Morphological and immunohistochemical characteristics of skin specimens after isolated and combined injections of poly-L-lactic acid and hyaluronic acid

Timofeev A.V.; Murakov S.V.; Glavnova A.M.; Verevkin A.A.; Sokolova O.F.

doi:https://doi.org/10.17116/plast.hirurgia202503150

Timofeev A.V.

Lotos 288, LLC

ORCID: 0009-0009-1098-3171

Murakov S.V.

Lotos 288 LLC;
Academy of Postgraduate Education of the Federal Scientific and Clinical Center of Federal Medical-Biological Agency of Russia

ORCID: 0000-0003-4330-2570

Glavnova A.M.

Lotus 288 LLC

ORCID: 0009-0008-6734-1674

Verevkin A.A.

Kuban State Medical University

ORCID: 0000-0002-4159-2618

Sokolova O.F.

Kuban State Medical University

ORCID: 0009-0001-7230-1625

Morphological and immunohistochemical characteristics of skin specimens after isolated and combined injections of poly-L-lactic acid and hyaluronic acid

Authors:

Timofeev A.V., Murakov S.V., Glavnova A.M., Verevkin A.A., Sokolova O.F.

More about the authors

Journal: Plastic Surgery and Aesthetic Medicine. 2025;(3): 50‑62

DOI: 10.17116/plast.hirurgia202503150

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To cite this article:

Timofeev AV, Murakov SV, Glavnova AM, Verevkin AA, Sokolova OF. Morphological and immunohistochemical characteristics of skin specimens after isolated and combined injections of poly-L-lactic acid and hyaluronic acid. Plastic Surgery and Aesthetic Medicine. 2025;(3):50‑62. (In Russ., In Engl.)
https://doi.org/10.17116/plast.hirurgia202503150

Подписка 2026 Пластическая хирургия и эстетическая медицина (Plastic Surgery and Aesthetic Medicine)

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BACKGROUND

The mechanisms of skin aging are based on morphofunctional processes in the skin and underlying tissues that are influenced by genetic, hormonal, and environmental factors. Dermal fillers regulate skin cell metabolism and stimulate the synthesis of intracellular and extracellular components. Immunohistochemistry (IHC) demonstrates changes in biomarkers of skin aging and offers an objective assessment of skin remodeling processes following filler injections.

OBJECTIVE

To compare the efficacy and safety of poly-L-lactic acid (PLLA) and hyaluronic acid (HA) injections administered separately or in combination for the treatment of age-related skin changes.

MATERIAL AND METHODS

The present study included two patients who received injections of the investigational products into each of the three quadrants of the anterior abdominal wall. Prior to the injections and six weeks after the initial treatment, biopsy specimens were obtained from each quadrant for histological evaluation (hematoxylin and eosin staining, IHC). To improve the study’s reliability, a single-blind approach was used.

RESULTS

Immunohistochemical analysis revealed an upregulation of the dermal transforming growth factor beta-1 (TGF-β1) expression in both patients following administration of PLLA and HA, both separately and in combination. Upregulation in the receptor for hyaluronan-mediated motility (RHAMM) expression was observed in both study participants following HA administration and the combined application of PLLA and HA. Collagen fibrils hydration level, as determined by relative optical transmission coefficient of collagen, increased after the application of HA and the combination of PLLA and HA. The absence of adverse events following treatment with PLLA and HA, both as separate treatments and in combination, indicates a favorable safety profile for these products.

CONCLUSION

The investigational products have been shown to be effective and safe. Synergistic effects were observed when PLLA and HA were administered in combination. The obtained results demonstrate significant potential for further investigation of combined methods for the treatment of age-related skin changes.

Keywords:

skin aging

poly-L-lactic acid

hyaluronic acid

combination treatment

immunohistochemistry

biomarkers

Authors:

Timofeev A.V.

Lotos 288, LLC

ORCID: 0009-0009-1098-3171

Murakov S.V.

Lotos 288 LLC;
Academy of Postgraduate Education of the Federal Scientific and Clinical Center of Federal Medical-Biological Agency of Russia

ORCID: 0000-0003-4330-2570

Glavnova A.M.

Lotus 288 LLC

ORCID: 0009-0008-6734-1674

Verevkin A.A.

Kuban State Medical University

ORCID: 0000-0002-4159-2618

Sokolova O.F.

Kuban State Medical University

ORCID: 0009-0001-7230-1625

Received:

02.04.2025

Accepted:

31.05.2025

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