A Face-Split Study to Evaluate the Effects of Microneedle Radiofrequency with Q-Switched Nd:YAG Laser for the Treatment of Melasma

BackgroundLaser toning using a low-fluence 1,064 nm Q-switched Nd:YAG laser is one of the most frequently used treatment modalities for melasma. However, this therapy is time consuming because it requires a lot of treatment sessions. Recently, it has been reported that transdermal radiofrequency (RF) is effective for the treatment of melasma.ObjectiveTo determine whether microneedle RF conduction could be an adjunct therapy for melasma, we have studied the effect of simultaneous treatments with laser toning and RF for melasma.MethodsFifteen patients with melasma underwent five sessions of laser toning and microneedle RF on the right side of the face, and only laser toning on the left side. Responses to treatments were evaluated using the Mexameter® (Courage Khazaka, Germany) score, the pigmentation and severity index (PSI) score, and the patient''s overall assessment. Additionally, an electron microscopic study of a skin biopsy was performed.ResultsBoth laser toning and combination therapy showed significant decreases in the Mexameter® and PSI score after five treatment sessions. Combination therapy showed a more significant improvement of melasma than laser toning. No remarkable side effects were reported. Electron microscopic analysis showed a greater number of vacuolar changes and increased loosening of melanocytes and adjacent epidermal cells after combination therapy.ConclusionThe combination treatment of laser toning and microneedle RF therapy showed a better therapeutic effect for melasma than laser toning alone. Therefore, the microneedle RF technique could be a new and safe adjunct therapy for the treatment of melasma.     

The Efficacy,Longevity, and Safety of Combined Radiofrequency Treatment and Hyaluronic Acid Filler for Skin Rejuvenation

Background

Recent advances in hyaluronic acid (HA) fillers and radiofrequency (RF) devices have been made in the context of skin rejuvenation and cosmetic surgery. Moreover, combination regimens with both techniques are currently being developed.

Objective

The present study was designed to examine the clinical and histologic effects of a new needle that incorporates an RF device for HA injections.

Methods

A new intradermal needle RF device (INNOfill; Pacific Pharma, Korea) was assessed in the present study. In the animal arm, procollagen production was measured by using enzyme-linked immunosorbent assay, the filler volume was quantified by incorporating a dye with filler, and the filler distribution was assessed through the changes in tissue structure. In the human arm, the efficacy of the combination regimen was assessed by using the wrinkle severity rating scale (WSRS).

Results

In the animal study, RF treatment increased procollagen production in a time-dependent fashion. The total volume was significantly increased with the RF treatment when compared with the filler injections alone, and lasted for up to 7 weeks after treatment. Additionally, the filler distribution was reduced in animals treated with RF when compared with the untreated group. In the human study, the nasolabial folds of subjects treated with RF before filler injections exhibited a significantly greater change in the WSRS score from baseline when compared with the nasolabial folds treated with filler injections alone.

Conclusion

A new device incorporating RF treatment before HA filler injection may represent a biocompatible and long-lasting advance in skin rejuvenation.     

基质金属蛋白酶表达在皮肤光老化皱纹形成中的作用

目的 探讨皮肤光老化皱纹形成与真皮成纤维细胞基质金属蛋白酶(MMP)-1,MMP-3mRNA及其组织抑制剂(TIMP)-1表达的关系。方法 采用原位杂交和免疫组化的方法检测紫外线光化学疗法(PUVA)治疗期间及治疗后不同时间银屑病患者背部非皮损区真皮成纤维细胞MMP-1,MMP-3mRNA及TIMP-1蛋白的表达并定量分析。结果 在PUVA治疗期间、治疗后1~6个月及治疗后6个月以上的银屑病患者背部非皮损区真皮成纤维细胞均持续表达MMP-1、MMP-3mRNA,而TIMP-1蛋白仅在治疗期间一过性轻度表达。结论 PUVA治疗引起的皮肤光老化皱纹形成可能与真皮成纤维细胞基质金属蛋白酶及其组织抑制剂表达失衡密切相关。     

