12,043 results on '"Injections, Intradermal"'
Search Results
2. Clinical Anatomy of the Face for Filler and Botulinum Toxin Injection
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Hee-Jin Kim, Kyle K. Seo, Hong-Ki Lee, Ji-Soo Kim, Kwan-Hyun Youn, Hee-Jin Kim, Kyle K. Seo, Hong-Ki Lee, Ji-Soo Kim, and Kwan-Hyun Youn
- Subjects
- Face, Botulinum toxin--Therapeutic use, Injections, Intradermal
- Abstract
In the second edition of this highly successful book, the authors once again aim to equip the reader with up-to-date information. This book, containing more than 200 cadaveric photos and 200 illustrations, aims to familiarize physicians practicing botulinum neurotoxin type A (BoNT-A) and filler injection with the anatomy of the facial mimetic muscles, vessels, and soft tissues in order to enable them to achieve optimum cosmetic results while avoiding possible adverse events. Anatomic considerations of importance when administering BoNT-A and fillers are identified and in addition invaluable clinical guidelines are provided, highlighting, for example, the preferred injection points for BoNT-A and the adequate depth of filler injection. Unique insights are also offered into the differences between Asians and Caucasians with regard to relevant anatomy. The contributing authors include an anatomist who offers distinctive anatomic perspectives on BoNT-A and filler treatments and three expert physicians from different specialties, namely a dermatologist, a plastic surgeon, and a cosmetic physician, who share insights gained during extensive clinical experience in the use of BoNT-A and fillers.
- Published
- 2024
3. Improvement of plantar hyperhidrosis following the treatment of primary palmar hyperhidrosis with botulinum toxin injection.
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Moieneddin F, Hasanzadeh S, Kassir M, and Robati RM
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- Humans, Female, Treatment Outcome, Adult, Foot, Injections, Intradermal, Neuromuscular Agents administration & dosage, Neuromuscular Agents adverse effects, Hand, Male, Hyperhidrosis drug therapy, Botulinum Toxins, Type A administration & dosage, Botulinum Toxins, Type A adverse effects
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- 2024
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4. Relative vaccine effectiveness of ChAdOx1/AZD1222 vaccines as booster dose via intradermal injection with a one-fifth dose compared with the intramuscular injection in the prevention of SAR-CoV-2 infections in Phuket: A retrospective cohort study.
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Jangiam W, Swangpun K, Iamsirithaworn S, Piriyasatit S, and Bhukdee D
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- Humans, Injections, Intramuscular, Retrospective Studies, Male, Injections, Intradermal, Female, Thailand epidemiology, Middle Aged, Adult, Immunization, Secondary, Vaccine Efficacy, ChAdOx1 nCoV-19 administration & dosage, COVID-19 Vaccines administration & dosage, COVID-19 Vaccines immunology, Aged, Young Adult, COVID-19 prevention & control, SARS-CoV-2 immunology
- Abstract
Objectives: This study assessed the real-world relative vaccine effectiveness of the ChAdOx1/AZD1222 vaccine given intradermally at one-fifth dose compared to the standard intramuscular injection, following the completion of 2 doses of CoronaVac, due to limited vaccine availability in Thailand during the Coronavirus disease 2019 (COVID-19) pandemic., Method: This retrospective cohort study used 138,264 records from Vachira Phuket Hospital, Phuket, Thailand. The records were divided into 2 groups: 49,387 recipients received one-fifth doses via intradermal injections, and 88,877 recipients received standard-dose intramuscular injections from September 14 to October 3, 2021, with follow-up until December 31, 2021. Relative vaccine effectiveness for the cohorts was estimated using Cox regression, adjusting for demographic and clinical risk factors., Results: The adjusted hazard ratio between the intradermal and intramuscular groups was 0.88 (95% Confidence Interval 0.76-1.02, P = 0.09), indicating a nonsignificant protective factor for the intradermal group. Further stratified analysis revealed no significant difference between the 2 groups. The 21 and 28-day postvaccination periods minimized the possibility of confounding due to differences in the cohorts' timeframes., Conclusion: A booster dose of ChAdOx1/AZD1222 given intradermally at one-fifth dose did not show a significant difference compared to the standard intramuscular injection., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
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- 2024
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5. Standardizing the injection point distance in palmar hyperhidrosis treatment using three-dimensional printed molds.
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López Sanz P, Gómez Sánchez ME, García Vázquez A, Escario Méndez A, and Escario Travesedo E
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- Humans, Hand, Injections, Intradermal, Hyperhidrosis drug therapy, Printing, Three-Dimensional
- Abstract
Competing Interests: Conflicts of interest None disclosed.
