«Ульяновский медико-биологический журнал»

CLINICAL MEDICINE

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DOI 10.34014/2227-1848-2023-4-126-143

ATROPHIC SCARS AS AN OBJECT OF INORGANIC GEL TREATMENT

V.G. Nikonorova, V.V. Krishtop, I.V. Fateev, A.S. Ovchinnikova

State Scientific Research Testing Institute of Military Medicine, Ministry of Defense of the Russian Federation, St. Petersburg, Russia

 

Atrophic scars are a complex problem, covering a huge number of patients with striae gravidarum, acne, atrophic surgical scars, and striae due to hypercortisolism and other metabolic disorders. Taking into account patients’ social status (pregnant women, adolescents, people with chronic hormonal disorders), our goal was to systematize the literature data on the least invasive treatment modality – atrophic scar therapy with inorganic gels – to identify new chemical classes with potential anti-scar activity.

When summarizing research data over the past 10 years, it was found that the effect of anti-scar therapy depends on the atrophic scar color – hyper- or hypopigmented, its type – wedge-shaped, scaphoid, or rectangular, its origin – post-acne, cicatricial alopecia, infectious scars, stretch marks, or post-traumatic atrophic. The stage of pathogenesis also plays a significant role: aseptic inflammation, infiltration of hematogenous differential cells, mast cell degranulation, release of bioactive substances and changes in the VEGF, TGF-β1, EGF, FGF, PDGF growth factors, migration of activated macrophages, damage to elastic and collagen fibers, perivascular lymphocytic infiltration, impaired hemorheology, chronic inflammatory process, increased number of senescent fibroblasts, decreased synthetic activity of atrophic scar cells, decreased cellularity and vascularization of the atrophic scar area. In case of high bioinertness of inorganic gels, the anti-scar effect is achieved due to the exfoliating effect, epidermal-mesenchymal interactions, and the impact of the mesoporous gel structure on scar hydration. In addition to the well-known silicone gel, sol-gels based on aluminum dioxide have similar properties, which makes it possible to consider sol-gel as an alternative to silicone gel.

Key words: atrophic scars, nanomaterials, inorganic gels, therapy.

 

Conflict of interest. The authors declare no conflict of interest.

Author contributions

Research concept and design: Nikonorova V.G., Krishtop V.V.

Participation in the research study, data processing: Nikonorova V.G., Krishtop V.V., Fateev I.V., Ovchinnikova A.S.

Statistical data processing: Nikonorova V.G., Krishtop V.V.

Data analysis and interpretation: Nikonorova V.G., Krishtop V.V.

Text writing and editing: Nikonorova V.G., Krishtop V.V.


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Received March 31, 2023; accepted August 08, 2023.

 

Information about the authors

Nikonorova Varvara Gennad'evna, Candidate of Sciences (Medicine), State Scientific Research Testing Institute of Military Medicine, Ministry of Defense of the Russian Federation. 195043, Russia, St. Petersburg, Lesoparkovaya St., 4; e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра., ORCID ID: https://orcid.org/0000-0001-9453-4262

Krishtop Vladimir Vladimirovich, Candidate of Sciences (Medicine), Leading Researcher, State Scientific Research Testing Institute of Military Medicine, Ministry of Defense of the Russian Federation. 195043, Russia, St. Petersburg, Lesoparkovaya St., 4; e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра., ORCID ID: https://orcid.org/0000-0002-9267-5800

Fateev Ivan Vladimirovich, Doctor of Sciences (Medicine), State Scientific Research Testing Institute of Military Medicine, Ministry of Defense of the Russian Federation. 195043, Russia, St. Petersburg, Lesoparkovaya St., 4; e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра., ORCID ID: https://orcid.org/0000-0003-4014-3973

Ovchinnikova Anna Sergeevna, Demonstrator, State Scientific Research Testing Institute of Military Medicine, Ministry of Defense of the Russian Federation. 195043, Russia, St. Petersburg, Lesoparkovaya St., 4; e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра., ORCID ID: https://orcid.org/0000-0002-6929-9923

 

For citation

Nikonorova V.G., Krishtop V.V., Fateev I.V., Ovchinnikova A.S. Atroficheskie rubtsy kak ob"ekt terapii neorganicheskimi gelyami [Atrophic scars as an object of inorganic gel treatment]. Ul'yanovskiy mediko-biologicheskiy zhurnal. 2023; 4: 126–143. DOI: 10.34014/2227-1848-2023-4-126-143 (in Russian).