天冬氨酸/半胱氨酸组织蛋白酶在光老化成纤维细胞中的表达变化

目的 探讨天冬氨酸组织蛋白酶（cathepsin D）及半胱氨酸组织蛋白酶（cathepsin K）在光老化成纤维细胞中的表达变化。方法 培养原代人皮肤成纤维细胞,在50 mg/L的8-甲氧沙林（8-MOP）培养基中避光孵育24 h后,用80 kJ/m2 UVA照射,体外诱导培养细胞光老化。衰老相关-β-半乳糖苷酶（SA-β-Gal）染色证明老化诱导成功。Western印迹及实时定量RT-PCR对比检测光老化成纤维细胞及正常成纤维细胞cathepsin K和cathepsin D蛋白及基因表达。结果 Western印迹结果显示,光老化组表达的cathepsin D的灰度值为3.25 ± 0.33,对照组为14.18 ± 2.25,t = 30.61,P < 0.01,两组间差异有统计学意义;光老化组表达的cathepsin K灰度值为2.39 ± 0.66,对照组为29.38 ± 4.62,t = 12.63,P < 0.01,两组差异有统计学意义。光老化组cathepsin D mRNA的ΔCt值为2.79 ± 0.17,对照组为4.54 ± 0.34,根据2-ΔΔCt值计算得cathepsin D mRNA在光老化组的表达下调为对照组的0.24 ± 0.021（t = 20.78,P < 0.01）;光老化组cathepsin K mRNA的ΔCt值为-0.92 ± 0.06,对照组为2.57 ± 0.13,根据2-ΔΔCt值计算得cathepsin K mRNA在光老化组的表达下调为对照组的0.09 ± 0.005（t = 28.50,P < 0.01）。结论 cathepsin D及cathepsin K在光老化成纤维细胞中表达均下调。     

组织蛋白酶B在光老化皮肤中的表达及意义

目的 探讨组织蛋白酶B在光老化皮肤中的表达意义。方法 6例成人曝光和非曝光皮肤标本,采用免疫组化法定位及对比组织蛋白酶B的表达。体外培养原代人皮肤成纤维细胞,甲氧沙林 ＋ UVA法体外诱导培养细胞光老化。衰老相关-β-半乳糖苷酶染色证明老化诱导成功。Western印迹技术及RT-PCR对比检测光老化成纤维细胞及正常成纤维细胞组织蛋白酶B蛋白及基因表达。结果 6例成人曝光和非曝光活体皮肤均见组织蛋白酶B阳性染色,和非曝光部位相比,曝光部位皮肤阳性染色A值降低。Western印迹结果示,成纤维细胞光老化诱导组蛋白表达较UVA诱导组、甲氧沙林孵育组及空白组明显下调。光老化成纤维细胞诱导后1周,组织蛋白酶B与内参的灰度比由28.099 ± 0.054下降为25.103 ± 0.102,诱导后3周灰度值进一步下降为17.693 ± 0.099。实时定量RT-PCR结果示,光老化细胞组织蛋白酶B mRNA表达下调为正常组的64％（P < 0.05）。结论 组织蛋白酶B在光老化皮肤及老化成纤维细胞中表达降低,且有时间依赖性,与光老化皮肤自我修复能力下降有关。     