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- 2024
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6. Clinical effects of polynucleotide with hyaluronic acid intradermal injections on facial erythema: Effective redness treatment using polynucleotides.
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Lee DK, Oh M, Kim MJ, and Oh SM
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- Humans, Injections, Intradermal, Female, Adult, Middle Aged, Treatment Outcome, Dermal Fillers administration & dosage, Face, Male, Hyaluronic Acid administration & dosage, Erythema drug therapy, Polynucleotides administration & dosage
- Published
- 2024
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7. Different Dilutions of Mesobotox in Facial Rejuvenation: Which is Better?
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Salem SA, Seoudy WM, Abd El-Rahman NS, and Afify AA
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- Humans, Female, Prospective Studies, Middle Aged, Adult, Treatment Outcome, Cosmetic Techniques, Esthetics, Injections, Intradermal, Neuromuscular Agents administration & dosage, Dose-Response Relationship, Drug, Patient Satisfaction, Rejuvenation, Botulinum Toxins, Type A administration & dosage, Skin Aging drug effects
- Abstract
Background: Microbotulinum toxin A treatment is a technique of delivering multiple intradermal injections of diluted botulinum toxin type A into the dermis or the interface between the dermis and the superficial layer of the facial muscles to preserve the facial mobility. The current study aimed to evaluate and compare the clinical effect of different dilutions of microbotulinum toxin A in periorbital and mid-facial rejuvenation., Methods: This randomized prospective interventional study included 30 female patients with different types of wrinkles in periorbital and/or mid-face. Patients were divided into three groups: group I (10 patients): 100U botulinum toxin in 5 ml saline, group II (10 patients): 100U botulinum toxin in 7 ml saline and group III (10 patients): 100U botulinum toxin in 10 ml saline., Results: A statistically significant better global esthetic improvement scale (GAIS) scores after 1 month were observed in group I compared to groups II and III. Also, after 6 months better GAIS scores were observed in group I compared to group II and in group II compared to group III. Assessment of different esthetic parameters measured by the Antera 3D camera revealed a statistically significant improvement in all parameters (periorbital and mid-face) in group I and in most of parameters (periorbital and mid-face) in groups II and III with more evident improvement after 1 month compared to after 6 months., Conclusion: Intradermal microbotulinum toxin A is a cost-effective method for improving periorbital and mid-face wrinkles with a better effect of 1:5 than 1:7 and 1:10 dilutions. Facial wrinkles possess a great burden on patients' psychological status, and the emergence of novel rejuvenation technique with minimal side effects is necessary. MicroBoNT-A usage in the literature was through variety of dilutions and concentrations. Therefore, a conclusive and comparative study was essential to compare the effect of different microBoNT-A dilutions. In this context, the current study aimed to evaluate and compare the clinical effect of different dilutions of microBoNT-A in periorbital and mid-facial rejuvenation., Level of Evidence Iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 ., (© 2024. The Author(s).)
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- 2024
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8. Separable nanocomposite hydrogel microneedles for intradermal and sustained delivery of antigens to enhance adaptive immune responses.
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Zheng Y, Li Z, Li S, Zhao P, Wang X, Lu S, Shi Y, and Chang H
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- Animals, Antigens administration & dosage, Dendritic Cells immunology, Dendritic Cells metabolism, Dendritic Cells drug effects, Mice, Mice, Inbred C57BL, Female, Injections, Intradermal, Hyaluronic Acid chemistry, Delayed-Action Preparations chemistry, Delayed-Action Preparations pharmacology, Silicates, Ovalbumin immunology, Ovalbumin administration & dosage, Adaptive Immunity drug effects, Needles, Hydrogels chemistry, Nanocomposites chemistry
- Abstract
Vaccines play a critical role in combating infectious diseases and cancers, yet improving their efficacy remains challenging. Here, we introduce a separable nanocomposite hydrogel microneedle (NHMN) patch designed for intradermal and sustained delivery of ovalbumin (OVA), a model antigen, to enhance adaptive immune responses. The NHMN patch consists of an array of OVA-loaded microneedles made from photo-cross-linked methacrylated hyaluronic acid and laponite (LAP), supported by a hyaluronic acid backing. The incorporation of LAP not only enhances the mechanical strength of the pure hydrogel microneedles but also significantly prolongs OVA release. Furthermore, in vitro cell experiments demonstrate that NHMNs effectively activate dendritic cells without compromising cell viability. Upon skin penetration, NHMNs detach from the backing as the hyaluronic acid rapidly dissolves upon contact with the skin interstitial fluid, thereby acting as antigen reservoirs to release antigens to abundant skin dendritic cells. NHMNs containing 0.5% w/v LAP achieved a 15-day OVA release in vivo. Immunization studies demonstrate that the intradermal and sustained release of OVA via NHMNs elicited stronger and longer-lasting adaptive immune responses compared to conventional bolus injection. Given its easy to use, painless and minimally invasive features, the NHMN patch shows promise in improving vaccination accessibility and efficacy against a range of diseases. STATEMENT OF SIGNIFICANCE: The study introduces a separable nanocomposite hydrogel microneedle (NHMN) patch. This patch consists of an array of ovalbumin (OVA, a model antigen)-loaded microneedles made from photo-cross-linked methacrylated hyaluronic acid and laponite, with a hyaluronic acid backing, designed for intradermal and sustained delivery of antigens. This patch addresses several key challenges in traditional vaccination methods, including poor antigen uptake and presentation, and rapid systematic clearance. The incorporation of laponite enhances mechanical strength of microneedles, promotes dendritic cell activation, and significantly slows down antigen release. NHMN-based vaccination elicits stronger and longer-lasting adaptive immune responses compared to conventional bolus injection. This NHMN patch holds great potential for improving the efficacy, accessibility, and patient comfort of vaccinations against a range of diseases., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.)
