SODIUM HYALURONATE

Periorbital rejuvenation presents significant challenges: hyaluronic acid (HA) fillers carry risks of edema and the Tyndall effect, whereas traditional poly-L-lactic acid (PLLA) may lead to nodule formation and delayed inflammatory reactions. To address these limitations, the PLLA-b-poly (ethylene glycol) (PLLA-b-PEG)/HA composite filler is designed to optimize tissue compatibility and minimize these specific adverse reactions. To comprehensively evaluate the physicochemical properties, biocompatibility, and clinical efficacy of this filler for periorbital volume deficiency. Physicochemical validation included SEM morphology, extrusion force, osmolality, and mechanical support testing. In vivo safety and collagenogenesis were assessed via histology in a rabbit model. Additionally, a retrospective clinical study of 15 subjects with infraorbital hollowing evaluated efficacy at 1, 3, and 6 months using the Allergan Infraorbital Hollows Scale (AIHS) and Global Aesthetic Improvement Scale (GAIS). All subjects also underwent clinical safety follow-up through 12-14 months; in a subset of subjects, additional 12-14-month photographs were available for descriptive review, but these images were not included in the formal efficacy analysis. The filler exhibited uniform microspheres, physiological osmolality (302 mOsmol/kg), and superior mechanical support. In vivo, it showed mild inflammation with neocollagenesis. In the retrospective clinical analysis (N = 15), the median AIHS score improved significantly from 2.0 at baseline to 1.0 at 6 months (p < 0.0001). At 6 months, 93.3% of subjects achieved ≥ 1-grade improvement. GAIS improvement rates were stable (p > 0.05), with no significant difference between subject and investigator ratings. Adverse events were mild, and no delayed or late-onset adverse events, such as nodules or granulomas, were identified during the extended safety follow-up. The PLLA-b-PEG/HA filler demonstrates unique physicochemical properties and a dual-action mechanism of immediate filling and long-term regeneration, establishing it as a promising, safe treatment for periorbital rejuvenation.

Functional hydrogel dressings that combine excellent mechanical properties, biological activity, and environmental responsiveness are urgently needed in wound management. Polyphenols have antioxidant, anti-inflammatory, and wound-healing properties. However, their impact on structural fidelity and long-term stability in 3D-printed hydrogel systems remains poorly understood. Additionally, previous studies lack systematic investigation into swelling behavior within the dynamic pH environment of wound healing. This study aims to develop a multifunctional wound dressing capable of adapting to dynamic pH changes within wounds through systematic modification with polyphenols. Functionalized hyaluronic acid (HA)-xanthan gum (XG)-N-acryloylglycine (NAGA) composite hydrogels (NHX) were prepared using a polyphenol (tea polyphenols (TP), tannic acid (TA), and gallic acid (GA)) immersion modification strategy. The effects of polyphenol type, concentration, and immersion time on the material properties were systematically investigated. Incorporating TPs synergistically optimized mechanical properties (337% tensile strain, 0.45 MPa stress), pH-responsive swelling behavior (up to 160% swelling at pH 9), and antioxidant activity (ABTS scavenging >99%) of the hydrogel by forming dynamic hydrogen bonds within the polymer network. In vitro anti-inflammatory experiments confirmed that the NHXTP hydrogel significantly upregulates IL-10, and suppresses IL-1β and TNF-α expression. In a rat full-thickness skin defect model, NHXTP dressings markedly accelerated wound closure (98.1% healing rate at 14 days) and promoted organized tissue regeneration. These findings contribute to the development of next-generation high-performance wound dressings.

