title: Expression of transforming growth factor-β after different non-invasive facial rejuvenation modalities.
abstract: BACKGROUND
  Transforming growth factor-β (TGF-β) is a major regulator of the synthesis of extracellular matrix (ECM) proteins in human skin as it stimulates fibroblast proliferation and collagen production. Perturbed TGF-β expression may play a key role in the pathogenesis of skin aging.
  
  
  OBJECTIVE
  This study was conducted to objectively evaluate the effects of different modalities of non-invasive facial rejuvenation on TGF-β expression and to correlate its level with that of newly synthesized collagen.
  
  
  METHODS
  A total of 36 patients with Fitzpatrick skin types III and IV were divided into six groups. Each group of six patients was subjected to a different non-invasive modality for the treatment of skin aging, including radiofrequency (RF), Nd:YAG 1320-nm laser and Er:YAG 2940-nm laser mini-peels, intense pulsed light (IPL), mesotherapy injection, and electro-optical synergy (ELOS). Skin biopsies were obtained before treatment, at the end of treatment, and at three months post-treatment. In addition, biopsies were obtained from 30 control subjects. Levels of TGF-β were quantitatively evaluated using computerized image analysis of immunostained sections.
  
  
  RESULTS
  The expression of TGF-β was statistically significantly increased (P < 0.05) at the end of Nd:YAG 1320-nm and Er:YAG 2940-nm mini-peel treatments compared with baseline levels, and at three months post-treatment with RF and ELOS compared with pretreatment and end-of-treatment levels. However, no significant differences (P > 0.05) were observed in TGF-β level in response to IPL or mesotherapy treatments in comparison with baseline. The level of TGF-β was positively correlated (P < 0.05) to that of newly synthesized collagen at the end of Nd:YAG 1320-nm laser and Er:YAG 2940-nm laser mini-peels, as well as at three months after RF and ELOS treatments.
  
  
  CONCLUSIONS
  Radiofrequency, ELOS, and Nd:YAG 1320-nm laser and Er:YAG 2940-nm laser mini-peels resulted in an increase in TGF-β expression, which may mediate the effects of these modalities in enhancing dermal collagen expression through the activation of fibroblasts and thereby reverse the photoaging of skin.
authors.affiliation: Department of Dermatology, Al-Minya University, Al-Minya, Egypt.
authors.forename: Moetaz
authors.initials: M
authors.lastname: El-Domyati
authors.forename: Tarek S
authors.initials: TS
authors.lastname: El-Ammawi
authors.forename: Walid
authors.initials: W
authors.lastname: Medhat
authors.forename: Osama
authors.initials: O
authors.lastname: Moawad
authors.forename: Mỹ G
authors.initials: MG
authors.lastname: Mahoney
authors.forename: Jouni
authors.initials: J
authors.lastname: Uitto
mesh_terms: D000328:Adult; D000368:Aged; D003357:Cosmetic Techniques; D005145:Face; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012060:Rejuvenation; D012867:Skin / Q000033:anatomy & histology / Q000378:metabolism*; D016212:Transforming Growth Factor beta / Q000096:biosynthesis*
chemical_list: D016212:Transforming Growth Factor beta