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- 2024
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9. The impact of purified protein derivative prior to intravesical bacillus Calmette-Guérin for the treatment of patients with non-muscle invasive bladder cancer.
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Zawky M, Elsayed A, Awadallah A, Abdelhalim A, Abolenein H, and Shokeir A
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- Humans, Male, Female, Administration, Intravesical, Aged, Middle Aged, Prospective Studies, Adjuvants, Immunologic administration & dosage, Adjuvants, Immunologic therapeutic use, Adjuvants, Immunologic pharmacology, Adjuvants, Immunologic adverse effects, Neoplasm Invasiveness, Tuberculin immunology, Tuberculin administration & dosage, Injections, Intradermal, Treatment Outcome, Non-Muscle Invasive Bladder Neoplasms, Urinary Bladder Neoplasms drug therapy, Urinary Bladder Neoplasms immunology, Urinary Bladder Neoplasms pathology, BCG Vaccine therapeutic use, BCG Vaccine administration & dosage, BCG Vaccine immunology
- Abstract
Background: The aim of this study is to investigate the impact of the intradermal injection of purified protein derivative (PPD) and PPD skin test reactions on the oncological outcomes of patients with non-muscle invasive bladder cancer (NMIBC) treated by trans-urethral resection of bladder tumor (TURBT) and adjuvant intravesical BCG., Methods: The study included 100 consecutive patients with NMIBC prospectively given intradermal PPD 1-2 weeks before starting BCG therapy. Another 100 patients with NMIBC not given intradermal PPD before starting BCG were chosen as a historical control. The control group was chosen to be matching with the study group regarding baseline characteristics. The study group was divided into 2 subgroups with positive and negative reaction to PPD skin test. Oncological outcomes, immunological markers (TNF-α and IL-6) changes and BCG side effects were evaluated., Results: There were no significant differences between patients who received PPD or not regarding the 2-year recurrence free survival (RFS) rates and progression-free survival (PFS) rates and immunological markers changes. The 2-year RFS and PFS rates were significantly higher in patients with positive reactions. Post-induction values of immunological markers increased in all patients with a significant increase in patients with positive reactions. BCG side effects were significantly higher in patients with positive reactions., Conclusions: The intradermal injection of PPD before intravesical BCG has no impact on oncological outcomes of patients with NMIBC treated with TURBT and intravesical BCG. However, the PPD skin test reactions before BCG therapy can predict the oncological outcomes, BCG side effects and the immunological outcomes of patients.
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- 2024
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10. Evaluation of the effects of carboxytherapy in the treatment of periorbital dark circles.