Injectable sodium hyaluronate (NaHA) is extensively utilized in aesthetic medicine as a dermal hydrating agent. However, there are few standardized, human-relevant preclinical methods that can reliably evaluate the moisturizing performance of those products. Existing animal and simplified cell-based models show restricted physiological relevance and insufficient sensitivity. To address this gap, we established a depot-mimicking reconstructed human full-thickness skin (RhFS) platform incorporating an inclusion-based intradermal delivery strategy. Instead of conventional mixing, this strategy mimics the clinical 'depot effect' of intradermal injection, allowing for the simultaneous assessment of cellular responses and tissue-level hydration dynamics. It forms a localized NaHA depot within the dermal compartment of RhFS and preserves spatial hydration gradients, which are lost when NaHA is mixed homogenously. The platform integrates physicochemical characterization of polymer-bound water states with cellular and tissue-level functional readouts. By quantifying key biomarkers, including CD44, aquaporin-3 (AQP3) and natural moisturizing factors (NMFs), our results demonstrate that the inclusion-based delivery strategy significantly outperforms conventional mixing approaches in activating epidermal hydration pathways. Crucially, this platform effectively distinguished the moisturizing efficacy of multiple commercial NaHA formulas, thereby revealing a structure-activity relationship between water-binding states and biological outcomes. Overall, this study presents a reproducible, mechanism-informed and human-relevant framework for preclinical performance evaluation of NaHA-based injectable biomaterials and provides a sensitive alternative to conventional animal-based approaches.

Poly lactic acid microsphere fillers stimulate neocollagenesis, but aggregation can yield heterogeneous remodeling. We compared poly-L-lactic acid (PLLA)- and poly-D,L-lactic acid (PDLLA)-based fillers to connect stereochemistry with microsphere stability, dispersion, and in vivo outcomes. Poly lactic acid/sodium hyaluronate composite fillers were analyzed by scanning electron microscopy, nuclear magnetic resonance, differential scanning calorimetry, and micro-compression. Dispersion-aggregation-redispersion in saline was quantified over 3 days by optical microscopy with circularity-based analysis. In SKH mice, 100 μl filler was injected subcutaneously. Projection volume was measured at baseline (day 0) and at 2, 4, 8, and 12 weeks post-injection using phase-shift rapid in vivo measurement of skin (PRIMOS). Tissue response was observed at the same time points using hematoxylin and eosin, Masson's trichrome, and macrophage immunofluorescence. PLLA microspheres remained discrete after saline dispersion and excipient removal, whereas PDLLA particles deformed and collapsed into compact clusters. PLLA particles (median 49.10 μm) were larger than PDLLA particles (median=19.85 μm) and showed semicrystalline differential scanning calorimetry features (glass transition temperature=60.88°C, cold crystallization temperature=94.2°C, melting temperature=169.18°C), while PDLLA was predominantly amorphous. PDLLA formed larger, poorly re-dispersible aggregates (median cluster=458.06 μm) than PLLA (median cluster=380.02 μm). In vivo , volume declined through week 4 then recovered. PLLA rebounded more uniformly with greater collagen area and weaker inflammatory and macrophage signals than PDLLA. PLLA crystallinity and mechanical robustness support re-dispersibility and more homogeneous collagen remodeling, whereas PDLLA aggregation is linked to heightened inflammation and reduced collagen deposition. Collectively, these findings suggest that maintaining microsphere integrity and dispersion is a key, actionable determinant of more uniform biostimulatory outcomes in PLA-based fillers.

Melasma is a common hyperpigmentation disorder that presents a significant therapeutic challenge. This study aims to evaluate the efficacy and safety of a novel combination approach using a picosecond laser followed by microinjections of a sodium hyaluronate composite solution for the treatment of mixed-type melasma. In this retrospective study, 30 female patients with mixed-type melasma received 3 treatment sessions. Each session consisted of a fractional picosecond laser treatment followed by the administration of a non-cross-linked sodium hyaluronate composite solution. Efficacy was primarily assessed by the change in the Melasma Area and Severity Index score from baseline to 4 weeks posttreatment, as evaluated by an independent blinded investigator. Secondary endpoints included Physician's Global Assessment and patient satisfaction. The combination therapy resulted in a statistically significant reduction in the mean Melasma Area and Severity Index score, from a baseline of 18.30 ± 7.85 to 8.20 ± 3.50 posttreatment ( P < 0.05). Physician assessments showed marked or moderate improvement in 70% of patients, and the overall patient satisfaction rate was high (86.7%). The treatment was well tolerated with only mild, transient side effects and no serious adverse events reported. The combination of a picosecond laser with a sodium hyaluronate composite solution demonstrated significant short-term efficacy at 4 weeks posttreatment with an acceptable safety profile, offering a promising approach for its clinical management.

