreased over time but slightly increased at 4 weeks in some samples. No capsule formation was observed around SA. However, granulomatous reactions, including macrophage recruitment, were observed 4 weeks after SA implantation, although fewer macrophages and granulomatous reactions were observed at 24 weeks. The long-term volumizing effects and degree of granulomatous reactions differed depending on the M/G ratio and viscosity. By contrast, SH showed capsule formation but with minimal granulomatous reactions. The beneficial and adverse effects of SA as a filler differed according to the viscosity or M/G ratio, suggesting a better long-term volumizing effect than SH with relatively low immunogenicity.
填充物注射需求在全球范围内不断增加，但目前尚无安全且持久的理想填充物。海藻酸钠（SA）是褐藻酸的钠盐，是由两种类型的糖醛酸，即 D-甘露糖醛酸（M）和 L-古洛糖醛酸（G）通过线性聚合而成的聚合多糖。本研究旨在评估 SA 的治疗价值。测试并比较了 9 种具有不同 M/G 比和粘度的 SA 类型与市售透明质酸钠（SH）填充物。每种物质在 6 只大鼠中采用 3 种注射方式（骨膜上、皮内或皮下），在 4 或 24 周后处死动物。通过宏观和计算机断层扫描测量直径和体积的变化，并进行组织病理学评估。具有低 M/G 比的 SA 通常保持皮肤隆起。随着时间的推移，凸起逐渐减小，但在一些样本中 4 周时略有增加。在 SA 周围未观察到囊形成。然而，在 SA 植入后 4 周观察到了包括巨噬细胞募集在内的肉芽肿反应，尽管在 24 周时观察到的巨噬细胞和肉芽肿反应较少。长期的体积填充效果和肉芽肿反应的程度取决于 M/G 比和粘度。相比之下，SH 虽然有囊形成，但肉芽肿反应较小。SA 作为填充物的有益和不良反应因粘度或 M/G 比而异，表明其具有比 SH 更好的长期体积填充效果，且免疫原性相对较低。