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Tabaie SM, Shirkavand A, Mansouri P, Mehrizi AAH, and Farshi S
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- Humans, Female, Adult, Male, Treatment Outcome, Middle Aged, Eyelids drug effects, Young Adult, Injections, Intradermal, Hyperpigmentation drug therapy, Patient Satisfaction, Carbon Dioxide administration & dosage, Cosmetic Techniques
- Abstract
Background: Dark eye circle (DEC) is one of the most common cosmetic problems. It has a great impact on the patients' quality of life. Carboxytherapy is a cosmetic technique using pure carbon dioxide for different uses in different areas of the body. The goal of this study is to evaluate the efficacy and tolerability of carboxytherapy in the cosmetic correction of DECs., Methods: This study was conducted on 27 patients requesting the correction of DEC. The treatment was performed using a carboxy device in medical grade. The gas injection was performed intradermal after local anesthesia, with a pressure of one tenth bar and a speed of 20 cc/min, 1 cc in each upper and lower eyelid. The treatment sessions were done every 2 weeks for four sessions., Results: The mean physicians' score of DECs before and after treatment was 8.7 ± 0.81 and 4.6 ± 1.1, respectively. The mean patients' score before and after treatment was 9.2 ± 0.5 versus 5.41 ± 1.37. The mean scores showed a significant reduction of skin discoloration without major side effects (p < 0.00001)., Conclusion: Carboxytherapy seems to be an effective treatment option for dark circles around the eyes with a good safety profile and patient satisfaction., (© 2024 The Author(s). Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.)
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- 2024
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11. Safety of a controlled human infection model of tuberculosis with aerosolised, live-attenuated Mycobacterium bovis BCG versus intradermal BCG in BCG-naive adults in the UK: a dose-escalation, randomised, controlled, phase 1 trial.
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Satti I, Marshall JL, Harris SA, Wittenberg R, Tanner R, Lopez Ramon R, Wilkie M, Ramos Lopez F, Riste M, Wright D, Peralta Alvarez MP, Williams N, Morrison H, Stylianou E, Folegatti P, Jenkin D, Vermaak S, Rask L, Cabrera Puig I, Powell Doherty R, Lawrie A, Moss P, Hinks T, Bettinson H, and McShane H
- Subjects
- Humans, Adult, Male, Female, United Kingdom, Middle Aged, Injections, Intradermal, Young Adult, Administration, Inhalation, Mycobacterium bovis immunology, Adolescent, Aerosols, Vaccines, Attenuated administration & dosage, Tuberculosis prevention & control, BCG Vaccine administration & dosage, BCG Vaccine immunology, BCG Vaccine adverse effects
- Abstract
Background: Mycobacterium tuberculosis is the main causative agent of tuberculosis. BCG, the only licensed vaccine, provides inadequate protection against pulmonary tuberculosis. Controlled human infection models are useful tools for vaccine development. We aimed to determine a safe dose of aerosol-inhaled live-attenuated Mycobacterium bovis BCG as a surrogate for M tuberculosis infection, then compare the safety and tolerability of infection models established using aerosol-inhaled and intradermally administered BCG., Methods: This phase 1 controlled human infection trial was conducted at two clinical research facilities in the UK. Healthy, immunocompetent adults aged 18-50 years, who were both M tuberculosis-naive and BCG-naive and had no history of asthma or other respiratory diseases, were eligible for the trial. Participants were initially enrolled into group 1 (receiving the BCG Danish strain); the trial was subsequently paused because of a worldwide shortage of BCG Danish and, after protocol amendment, was restarted using the BCG Bulgaria strain (group 2). After a dose-escalation study, during which participants were sequentially allocated to receive either 1 × 10
3 , 1 × 104 , 1 × 105 , 1 × 106 , or 1 × 107 colony-forming units (CFU) of aerosol BCG, the maximum tolerated dose was selected for the randomised controlled trial. Participants in this trial were randomly assigned (9:12), by variable block randomisation and using sequentially numbered sealed envelopes, to receive aerosol BCG (1 × 107 CFU) and intradermal saline or intradermal BCG (1 × 106 CFU) and aerosol saline. Participants were masked to treatment allocation until day 14. The primary outcome was to compare the safety of a controlled human infection model based on aerosol-inhaled BCG versus one based on intradermally administered BCG, and the secondary outcome was to evaluate BCG recovery in the airways of participants who received aerosol BCG or skin biopsies of participants who received intradermal BCG. BCG was detected by culture and by PCR. The trial is registered at ClinicalTrials.gov, NCT02709278, and is complete., Findings: Participants were assessed for eligibility between April 7, 2016, and Sept 29, 2018. For group 1, 15 participants were screened, of whom 13 were enrolled and ten completed the study; for group 2, 60 were screened and 33 enrolled, all of whom completed the study. Doses up to 1 × 107 CFU aerosol-inhaled BCG were sufficiently well tolerated. No significant difference was observed in the frequency of adverse events between aerosol and intradermal groups (median percentage of solicited adverse events per participant, post-aerosol vs post-intradermal BCG: systemic 7% [IQR 2-11] vs 4% [1-13], p=0·62; respiratory 7% [1-19] vs 4% [1-9], p=0·56). More severe systemic adverse events occurred in the 2 weeks after aerosol BCG (15 [12%] of 122 reported systemic adverse events) than after intradermal BCG (one [1%] of 94; difference 11% [95% CI 5-17]; p=0·0013), but no difference was observed in the severity of respiratory adverse events (two [1%] of 144 vs zero [0%] of 97; 1% [-1 to 3]; p=0·52). All adverse events after aerosol BCG resolved spontaneously. One serious adverse event was reported-a participant in group 2 was admitted to hospital to receive analgesia for a pre-existing ovarian cyst, which was deemed unrelated to BCG infection. On day 14, BCG was cultured from bronchoalveolar lavage samples after aerosol infection and from skin biopsy samples after intradermal infection., Interpretation: This first-in-human aerosol BCG controlled human infection model was sufficiently well tolerated. Further work will evaluate the utility of this model in assessing vaccine efficacy and identifying potential correlates of protection., Funding: Bill & Melinda Gates Foundation, Wellcome Trust, National Institute for Health Research Oxford Biomedical Research Centre, Thames Valley Clinical Research Network, and TBVAC2020., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)- Published
- 2024
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12. Immediate SVF-Gel Injection Reduced Incision Scar Formation: A Prospective, Double-Blind, Randomized, Self-control Trial.