Conventional cosmetic serums often suffer from rapid dehydration, phase separation, and component aggregation, leading to non-uniform ingredient dispersion and limited hydration durability. In this study, hydroxyethyl cellulose (HEC) was investigated as a structural modifier to improve the physicochemical stability and moisturizing performance of surfactant-free cosmetic serums. Moisture retention tests showed that HEC-containing formulations exhibited improved hydration durability, with moisture loss limited to approximately 5% after 30 min even after 7 days of storage. Extended measurements further showed that HEC-containing systems maintained higher moisture retention over longer time scales than HEC-free formulations. Scanning electron microscopy revealed a smoother and more homogeneous dried microstructure in the presence of HEC, indicating improved structural uniformity without conventional surfactants. Thermogravimetric analysis showed altered dehydration behavior, suggesting modified water-binding environments rather than changes in intrinsic thermal stability. FT-IR spectroscopy with peak deconvolution provided strong evidence for intermolecular hydrogen bonding between the hydroxyl groups of HEC and the carbonyl groups of sodium hyaluronate, while complementary 1 H NMR analysis revealed peak broadening and subtle chemical shift variations, indicating changes in local proton environments and intermolecular interactions. These results support the formation of a stabilized polymeric network by HEC, which contributes to improved structural integrity and sustained hydration performance in surfactant-free serum systems.

This study reports a 50-year-old male case of Thelazia callipaeda infection without a history of pet contact. The patient exhibited chronic ocular surface inflammation after exposure to wild insects and was misdiagnosed multiple times with bacterial conjunctivitis before definitive diagnosis by an ophthalmic specialist. This report emphasizes the core steps of the T. callipaeda extraction procedure. These steps include preoperative preparation, topical ocular anesthesia using 0.4% oxybuprocaine hydrochloride eye drops, sufficient exposure of the surgical field with an eyelid speculum, precise clamping and complete removal of nematodes under ophthalmic visualization, and immediate postoperative management. The entire procedure was recorded in a supplementary operative video. Additionally, the procedure can be conducted under conventional outpatient clinic conditions, making it suitable for primary medical institutions. Postoperatively, the patient received anti-infective therapy with 0.5% levofloxacin eye drops, administered four times daily, and ocular surface moisturization with 0.1% sodium hyaluronate eye drops, administered four times daily, for 1 week, with standard follow-up at 1, 3, and 6 months postoperatively. The clinical manifestations, including conjunctival hyperemia and foreign body sensation, were completely alleviated without recurrence, and ocular surface function returned to normal. Etiological confirmation was verified through morphological observation, characterized by serrated cuticular striations, a hexagonal buccal capsule, and a gravid female reproductive system, and recombinase polymerase amplification-CRISPR-Cas12a molecular detection targeting the 18S ribosomal ribonucleic acid gene. Critical procedural precautions to prevent nematode fragmentation and residual inflammation are also underscored. This case enriches the clinical reports of T. callipaeda. infection without a pet contact history and offers a practical diagnosis and treatment protocol for ophthalmologists.