光老化对皮肤成纤维细胞降解晚期糖基化终末产物的影响

目的 探讨光老化对皮肤成纤维细胞降解胞内晚期糖基化终末产物（AGE）的影响。方法 连续长波紫外线（UVA）照射诱导成纤维细胞光老化,通过CCK8法、β半乳糖苷酶染色及细胞凋亡率检测验证模型是否构建成功。取原代成纤维细胞分为4组：光老化组（以UVA照射诱导光老化）,非光老化组（不做处理）,光老化 + AGE组（以UVA照射诱导光老化后加入200 mg/L AGE?BSA孵育）,非光老化 + AGE组（未诱导光老化细胞中加入200 mg/L AGE?BSA孵育）,孵育4 ~ 72 h后,流式细胞仪检测各组细胞内AGE?BSA荧光强度,激光扫描共聚焦显微镜定位、半定量各组细胞8 h点胞内AGE?BSA。ELISA检测各组细胞24 h内AGE?BSA浓度变化。结果 与对照组（未照射UVA）相比,UVA照射组细胞增殖活性显著下降（t = 7.559,P < 0.05）,而凋亡率及β半乳糖苷酶染色阳性率显著升高（t值分别为14.075、43.524,均P < 0.05）。流式细胞仪检测示,孵育4、8、16、24、48、72 h后,光老化 + AGE组AGE?BSA平均荧光强度分别为293 ± 8.19、359.67 ± 11.59、347 ± 12.29、338 ± 12.77,334.67 ± 14.22、336.3 ± 10.21,非光老化 + AGE组分别为222.33 ± 8.74、276.33 ± 6.11、256.33 ± 5.51、243 ± 10.15,236.33 ± 1.53、240.33 ± 1.52,均分别高于相应时间点光老化组和非光老化组,差异均有统计学意义（P < 0.05）。其中光老化 + AGE组AGE?BSA平均荧光强度显著高于相应非光老化 + AGE组细胞（P < 0.05）。激光扫描共聚焦显微镜观察发现,吞入胞内的AGE?BSA主要位于溶酶体内,光老化 + AGE组AGE?BSA荧光强度显著高于非光老化 + AGE组,P < 0.05。ELISA检测发现,32 h点非光老化 + AGE组细胞AGE浓度较8 h点下降（14.6 ± 1.2）%,显著高于光老化 + AGE组（t = 6.604,P < 0.05）。结论 光老化皮肤成纤维细胞对吞入胞内AGE?BSA的降解能力下降,可能致AGE在光老化皮肤堆积。     

Melasma and assessment of the quality of life in Brazilian women

BACKGROUND

Melasma is a chronic, acquired hyperpigmentation disease on sun-exposed areas of the skin, which affects patients'' quality of life.

OBJECTIVE

To assess the impact on the quality of life of women living in Florianópolis, Brazil, through questionnaire (MelasQol), and investigate the clinical aspects and risk factors for melasma, correlating them with the MelasQol scores.

METHODS

This study was performed on 51 melasma patients cared for at the University Hospital of the Universidade Federal de Santa Catarina. The variables included were: age, gender, age of onset of melasma, Fitzpatrick phototype (I-VI), duration and family history of melasma, onset of melasma during pregnancy, use of hormonal contraceptive, thyroid disorder and distribution of melasma. The MelasQoL questionnaire, validated for Brazilian Portuguese (MelasQoL-BP), was applied.

RESULTS

The mean age was 38.43±6.75 years. All patients were women. The most common Fitzpatrick skin phototypes were III (49.02%) and IV (33.33%). Melasma had a mean age of onset of 29.18±7.05 years and a mean duration of 9.25±6.18 years. The majority of patients did not have familial history of melasma (50.98%). Melasma onset was associated with pregnancy (45.10%). The MelasQoL-BP analysis revealed significant emotional impact on patients, such as feeling bothered (94.11%), frustrated and embarrassed (64.71%), and depressed (52.94%) about their skin appearance, as well as unattractive (78.43%). No social impact was observed (P>0.05).

CONCLUSION

Melasma has a strong emotional impact on quality of life, resulting especially from feelings about skin appearance.     