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Rong X, Tang J, Yang J, Wang K, Dang J, Yu Z, Zhang Z, and Yi C
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- Humans, Double-Blind Method, Female, Prospective Studies, Adult, Treatment Outcome, Middle Aged, Injections, Intradermal, Time Factors, Follow-Up Studies, Esthetics, Wound Healing physiology, Cicatrix prevention & control, Cicatrix etiology, Mammaplasty methods, Gels
- Abstract
Background: Skin incision scars are cosmetically displeasing; the effects of current treatments are limited, and new methods to reduce scar formation need to be found., Objective: We sought to determine whether immediate postoperative injection of stromal vascular fraction gel (SVF-gel) could reduce scar formation at skin incision sites., Methods: A prospective, randomized, double-blind, self-controlled trial was conducted in patients who underwent breast reduction. SVF-gel was intradermally injected into the surgical incision on one randomly selected side, with the other side receiving saline as a control. At the 6-month follow-up, the incision scars were evaluated using the Vancouver scar scale (VSS) and visual analog scale (VAS). Antera 3D camera was used for objective evaluation., Results: The VSS score and VAS score were significantly different between the SVF-gel-treated side (3.80 ± 1.37, 3.37±1.25) and the control side (5.25 ± 1.18, 4.94 ± 1.28). Moreover, the SVF-gel-treated side showed statistically significant improvements in scar appearance, based on evidences from Antera 3D camera., Limitations: This was a single-center, single-race, and single-gender study. Furthermore, the results were available only for the 6-month interim follow-up period., Conclusion: Postoperative immediate SVF-gel injection in surgical incisions can reduce scar formation, and exert a preventive effect on scars., Level of Evidence I: Evidence obtained from at least one properly designed randomized controlled trial. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 ., (© 2024. Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery.)
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- 2024
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13. Intradermal fractional dose vaccination as a method to vaccinate individuals with suspected allergy to mRNA COVID-19 vaccines.
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Roozen GVT, Granger A, van Binnendijk RS, den Hartog G, Roestenberg M, Visser LG, and Roukens AHE
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- Humans, Female, Male, Injections, Intradermal, Adult, Middle Aged, Immunoglobulin G blood, Aged, Injections, Intramuscular, Drug Hypersensitivity immunology, Drug Hypersensitivity prevention & control, Young Adult, COVID-19 prevention & control, COVID-19 immunology, 2019-nCoV Vaccine mRNA-1273 immunology, COVID-19 Vaccines immunology, COVID-19 Vaccines adverse effects, COVID-19 Vaccines administration & dosage, Antibodies, Viral blood, Vaccination methods, Vaccination adverse effects, SARS-CoV-2 immunology
- Abstract
Suspected allergic reactions after mRNA COVID-19 vaccination withheld multiple individuals from getting fully vaccinated during the pandemic. We vaccinated adults who had experienced possible allergic symptoms after their first intramuscular dose of a COVID-19 mRNA vaccine with a 1/5th fractional intradermal test dose of the mRNA-1273 (Moderna) COVID-19 vaccine. No anaphylactic reactions were observed after intradermal vaccination (n = 56). Serum anti-S1 IgG concentrations were measured using a bead-based multiplex assay four weeks after vaccinations. Antibody concentrations were compared with a previously collected nationwide cohort that had received two intramuscular doses of mRNA-1273. Antibody responses in all subjects tested (n = 47) were comparable to standard of care intramuscular dosing. Fractional intradermal dosing of mRNA COVID-19 vaccines may provide a pragmatic solution that is safe, time efficient compared to skin prick testing, dose sparing and immunogenic in individuals with suspected vaccine allergy., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2024
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14. Intravenous Bacillus Calmette-Guérin (BCG) Induces a More Potent Airway and Lung Immune Response than Intradermal BCG in Simian Immunodeficiency Virus-infected Macaques.