The purpose of this report is to document a technique involving anterior chamber viscoelastic injections to address a serous choroidal detachment in the setting of a concurrent rhegmatogenous retinal detachment to improve surgical conditions. A thorough chart review was performed on the patient in addition to a comprehensive literature review utilizing PubMed to gather current data on the treatment of combined choroidal and retinal detachments. A 72-year-old male presented with advanced glaucoma and high intraocular pressure (IOP). The patient's elevated IOP was refractory to maximum topical medical management; consequently, he underwent non-valved glaucoma drainage device (GDD) surgery. His recovery was complicated by chronic hypotony which led to the development of a combined choroidal and retinal detachment. Our team injected sodium chondroitin and sodium hyaluronate in the anterior chamber of the eye, which successfully alleviated the serous choroidal detachment prior to pars plana vitrectomy (PPV). The patient did not require any further retinal interventions for the 2 years of follow-up. His IOP has remained normal in the high single digits on three glaucoma agents with the tube still tied off permanently with 6-0 nylon. His visual acuity returned to baseline (20/200) after 6 weeks. This case demonstrates that intracameral viscoelastic injections prior to PPV can be utilized as rescue therapy to treat serous choroidal detachment in the setting of a rhegmatogenous retinal detachment in patients with GDD surgery to improve surgical conditions prior to retinal detachment repair.

Dry eye disease (DED) is a complex ocular surface disorder characterized by tear film instability, chronic inflammation, and epithelial damage, for which current treatments remain limited. Marine-derived bioactive oligosaccharides have attracted increasing interest due to their diverse pharmacological activities and favorable safety profiles. In this study, we investigated the therapeutic potential of neoagarotetraose (NA4), a marine oligosaccharide derived from red algal agar, in a murine model of DED. DED was induced in eight-week-old female C57BL/6 mice by topical instillation of 0.2% benzalkonium chloride for seven consecutive days. NA4 was administered topically at concentrations of 125, 250, and 500 mg/L. Therapeutic outcomes were evaluated by tear secretion, corneal fluorescein staining, histopathological analysis, immunofluorescence staining for Ki67, F4/80, IL-1β, IL-6, and TNF-α, TUNEL assay for apoptosis, and ELISA for cytokine levels. NA4 treatment significantly improved tear secretion and reduced corneal fluorescein staining scores. Histological analysis revealed that NA4 preserved corneal epithelial thickness and restored conjunctival goblet cell density. Immunofluorescence analysis revealed that NA4 reversed inflammation-associated epithelial hyperproliferation and attenuated macrophage infiltration. Moreover, NA4 markedly suppressed the expression and tissue levels of IL-1β, IL-6, and TNF-α, and attenuated corneal epithelial apoptosis, with the 500 mg/L NA4 group showing no significant difference in efficacy compared to the positive control 0.1% sodium hyaluronate. These findings demonstrate that NA4, a marine-derived oligosaccharide, exerts multi-targeted protective effects against DED by improving tear film stability, preserving ocular surface integrity, suppressing inflammation, and reducing apoptosis. Our study highlights the potential of marine oligosaccharides such as NA4 as promising candidates for ocular surface disease management and supports the further exploration of marine resources for ophthalmic therapeutic applications.

Background: To evaluate the effects of a preservative-free artificial tear formulation containing trehalose, sodium hyaluronate, and N-acetyl-aspartyl-glutamate (NAAGA) on ocular surface parameters and quality of life in patients with primary open-angle glaucoma (POAG) treated with preserved versus preservative-free prostaglandin analogues. Methods: For this prospective, observational clinical study, thirty-eight patients (76 eyes) with POAG receiving stable topical prostaglandin therapy were enrolled and divided into two groups: preserved prostaglandins (Group 1, n = 44) and preservative-free prostaglandins (Group 2, n = 32). All patients received adjunctive preservative-free artificial tears (trehalose, sodium hyaluronate, NAAGA) three times daily for one month. Assessments at baseline (T0) and 1 month (T1) included best-corrected visual acuity (BCVA), intraocular pressure (IOP), contrast sensitivity, Schirmer test, tear break-up time (BUT), Efron grading scale, Ocular Surface Disease Index (OSDI), visual field (VF) indices (Mean Deviation (MD), Pattern Standard Deviation (PSD), Visual Field Index (VFI)), and quality of life (QoL) measured using Visual Analogue Scales (VAS). Results: After 1 month, both groups demonstrated significant improvement in ocular surface parameters. Schirmer test increased by approximately 4-5 mm ( p = 0.001 in both groups), and BUT improved by 5 s ( p = 0.001 in both groups). OSDI scores significantly decreased (Group 1: -18.5; Group 2: -23; p = 0.001 for both), and Efron grading significantly improved ( p = 0.001 in both groups). Artificial tears-related QoL markedly increased in both groups ( p = 0.001), while pathology-related QoL remained unchanged. IOP showed a modest but significant reduction in both groups (Group 1 p = 0.011; Group 2 p = 0.003), without intergroup differences. VFI significantly improved in both groups from T0 to T1 (Group 1 p = 0.013; Group 2 p = 0.04). Group 1 also showed an improvement in terms of PSD ( p = 0.025). Conclusions: Adjunctive treatment with preservative-free artificial tears containing trehalose, sodium hyaluronate, and NAAGA significantly improved tear film stability VF indexes, ocular surface signs and symptoms, and patient-reported QoL in POAG patients treated with prostaglandins, regardless of preservative status. Routine ocular surface optimization should be considered an integral component of comprehensive glaucoma management.