Radiofrequency for the treatment of skin laxity: mith or truth

The nonablative radiofrequency is a procedure commonly used for the treatment of skinlaxity from an increase in tissue temperature. The goal is to induce thermal damageto thus stimulate neocollagenesis in deep layers of the skin and subcutaneous tissue.However, many of these devices haven''t been tested and their parameters are still notaccepted by the scientific community. Because of this, it is necessary to review theliterature regarding the physiological effects and parameters for application ofradiofrequency and methodological quality and level of evidence of studies. Aliterature search was performed in MEDLINE, PEDro, SciELO, PubMed, LILACS and CAPESand experimental studies in humans, which used radiofrequency devices as treatmentfor facial or body laxity, were selected. The results showed that the mainphysiological effect is to stimulate collagen synthesis. There was no homogeneitybetween studies in relation to most of the parameters used and the methodologicalquality of studies and level of evidence for using radiofrequency are low. This factcomplicates the determination of effective parameters for clinical use of this devicein the treatment of skin laxity. The analyzed studies suggest that radiofrequency iseffective, however the physiological mechanisms and the required parameters are notclear in the literature.     

A Randomized,Prospective, Split-Face Pilot Study to Evaluate the Safety and Efficacy of 532-nm and 1,064-nm Picosecond-Domain Neodymium:Yttrium-Aluminum-Garnet Lasers Using a Diffractive Optical Element for Non-Ablative Skin Rejuvenation: Clinical and Histological Evaluation

BackgroundThe advent of fractionated picosecond (ps) lasers has provided an opportunity to explore new ways of creating microinjuries in the skin to induce skin rejuvenation.ObjectiveTo compare the efficacy and safety of diffractive optical element (DOE)-assisted ps neodymium: yttrium-aluminum-garnet (Nd:YAG) lasers with 532-nm and 1,064-nm wavelengths (532-nm and 1,064-nm Nd:YAG P-DOE) using a novel fractional handpiece for the treatment of photoaged skin.MethodsAn ex vivo guinea pig skin experiment was performed by evaluating the histology of the skin after 532-nm Nd:YAG P-DOE irradiation. A randomized, prospective, split-face study was performed on eight subjects with 532-nm and 1,064-nm Nd:YAG P-DOE.ResultsBased on the histological evaluation using ex vivo guinea pig skin, a reasonable safety profile and the potential to generate effective skin rejuvenation was observed using the 532-nm Nd:YAG P-DOE. Results demonstrated that both 532- and 1,064-nm Nd:YAG P-DOE were similarly effective in improving skin texture and skin pores; however, 532-nm Nd:YAG P-DOE was more effective in treating dyspigmentation.ConclusionAt a preliminary level, this study revealed that 532-nm and 1,064-nm ps Nd:YAG lasers using DOE fractional technology may improve photoaged skin. In conclusion, 532-nm Nd:YAG P-DOE may be especially beneficial for skin with epidermal pigmentary lesions.     

射频电刀联合中药外敷治疗肥大增生型酒渣鼻的临床疗效观察

目的 观察射频电刀微雕整形修复联合中药治疗肥大增生型酒渣鼻的安全性和有效性.方法 将确诊为肥大增生型酒渣鼻的患者38例,随机分为射频刀A组(13例)、射频刀B组(13例)和普通电刀组(12例).射频刀A组采用射频电刀微雕整形修复+复方紫草油纱,射频刀B组采用射频电刀微雕整形修复+抗生素油纱,普通电刀组采用普通电刀切除增...     

