Oculoplastic Surgery, The Jules Stein Eye Institute, University of California, Los Angeles.
Dermatol Surg. 2021 Sep 1;47(9):1233-1236. doi: 10.1097/DSS.0000000000003090.
Adverse events due to hyaluronic acid fillers (HAFs) may be treated with hyaluronidase, an enzyme that cleaves bonds within hyaluronic acid. This study reviews the efficacy of currently available hyaluronidase preparations in breaking down commercial, cross-linked HAFs.
Three HAFs were used in this study (Restylane, Juvederm Voluma, and Belotero [BEL] Balance). A laser-based particle size analyzer (Malvern Mastersizer 3000) was used to calculate particle sizes in untreated HAFs (controls) and those treated with 450 units of hyaluronidase (Hylenex) for 5 and 30 minutes.
Particle size analysis revealed that when Restylane was treated with hyaluronidase for 5 minutes, the average particle size reduced modestly, from 472 to 440 μm. At 30 minutes, the average particle size was 419 μm. For Juvederm, the average size of particles reduced from 703 μm in controls to 676 μm after treatment with hyaluronidase for 5 minutes and 635 μm after treatment for 30 minutes. For Belotero, the average size of control particles was 410 μm, reducing to 376 μm after treatment with hyaluronidase for 5 minutes and 345 μm after treatment for 30 minutes.
After treatment with hyaluronidase for up to 30 minutes, there was only a modest breakdown of all 3 HAFs used. The results of this study raise questions regarding the efficacy of hyaluronidase in degrading cross-linked HAFs.
透明质酸填充物（HAFs）引起的不良反应可以用透明质酸酶治疗，这种酶可以分解透明质酸中的键。本研究综述了目前市售的透明质酸酶制剂在分解商业交联 HAF 的效果。
本研究使用了三种 HAF（瑞蓝、乔雅登 Voluma 和贝洛特 Balance）。使用基于激光的粒度分析仪（马尔文 Mastersizer 3000）来计算未经处理的 HAF（对照）和用 450 单位透明质酸酶（海薇）处理 5 和 30 分钟后的颗粒大小。
颗粒大小分析表明，当瑞蓝用透明质酸酶处理 5 分钟时，平均粒径略有减小，从 472 微米降至 440 微米。30 分钟时，平均粒径为 419 微米。对于乔雅登，在用透明质酸酶处理 5 分钟后，颗粒的平均尺寸从对照的 703 微米减小到 676 微米，处理 30 分钟后减小到 635 微米。对于贝洛特，对照颗粒的平均尺寸为 410 微米，用透明质酸酶处理 5 分钟后减小到 376 微米，处理 30 分钟后减小到 345 微米。
用透明质酸酶处理最多 30 分钟后，只有适度的分解了所有三种使用的 HAF。本研究的结果对透明质酸酶在降解交联 HAF 的效果提出了质疑。