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Jauro S, Larson EC, Gleim JL, Wahlberg BM, Rodgers MA, Chehab JC, Lopez-Velazques AE, Ameel CL, Tomko JA, Sakal JL, DeMarco T, Borish HJ, Maiello P, Potter EL, Roederer M, Ling Lin P, Flynn JL, and Scanga CA
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- Animals, Injections, Intradermal, Coinfection immunology, Mycobacterium bovis immunology, Cytokines immunology, Tuberculosis immunology, Vaccination, Simian Acquired Immunodeficiency Syndrome immunology, Simian Immunodeficiency Virus immunology, BCG Vaccine immunology, BCG Vaccine administration & dosage, Lung immunology, Macaca fascicularis
- Abstract
Tuberculosis (TB), caused by Mycobacterium tuberculosis, is one of the leading causes of death due to an infectious agent. Coinfection with HIV exacerbates M. tuberculosis infection outcomes in people living with HIV. Bacillus Calmette-Guérin (BCG), the only approved TB vaccine, is effective in infants, but its efficacy in adolescents and adults is limited. In this study, we investigated the immune responses elicited by BCG administered via i.v. or intradermal (i.d.) routes in SIV-infected Mauritian cynomolgus macaques (MCM) without the confounding effects of M. tuberculosis challenge. We assessed the impact of vaccination on T cell responses in the airway, blood, and tissues (lung, thoracic lymph nodes, and spleen), as well as the expression of cytokines, cytotoxic effectors, and key transcription factors. Our results showed that i.v. BCG induces a robust and sustained immune response, including tissue-resident memory T cells in lungs, polyfunctional CD4+ and CD8αβ+ T cells expressing multiple cytokines, and CD8αβ+ T cells and NK cells expressing cytotoxic effectors in airways. We also detected higher levels of mycobacteria-specific IgG and IgM in the airways of i.v. BCG-vaccinated MCM. Although i.v. BCG vaccination resulted in an influx of tissue-resident memory T cells in lungs of MCM with controlled SIV replication, MCM with high plasma SIV RNA (>105 copies/ml) typically displayed reduced T cell responses, suggesting that uncontrolled SIV or HIV replication would have a detrimental effect on i.v. BCG-induced protection against M. tuberculosis., (Copyright © 2024 by The American Association of Immunologists, Inc.)
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- 2024
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15. Injectable Fillers : Facial Shaping and Contouring
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Derek H. Jones, Arthur Swift, Derek H. Jones, and Arthur Swift
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- Surgery, Plastic, Injections, Intradermal
- Abstract
In the innovative field of cosmetic dermatology, the range of products and methods available to patients is expanding all the time. Prominent among these are facial fillers, which, when injected into and beneath the skin, help alleviate wrinkles and improve smoothness. However, the many fillers on offer have varying characteristics and effects, and practitioners must be properly trained in order to administer them safely and successfully. Injectable Fillers offers those performing these popular procedures an in-depth and far-reaching survey of current best practices, with a strong emphasis on safety. Covering everything from the science behind facial fillers to their appropriate means of application, the book places each product in context, demonstrating the pros and cons of the expanding range of hyaluronic acids and calcium hydroxylapatite microspheres, and exploring injectable submental fat reduction with sodium deoxycholate. This second edition broadens the scope of discussion to also include chin, mandible, temple, nose, brow, and forehead injections, as well as the use of cannulas as an alternative to needles.
