Aesthet Surg J. 2024 May 15;44(6):NP402-NP410. doi: 10.1093/asj/sjae032.
The ability to degrade hyaluronic acid (HA)-based fillers with hyaluronidase allows for better management of adverse effects and reversal of suboptimal treatment outcomes.
The aim of this study was to compare the enzymatic degradation kinetics of 16 commercially available HA-based fillers, representing 6 manufacturing technologies.
In this nonclinical study, a recently developed in vitro multidose hyaluronidase administration protocol was used to induce degradation of HA-based fillers, enabling real-time evaluation of viscoelastic properties under near-static conditions. Each filler was exposed to repeated doses of hyaluronidase at intervals of 5 minutes to reach the degradation threshold of G' ≤ 30 Pa.
Noticeable differences in degradation characteristics were observed based on the design and technology of different filler classes. Vycross fillers were the most difficult to degrade and the Cohesive Polydensified Matrix filler was the least difficult to degrade. Preserved Network Technology products demonstrated proportional increases in gel degradation time and enzyme volume required for degradation across the individual resilient hyaluronic acid (RHA) products and indication categories. No obvious relationship was observed between gel degradation characteristics and the individual parameters of HA concentration, HA chain length, or the degree of modification of each filler when analyzed separately; however, a general correlation was identified with certain physicochemical properties.
Manufacturing technology was the most important factor influencing the reversibility of an HA product. An understanding of the differential degradation profiles of commercially available fillers will allow clinicians to select products that offer a higher margin of safety due to their preferential reversibility.
透明质酸（HA）酶能够降解基于 HA 的填充物，这使得更好地管理不良反应和逆转不理想的治疗结果成为可能。
本研究旨在比较 16 种市售基于 HA 的填充物的酶促降解动力学，这些填充物代表 6 种制造技术。
在这项非临床研究中，使用了最近开发的体外多剂量透明质酸酶给药方案来诱导 HA 基填充物的降解，从而能够在近静态条件下实时评估粘弹性特性。每个填充物都以 5 分钟的间隔接受重复剂量的透明质酸酶，以达到 G'≤30Pa 的降解阈值。
基于不同填充物类别的设计和技术，观察到降解特征的显著差异。Vycross 填充物最难降解，而 Cohesive Polydensified Matrix 填充物最容易降解。保留网络技术产品在单个弹性透明质酸（RHA）产品和适应症类别中，凝胶降解时间和降解所需的酶体积呈比例增加。当单独分析时，没有观察到凝胶降解特征与 HA 浓度、HA 链长或每个填充物的修饰程度等单个参数之间存在明显关系；然而，确定了与某些物理化学特性的一般相关性。
制造技术是影响 HA 产品可逆性的最重要因素。了解市售填充物的差异降解谱将使临床医生能够选择由于其优先可逆性而提供更高安全边际的产品。