MiR-146a 在长波紫外线诱导人皮肤成纤维细胞光老化中作用机制的研究

目的：探讨长波紫外线（UVA）诱导人皮肤成纤维细胞（HSF）光老化中 miR-146a 的表达情况,以及上调 miR-146a 表达对其靶基因 Smad4及细胞光老化的影响。方法以10 J/cm2 UVA 照射 HSF （UVA 照射组）,分别在0、3、7、14 d 提取 RNA,实时定量 PCR 检测 miR-146a 的表达量。通过慢病毒转染上调 miR-146a 的表达（miR-146a 过表达组）,在7 d、14 d 后用荧光显微镜观察转染效率,并通过实时定量 PCR 验证细胞内miR-146a 表达量。空白对照组为正常培养的 HSF（不做任何处理）,miR-146a 过表达组为慢病毒转染 HSF 后,再用 UVA 照射。MTT 法检测空白对照组、UVA 照射组、miR-146a 过表达组、miR-146a 过表达组细胞增殖吸光度（A 值）,实时定量 PCR 检测各组细胞内老化相关基因 p53、p16和 p21 mRNA 的表达,Western 印迹法检测各组细胞内 Smad4蛋白表达。采用重复测量的方差分析、析因设计的方差分析进行统计学分析。结果重复测量的方差分析显示,随培养时间的延长,UVA 照射组和空白对照组 miR-146a 的表达量均逐渐下降（F =213.840, P <0.01）;UVA 照射组表达量低于空白对照组（F =52.55,P <0.01）,且照射时间越长,下调越明显。慢病毒转染HSF 后,细胞内均有较高的荧光表达,miR-146a 过表达组在第7天（10.31±0.17）与第14天时（9.65±0.19）的miR-146a 表达量差异无统计学意义（P >0.05）,但较空白对照组（分别为8.33±0.13和7.86±0.11）显著增高,组间差异有统计学意义（F =42.49,P <0.01）。析因设计的方差分析显示,UVA 照射对细胞增殖活性有抑制作用（P <0.01）,UVA 照射组、UVA + miR-146a 组细胞增殖均分别低于空白对照组、miR-146a 过表达组（P <0.01）;慢病毒转染上调 miR-146a 的表达对细胞增殖活性也有影响（P <0.01）,但 miR-146a 过表达组与空白对照组差异无统计学意义（P >0.05）,UVA + miR-146a 组显著高于 UVA 照射组（P <0.01）。实时定量 PCR 和 Western 印迹法结果显示,UVA 照射可上调 p21、p53、p16 mRNA 的表达（均 P <0.01）,同时对细胞内 Smad4蛋白表达有促进作用（P <0.01）;UVA 照射组、UVA + miR-146a 组 p21、p53、p16 mRNA 和 Smad4蛋白表达均分别高于空白对照组、miR-146a 过表达组（均 P <0.01）,而 miR-146a 过表达组与空白对照组相比差异均无统计学意义（均 P >0.05）, UVA + miR-146a 组均显著低于 UVA 照射组（均 P <0.01）。结论在 UVA 诱导光老化的 HSF 中,miR-146a 的表达受到抑制,上调其表达能够抑制 Smad4的表达,促进光老化细胞增殖,起到抗细胞光老化的作用。     

皮肤光老化的光电治疗进展

皮肤光老化是由环境因素,尤其是紫外线长期照射引起皮肤外观的改变,影响美观并与多种皮肤病相关,甚至成为皮肤癌前病变、皮肤癌等潜在危险因素而受到高度关注.除药物、整形外科手术及填充剂等治疗以外,光电治疗技术已广泛用于皮肤光老化的治疗,其疗效确切、操作省时、损伤小而成为皮肤光老化治疗最重要的方法.     

长波紫外线对皮肤成纤维细胞表达和分泌组织蛋白酶G的影响

目的 研究长波紫外线（UVA）照射对皮肤成纤维细胞组织蛋白酶G（CatG）表达和分泌的影响。 方法 原代培养的皮肤成纤维细胞来自儿童包皮,10代以内的细胞行后续实验。①以10 J/cm2 UVA照射皮肤成纤维细胞,24、48、72 h后提取照射组和对照组细胞蛋白和mRNA,并收集细胞上清液;②分别以10、20、30 J/cm2 UVA照射皮肤成纤维细胞,24 h后收集细胞和上清液。用RT-PCR 和Western印迹分别检测各组细胞CatG mRNA及蛋白的表达,ELISA检测细胞上清液CatG的含量。 结果 10 J/cm2 UVA照射后24、48、72 h,照射组细胞CatG mRNA表达分别为0.376 ± 0.014、0.308 ± 0.022和0.296 ± 0.032,对照组分别为0.183 ± 0.003、0.185 ± 0.005、0.182 ± 0.004;照射组细胞CatG蛋白灰度值分别为1.80 ± 0.12、1.41 ± 0.17和1.27 ± 0.09,对照组分别为0.96 ± 0.06、0.95 ± 0.22、1.00 ± 0.14;照射组细胞CatG mRNA、蛋白表达及细胞上清液CatG含量较相应的对照组升高（均P < 0.05）,且以照射后24 h表达最高。10、20、30 J/cm2 UVA照射后24 h,皮肤成纤维细胞CatG mRNA表达分别为对照组的1.90、2.51、3.04倍,细胞CatG蛋白表达分别为对照组的1.88、3.97、4.72倍,细胞上清液CatG含量分别为对照组的1.36、1.50、1.66倍,均随UVA剂量的升高而增加,其差异有统计学意义（均P < 0.01）。 结论 急性UVA照射促进皮肤成纤维细胞表达和分泌CatG。     