 

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УДК 616-003.922:544.773.43

DOI 10.34014/2227-1848-2023-4-126-143

АТРОФИЧЕСКИЕ РУБЦЫ КАК ОБЪЕКТ ТЕРАПИИ НЕОРГАНИЧЕСКИМИ ГЕЛЯМИ

В.Г. Никонорова, В.В. Криштоп, И.В. Фатеев, А.С. Овчинникова

ФГБУ «Государственный научно-исследовательский испытательный институт военной медицины» Министерства обороны Российской Федерации, г. Санкт-Петербург, Россия

 

Атрофические рубцы представляют собой комплексную проблему, охватывающую колоссальное количество пациентов, имеющих striae gravidarum, угревую болезнь, атрофические рубцы после хирургического вмешательства, стрии при гиперкортицизме и других метаболических нарушениях. С учетом социального статуса пациентов (беременные женщины, подростки, лица, страдающие хроническими гормональными нарушениями) была поставлена цель – систематизировать литературные данные по наименее инвазивному методу лечения – терапии атрофических рубцов с использованием неорганических гелей для выявления новых химических классов с потенциальной противорубцовой активностью.

При обобщении данных исследований за последние 10 лет обнаружено, что эффект противорубцовой терапии зависит от окраски атрофического рубца – гипер- или гипопигментированный, его типа – клиновидный, ладьевидный, прямоугольный, происхождения – постакне, рубцовая алопеция, инфекционные рубцы, стрии, постравматический атрофический рубец. Также значимую роль играет стадия патогенеза: асептическое воспаление, инфильтрация клетками гематогенного дифферона, дегрануляция тучных клеток, выброс биоактивных веществ и изменение баланса факторов роста VEGF, TGF‐β1, EGF, FGF, PDGF, миграция активированных макрофагов, повреждение эластических и коллагеновых волокон, периваскулярная лимфоцитарная инфильтрация, нарушение гемореологии, хронизация воспалительного процесса, рост числа сенесцентных фибробластов, снижение синтетической активности клеток атрофического рубца, снижение клеточности и васкуляризации области атрофического рубца. При высокой биоинертности неорганических гелей противорубцовый эффект достигается за счет отшелушивающего действия, эпидермально-мезенхимальных взаимодействий, влияния на гидратацию рубца мезопористой структуры геля. Помимо известного силиконового геля, такими свойствами обладают золь-гели на основе наноматериала диоксида алюминия, что позволяет рассматривать их как альтернативу силиконовому гелю.

Ключевые слова: атрофические рубцы, наноматериалы, неорганические гели, терапия.

 

Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

Вклад авторов

Концепция и дизайн исследования: Никонорова В.Г., Криштоп В.В.

Участие в исследовании, обработка материала: Никонорова В.Г., Криштоп В.В., Фатеев И.В., Овчинникова А.С.

Статистическая обработка данных: Никонорова В.Г., Криштоп В.В.

Анализ и интерпретация данных: Никонорова В.Г., Криштоп В.В.

Написание и редактирование текста: Никонорова В.Г., Криштоп В.В.


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Поступила в редакцию 31.03.2023; принята 08.08.2023.

 

Авторский коллектив

Никонорова Варвара Геннадьевна – младший научный сотрудник, ФГБУ «Государственный научно-исследовательский испытательный институт военной медицины» Министерства обороны Российской Федерации. 195043, Россия, г. Санкт-Петербург, ул. Лесопарковая, 4; e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра., ORCID ID: https://orcid.org/0000-0001-9453-4262

Криштоп Владимир Владимирович – кандидат медицинских наук, ведущий научный сотрудник, ФГБУ «Государственный научно-исследовательский испытательный институт военной медицины» Министерства обороны Российской Федерации. 195043, Россия, г. Санкт-Петербург, ул. Лесопарковая, 4; e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра., ORCID ID: https://orcid.org/0000-0002-9267-5800

Фатеев Иван Владимирович – доктор медицинских наук, ФГБУ «Государственный научно-исследовательский испытательный институт военной медицины» Министерства обороны Российской Федерации. 195043, Россия, г. Санкт-Петербург, ул. Лесопарковая, 4; e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра., ORCID ID: https://orcid.org/0000-0003-4014-3973

Овчинникова Анна Сергеевна – препаратор, ФГБУ «Государственный научно-исследовательский испытательный институт военной медицины» Министерства обороны Российской Федерации. 195043, Россия, г. Санкт-Петербург, ул. Лесопарковая, 4; e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра., ORCID ID: https://orcid.org/0000-0002-6929-9923

 

Образец цитирования

Никонорова В.Г., Криштоп В.В., Фатеев И.В., Овчинникова А.С. Атрофические рубцы как объект терапии неорганическими гелями. Ульяновский медико-биологический журнал. 2023; 4: 126–143. DOI: 10.34014/2227-1848-2023-4-126-143.