Hyaluronidase Geneva

What is hyaluronidase? The term hyaluronidase identifies a class of different enzymes capable of degrading certain classical components of the extracellular matrix, such as hyaluronic acid, chondroitin and chondroitin sulfates. When these components are broken down, the permeability of the skin increases, making it more susceptible to infection, inflammation and allergic reactions. In these cases, hyaluronidase inhibition reduces inflammation and promotes healing of the skin. What is he doing? The natural hydrolytic activity of hyaluronidase is exploited by many pathogenic microorganisms, which have optimized the expression of this enzyme in order to easily penetrate host structures. Likewise, the first clinical use of this enzyme dates back to 1928, when hyaluronidase was used to facilitate the subcutaneous penetration of vaccines and various drugs, thus improving their preventive activity. Following on from these initial studies, hyaluronidase is now used as a vector for many active ingredients, facilitating their subcutaneous penetration and reducing the need for intravenous administration. With the growing popularity of hyaluronic acid fillers, hyaluronidase has also become an essential medicine to correct the complications and poor results of these treatments. In addition, hyaluronidase can be used to increase the reabsorption of hematomas and promote the absorption of contrast media in urinary angiography (urography with subcutaneous injection of contrast media)

Aesthetic and dermatological uses

Background Leading experts in anti-aging medicine have attempted to fully understand the complex mechanisms of extracellular matrix renewal and the role of the enzyme hyaluronidase in the renewal of these structures. Early work showed that during the neo-deposition phases of collagen and glycosaminoglycans, such as hyaluronic acid, there was an increase, both plasma and local, of a series of small molecules capable of inhibiting metallo-proteinases and hyaluronidases. These hyaluronidase inhibitors therefore seem to promote the repair and rejuvenation of the extracellular matrix, contributing to the local increase of collagen fibers and glycosaminoglycans, and giving the skin a firmer and brighter appearance. These observations paved the way for the testing of hyaluronidase inhibitors as an anti-aging system.

Medical and aesthetic applications

Given the physiological activity of hyaluronidase, this enzyme is currently one of the methods used in the medical-aesthetic-dermatological field. Specifically, intradermal hyaluronidase injections are used

1. to correct any error made by the doctor in the use of hyaluronic acid fillers;
2. for the rapid reduction of edema and inflammatory developments, for example after traumatic events;
3. for the treatment of cellulite in mesotherapy in combination with other medications.

Therefore, the use of hyaluronidase represents

1. a remedy for certain failed aesthetic medicine treatments;
2. a system capable of optimizing the local release of certain drugs;
3. an aesthetic treatment with its own purpose.

Possible side effects Technical advances have made it possible to move from the use of an extractive hyaluronidase, with all its limitations in terms of hygiene and contamination, to a recombinant form which is microbiologically pure and clinically safe. However, allergic reactions remain a relatively common side effect of hyaluronidase injections (with an incidence between 0.05% and 0.69%). These allergic reactions are mainly local, but in rare cases systemic reactions may occur. Since allergic reactions to hyaluronidase are most often immediate hypersensitivity reactions, it is recommended to perform skin testing before use. However, some patients experience delayed allergic reactions, which skin tests cannot always predict. Inhibition of hyaluronidase If the intradermal use of hyaluronidase can be important to correct certain medical errors or control the inflammatory outcome of certain events, in anti-aging medicine, the inhibition of this same enzyme has taken on a key role in the management of skin aging. The reason for this attempt is the possibility of blocking the endogenous degradation of hyaluronic acid. About half of the body's hyaluronic acid is found in the skin, where it binds to water to help retain moisture. However, the natural aging process and exposure to factors such as ultraviolet rays from the sun, tobacco smoke and pollution can reduce its amount in the skin. Hyaluronic acid deficiency is accompanied by a number of typical skin imperfections such as

• loss of skin radiance
• loss of normal hydration levels;
• the appearance of furrows and wrinkles.

Recent years have also seen a boom in research into natural constituents capable of inhibiting the hyaluronidase enzyme, thereby protecting the matrix from proteolysis induced by this enzyme. Significant efforts in this area have led to the identification of hyaluronidase inhibitors, which are often also active against metalloproteinases (which degrade collagen) and elastase (which degrade elastin). Known hyaluronidase inhibitors include anti-inflammatory agents (e.g. indomethacin, dexamethasone and salicylates), antihistamines, mast cell stabilizers, heparin, vitamin C, dicumarene. Doctor Grept Locher offers you his expertise in hyaluronidase injections