Hyaluronic acid (HA) is a glycosaminoglycan widely distributed in the human body, especially in body fluids and the extracellular matrix of tissues. It plays a crucial role not only in maintaining tissue hydration but also in cellular processes such as proliferation, differentiation, and the inflammatory response. HA has demonstrated its efficacy as a powerful bioactive molecule not only for skin antiaging but also in atherosclerosis, cancer, and other pathological conditions. Due to its biocompatibility, biodegradability, non-toxicity, and non-immunogenicity, several HA-based biomedical products have been developed. There is an increasing focus on optimizing HA production processes to achieve high-quality, efficient, and cost-effective products. This review discusses HA's structure, properties, and production through microbial fermentation. Furthermore, it highlights the bioactive applications of HA in emerging sectors of biomedicine.

Collagen dietary supplements are becoming increasingly popular as a means to reduce signs of skin ageing. The objective of this three-way, randomised, placebo-controlled, double-blind study was to examine and contrast the effects of dietary supplementation with a daily dose of 5 g hydrolysed collagen with 80 mg of vitamin C (CP product) and their combination with 30 mg of hyaluronic acid (CPHA product) over 16 weeks. Validated methods were utilised for the objective evaluation of skin parameters. In total, 87 subjects (women, 40-65 years) completed the entire trial, distributed across the groups as follows: placebo group ( n = 29), CPHA group ( n = 28), and CP group ( n = 30). The results showed beneficial effects of both test products, with notable enhancements in dermis density, skin texture, and a reduction in the severity of wrinkles. In contrast, the administration of either of the products did not yield any significant impacts on skin elasticity or hydration. Observation of the investigated skin parameters did not show superior effects of the addition of hyaluronic acid (HA) to collagen. Therefore, the ability of supplementation with HA to improve the effects on investigated skin parameters beyond the supplementation of collagen alone cannot be confirmed.

Hyaluronic acid (HA) plays multifaceted role in regulating the various biological processes such as skin repairmen, diagnosis of cancer, wound healing, tissue regeneration, anti-inflammatory, and immunomodulation. Owing to its remarkable biomedical and tissue regeneration potential, HA has been numerously employed as one of the imperative components of the cosmetic and nutricosmetic products. The present review aims to summarize and critically appraise recent developments and clinical investigations on cosmetic and nutricosmetic efficacy of HA for skin rejuvenation. A thorough analysis of the literature revealed that HA based formulations (i.e., gels, creams, intra-dermal filler injections, dermal fillers, facial fillers, autologous fat gels, lotion, serum, and implants, etc.) exhibit remarkable anti-wrinkle, anti-nasolabial fold, anti-aging, space-filling, and face rejuvenating properties. This has been achieved via soft tissue augmentation, improved skin hydration, collagen and elastin stimulation, and face volume restoration. HA, alone or in combination with lidocaine and other co-agents, showed promising efficacy in skin tightness and elasticity, face rejuvenation, improving aesthetic scores, reducing the wrinkle scars, longevity, and tear trough rejuvenation. Our critical analysis evidenced that application/administration of HA exhibits outstanding nutricosmetic efficacy and thus is warranted to be used as a prime component of cosmetic products.