- Published
- 2019
16. PRP and Microneedling in Aesthetic Medicine
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Amelia K. Hausauer, Derek H. Jones, Amelia K. Hausauer, and Derek H. Jones
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- Cosmetic Techniques, Head--surgery, Platelet-Rich Plasma, Injections, Intradermal
- Abstract
State-of-the-art PRP and microneedling aesthetic procedures from internationally renowned expertsPlatelet rich plasma (PRP) and microneedling are two increasingly popular off-label modalities intended to harness the body's self-rejuvenation and repair abilities. PRP and Microneedling in Aesthetic Medicine is the most comprehensive, clinically informed resource available today on these two techniques. Internationally renowned, minimally invasive facial aesthetics experts Amelia K. Hausauer, Derek H. Jones, and a cadre of esteemed contributors have written the definitive guide on this topic. Readers will learn how to evaluate and critically appraise various approaches and leverage evidence-based methods to guide best practices.Divided into three parts, the first chapters on PRP and microneedling lay a solid foundation, covering basic science, mechanism of action, preparation, and practical considerations. Each chapter includes in-depth discussion, technical pearls, and practical tips for incorporating specific techniques into clinical practice. Part three focuses on special topics including applications and safety in skin of color, combination therapies, and managing complications.Key HighlightsApplications for PRP including chronic wound healing, scars and scar revision, aesthetic rejuvenation and augmentation, and alopecia and hair restorationMicroneedling for the treatment of acne and other scars, striae, melasma and dyschromia, skin rejuvenation, hyperhidrosis, and photodamageThe concurrent use of PRP and microneedling; PRP and laser resurfacing, rhitidectomy, and ultrasound; and microneedling with radiofrequency and drug-assisted deliveryAbout 100 images elucidate impacted anatomy and techniques; and 10 short online videos provide enhanced procedural guidanceThis is an essential resource for practitioners and training providers in dermatology and plastic surgery, particularly those specializing in facial and oculoplastic sub-specialties. It is a must-have for all aesthetic physicians seeking to expand their repertoire of minimally invasive facial surgery approaches.
- Published
- 2019
17. Intradermal injection of Cutibacterium acnes and staphylococcus: A pustular acne-like murine model.
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Zhou N, Sun Y, Ren X, Wang Y, Gao X, Li L, Ma Y, Hao Y, and Wang Y
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- Animals, Mice, Injections, Intradermal, Staphylococcus aureus isolation & purification, Propionibacterium acnes isolation & purification, Humans, Skin microbiology, Skin pathology, Propionibacteriaceae isolation & purification, Acne Vulgaris microbiology, Acne Vulgaris pathology, Disease Models, Animal
- Abstract
Background: Skin 16S microbiome diversity analysis indicates that the Staphylococcus genus, especially Staphylococcus aureus (S. aureus), plays a crucial role in the inflammatory lesions of acne. However, current animal models for acne do not fully replicate human diseases, especially pustular acne, which limits the development of anti-acne medications., Aims: The aim is to develop a mouse model for acne, establishing an animal model that more closely mimics the clinical presentation of pustular acne. This will provide a new research platform for screening anti-acne drugs and evaluating the efficacy of clinical anti-acne experimental treatments., Methods: Building upon the existing combination of acne-associated Cutibacterium acnes (C. acnes) with artificial sebum, we will inject a mixture of S. aureus and C. acnes locally into the dermis in a 3:7 ratio., Results: We found that the acne animal model with mixed bacterial infection better replicates the dynamic evolution process of human pustular acne. Compared to the infection with C. acnes alone, mixed bacterial infection resulted in pustules with a distinct yellowish appearance, resembling pustular acne morphology. The lesions exhibited redness, vascular dilation, and noticeable congestion, along with evident infiltration of inflammatory cells. This induced higher levels of inflammation, as indicated by a significant increase in the secretion of inflammatory factors such as IL-1β and TNF-α., Conclusion: This model can reflect the clinical symptoms and development of human pustular acne, overcoming the limitations of animal models commonly used in basic research to study this situation. It provides support for foundational research and the development of new acne medications., (© 2024 The Authors. Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.)
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- 2024
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18. Low Molecular Weight Hyaluronic Acid Added to Six Specific Amino Acids in the Treatment of Striae Alba (SA): An Observational Study.
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Fasola E and Nobile V
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- Humans, Female, Adult, Amino Acids administration & dosage, Amino Acids therapeutic use, Treatment Outcome, Injections, Intradermal, Young Adult, Middle Aged, Patient Satisfaction statistics & numerical data, Cosmetic Techniques, Esthetics, Cohort Studies, Hyaluronic Acid administration & dosage, Hyaluronic Acid adverse effects, Striae Distensae drug therapy
- Abstract
Striae distensae or stretch marks are a common complaint among women and can be distressing. The present study aimed to assess the efficacy of a mixture of low molecular weight hyaluronic acid and six amino acids when applied with a specific intradermal injection technique known as intra-mural fluid technique. A clinical study was carried out in 32 patients (with a dropout rate by 9.4%) with striae distensae alba (SA) in one or more of the following anatomical areas: breast, abdomen, inner thigh, trochanteric area, gluteal area, posterior supra-iliac area, and lumbar area. Product efficacy was assessed by the investigator using the Global Aesthetic Improvement Scale, while a Likert scale was used to evaluate to score the treatment tolerability and a QoL stretch marks questionnaire was used to investigate the patients' self-body image. The treatment was effective in improving the appearance of SA fifteen days after the second treatment and 6 months after the first treatment (and after a total of 4 treatments). The product efficacy and tolerability were also perceived by the patients during each treatment session. Our results suggest that the test treatment is a valid treatment option to decrease the appearance of SA. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors https://www.springer.com/00266., (© 2024. The Author(s).)