一种胶原基质全层皮肤模型的构建和表征

目的 构建一种体外维持时间长、有利于后续测试研究的胶原基质皮肤模型。方法 将猪胶原和正常人皮肤成纤维细胞混合接种于培养皿,培养得到真皮层结构后,将第3 ~ 7代正常人角质形成细胞接种于真皮层表面,培养得到双层皮肤模型。通过HE和Masson染色评估皮肤模型的形态和组织结构,使用电镜观察模型的超微结构,并通过免疫组化和免疫荧光染色观察模型中各层的主要标记物表达情况。结果 HE和Masson染色发现,皮肤模型与正常人皮肤组织有相近的真皮及表皮结构,且模型收获后仍具有稳定良好的真表皮结构,可在体外继续培养14 d。电镜下显示,皮肤模型中可见角质层中脂质、颗粒层中透明角质颗粒、角化桥粒、桥粒、基底膜等超微结构。免疫组化及免疫荧光显示,皮肤模型在表皮层中具有与正常皮肤一致的转谷氨酰胺酶、丝聚合蛋白、角蛋白10、Ki67的表达,基底膜具有与正常皮肤一致的Ⅳ型胶原和层黏连蛋白5表达,真皮层具有一致的Ⅰ型胶原、Ⅲ型胶原及原纤维蛋白表达。结论 本研究构建的三维皮肤模型组织结构和多种蛋白的表达与正常人体皮肤相似,模型收获后体外可继续稳定培养至少14 d。     

富血小板血浆联合氨甲环酸治疗黄褐斑疗效观察

目的 探讨富血小板血浆(PRP)联合氨甲环酸片治疗黄褐斑的临床疗效及安全性.方法 将入选的79例患者随机分为两组,对照组(39例)单纯口服氨甲环酸片治疗,疗程为3个月,治疗组(40例)在对照组基础上,联合PRP治疗,每月1次,共3次.治疗结束后比较两组临床疗效及不良反应,6个月后观察复发情况.结果 3个月后,治疗组和对...     

皮肤光老化的外用药物预防与治疗

光老化是指皮肤衰老过程中由光线特别是紫外线辐射所造成的损伤。皮肤光老化可并发多种皮肤病甚至与皮肤肿瘤的发生有病因学的联系。因此,预防和治疗皮肤光老化很有必要。随着对光老化认识的加深,对其预防与治疗的方法也取得了相应进展。为此,综述了近年来皮肤光老化预防和治疗中应用的包括防晒剂、维A酸类、绿茶等多种外用药物,并从作用机制、临床应用及疗效等方面逐一介绍。     

A Comprehensive Review of the Long-Term and Short-Term Treatment of Melasma with a Triple Combination Cream