Skin aging goes beyond a chronological process and also results from extrinsic factors referred to as the exposome. Hyaluronic acid (HA) is an important component of the extracellular matrix, with loss starting at 25 years old. While many studies of HA concern topical use, few literature reviews only address the use of topical HA in dermatology. This review describes the different characteristics of HA-containing cosmeceuticals, with a focus on skin aging and the impact of exposome factors on HA synthesis and degradation. A review was performed using the terms HA, hyaluronan, topical, dermatology, cosmetic, aging treatment, exposome, and cosmeceuticals. Results are also presented from a recent randomized controlled trial (RCT), which investigated the additional benefit of using a HA epidermic filler (HA-filler serum) combined with Botulinum toxin type A (BoNTA) to treat signs of skin aging. Subjects were randomized to two groups: HA-filler serum starting 24 h after the BoNTA injection then twice daily for 24 weeks, or the control group, which received BoNTA. HA is a key ingredient used in cosmeceuticals for its hydration/antiaging properties (hygroscopic, rheological, and viscoelastic). Several clinical studies indicate that HA is both well tolerated and effective, adjuvant to both post-surgical and facial rejuvenation procedures. In the RCT, one of few studies to combine BoNTA and HA with a 6-month follow-up, the HA-filler serum lengthened the duration of BoNTA's effect in reducing wrinkles. Numerous studies support HA-based cosmeceuticals as a noninvasive, effective solution for improving skin hydration and rejuvenation.

Filler injection has become an extremely popular method for facial skin rejuvenation, including the periorbital area. In the recent years, new polynucleotide (PN)-containing filler products have been used for esthetic purposes. We aimed to investigate the efficacy and safety of PN filler injection in the periorbital area. A total of 27 subjects were enrolled in this randomized, pair-matched, and active-controlled study. Each subject received filler injections thrice with two-week intervals, with a PN filler injection on one side and a non-crosslinked hyaluronic acid (HA) filler injection on the contralateral side of the periorbital area. Improvements in the visual analog scale and global esthetic improvement scale scores were not significantly different between the PN and HA groups. The improvement rates of skin elasticity and hydration decreased over time in both groups, with the PN group showing a higher improvement rate. The improvement rates of roughness and pore volume were higher in the PN group than in the HA group. The improvement rate of dermal density was not significantly different between the groups. No serious adverse events were reported. The PN filler injection is effective and safe for periorbital rejuvenation.

This study proposes a review on hyaluronic acid (HA) known as hyaluronan or hyaluronate and its derivates and their application in cosmetic formulations. HA is a glycosaminoglycan constituted from two disaccharides (N-acetylglucosamine and D-glucuronic acid), isolated initially from the vitreous humour of the eye, and subsequently discovered in different tissues or fluids (especially in the articular cartilage and the synovial fluid). It is ubiquitous in vertebrates, including humans, and it is involved in diverse biological processes, such as cell differentiation, embryological development, inflammation, wound healing, etc. HA has many qualities that recommend it over other substances used in skin regeneration, with moisturizing and anti-ageing effects. HA molecular weight influences its penetration into the skin and its biological activity. Considering that, nowadays, hyaluronic acid has a wide use and a multitude of applications (in ophthalmology, arthrology, pneumology, rhinology, aesthetic medicine, oncology, nutrition, and cosmetics), the present study describes the main aspects related to its use in cosmetology. The biological effect of HA on the skin level and its potential adverse effects are discussed. Some available cosmetic products containing HA have been identified from the brand portfolio of most known manufacturers and their composition was evaluated. Further, additional biological effects due to the other active ingredients (plant extracts, vitamins, amino acids, peptides, proteins, saccharides, probiotics, etc.) are presented, as well as a description of their possible toxic effects.