Melasma is a common disorder of hyperpigmentation and generally involves areas of the face and neck. Hyperpigmentation is especially prevalent in darker complected patients and is often difficult to treat. Hydroquinone, tretinoin, and topical corticosteroids are well established monotherapeutic agents for treating melasma and hyperpigmentation; however, a stable, once-daily formulation triple combination cream containing 0.05% tretinoin, 4.0% hydroquinone, and 0.01% fluocinolone acetonide (Tri-Luma) represents the only commercially available combination of all three agents. This product is approved by the US FDA for the treatment of facial melasma. A number of publications have described the safety and efficacy of triple combination cream in over 2000 patients with melasma, some of whom were treated for >12 months. In the initial 8-week study, 29% of patients experienced complete clearing of melasma by week 8, and 77% were clear or almost clear by week 8. Similarly, good results were seen in the two long-term studies, with the clear/mild rate ranging from 78% to 84% of patients at month 6 and from 81% to 94% of patients at month 12. Adverse events were almost always mild in severity and typically occurred only at the application site. The primary concern for most physicians using corticosteroid-containing products on the face is skin atrophy. However, only two cases of skin atrophy were reported across the three published studies. Overall, the results of these extensive studies indicate that triple combination cream is efficacious in treating melasma and exhibits a safe profile with low potential for adverse events.     

紫外线及全反式维A酸对人皮肤及成纤维细胞中Hrd1表达的影响

目的 探讨紫外线照射及全反式维A酸（ATRA）对人皮肤及成纤维细胞中Hrd1表达的影响及机制。方法 2017年12月至2018年6月于南京医科大学附属第一医院皮肤科收集12份人皮肤组织标本,30 ~ 40岁、60 ~ 70岁曝光及非曝光部位标本各3份,免疫组化检测各组Hrd1表达。将40只BALB/c小鼠分为对照组、紫外线组、ATRA组及紫外线 + ATRA组,其中紫外线组、紫外线 + ATRA组每日照射UVA 10 J/cm2和UVB 30 mJ/cm2,紫外线 + ATRA组（照光前给药）、ATRA组小鼠背部剃毛区域每日均匀涂抹1次0.1 ml 0.1% ATRA药膏,对照组既不涂药也不照射紫外线。14周后处死小鼠并取背部皮肤免疫组化观察Hrd1的表达。体外培养的人皮肤成纤维细胞分为对照组、紫外线组、ATRA组及紫外线 + ATRA组,紫外线组和ATRA + 紫外线组照光前用磷酸盐缓冲液覆盖细胞上层,照射10 J/cm2 UVA或30 mJ/cm2 UVB,ATRA + 紫外线组（照光后给药）和ATRA组用含ATRA 1 μmol/L的培养基继续培养24 h。Western印迹法检测各组成纤维细胞Hrd1表达,荧光显微镜观察各组细胞内活性氧水平。组间比较采用单因素方差分析,两两比较采用LSD-t检验,P < 0.05认为差异有统计学意义。结果 30 ~ 40岁、60 ~ 70组曝光部位皮肤组织中Hrd1表达水平分别为0.307 ± 0.256、0.486 ± 0.579,均明显高于避光部位（0.196 ± 0.330、0.199 ± 0.375）,t值分别为5.486、10.579,P < 0.05。BALB/c小鼠体内实验中,对照组、紫外线组、ATRA组及紫外线 + ATRA组小鼠皮肤中Hrd1表达水平分别为0.189 ± 0.015、0.288 ± 0.017、0.187 ± 0.020、0.226 ± 0.021,差异有统计学意义（F = 19.553,P < 0.001）,紫外线组高于对照组（t = 5.337,P = 0.033）和ATRA + 紫外线组（t = 4.891,P = 0.039）。体外实验中,人皮肤成纤维细胞分别经UVA、UVB照射后,4组细胞Hrd1水平差异均有统计学意义（F值分别为120.704、102.119,均P < 0.001）,UVA或UVB照射对Hrd1表达水平的影响基本一致,紫外线组Hrd1水平均明显高于对照组和ATRA + 紫外线组（均P < 0.05）。紫外线照射后,紫外线组活性氧水平均明显高于对照组和ATRA + 紫外线组（均P < 0.05）。结论 ATRA可以抑制紫外线介导的皮肤成纤维细胞中Hrd1的表达,其机制可能与ATRA抑制细胞内活性氧生成有关。