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- 2024
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19. Efficacy and Safety of Type III Collagen Lyophilized Fibers Using Mid-to-Deep Dermal Facial Injections for the Correction of Dynamic Facial Wrinkles.
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Jia Y, Qiu L, Zhang H, Li Z, Zhao P, Zhang Y, and Zhang B
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- Humans, Retrospective Studies, Female, Middle Aged, Adult, Treatment Outcome, Male, Injections, Intradermal, Patient Satisfaction statistics & numerical data, Freeze Drying, Esthetics, Face, Cosmetic Techniques, Cohort Studies, Skin Aging drug effects, Collagen Type III, Dermal Fillers administration & dosage, Dermal Fillers adverse effects
- Abstract
Background: This study aimed to evaluate the therapeutic efficacy and safety of injecting Type III collagen lyophilized fibers into the mid-to-deep layers of the facial dermis to ameliorate dynamic facial wrinkles., Methods: In this retrospective analysis, clinical data were collected from patients exhibiting dynamic facial wrinkles (encompassing frown lines, forehead lines, and crow's feet) with a wrinkle severity rating scale (WSRS) score of 3 or higher. In the control group, 75 participants received collagen implant injections into the mid-to-deep facial dermal layers, whereas 76 participants in the experimental group received injections of Type III collagen lyophilized fibers in similar layers. The study analyzed and compared clinical efficacy, WSRS score alterations, patient satisfaction, and safety profiles between the groups over the 30-day and 90-day treatment periods., Results: At the 30-day mark, the therapeutic efficacy was not significantly different between the two groups (P > 0.05). However, at 90 days, the treatment efficacy in the experimental group surpassed that in the control group, showing a statistically significant difference (P < 0.05). After 30 days of treatment, the WSRS score improvement in the experimental group was significantly superior to that in the control group (P < 0.05). Conversely, at the 90-day mark, the results revealed no significant variation in WSRS score improvements between the two groups (P > 0.05). Regarding treatment satisfaction among researchers and participants post-30 and 90-day treatment in both groups, no statistically significant differences were observed (P > 0.05). Similarly, the incidence of adverse reactions between the groups was not statistically significant (P > 0.05)., Conclusions: Injections of lyophilized type III collagen fibers into the mid-to-deep layers of the facial dermis have a definitive therapeutic effect on dynamic facial wrinkles. This treatment not only substantially diminishes wrinkle severity but also has a commendable safety profile., Level of Evidence I: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 ., (© 2024. Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery.)
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- 2024
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20. Intradermal delivery of the third dose of the mRNA-1273 SARS-CoV-2 vaccine: safety and immunogenicity of a fractional booster dose.
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Roozen GVT, Prins MLM, Prins C, Janse JJ, de Gruyter HLM, Pothast CR, Huisman W, Koopman JPR, Lamers OAC, Kuijer M, Myeni SK, van Binnendijk RS, Hartog GD, Heemskerk MHM, Jochems SP, Feltkamp MCW, Kikkert M, Rosendaal FR, Roestenberg M, Visser LG, and Roukens AHE
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- Humans, Adult, Injections, Intradermal, Male, Female, Young Adult, Adolescent, Injections, Intramuscular, Vaccination methods, 2019-nCoV Vaccine mRNA-1273, Immunization, Secondary methods, COVID-19 prevention & control, COVID-19 immunology, Antibodies, Viral blood, SARS-CoV-2 immunology, Immunogenicity, Vaccine, COVID-19 Vaccines immunology, COVID-19 Vaccines administration & dosage, COVID-19 Vaccines adverse effects, Antibodies, Neutralizing blood
- Abstract
Objectives: The aim of this study was to assess the safety and immunogenicity of a dose-sparing fractional intradermal (ID) booster strategy with the mRNA-1273 COVID-19 vaccine., Methods: COVID-19 naive adults aged 18-30 years were recruited from a previous study on primary vaccination regimens that compared 20 μg ID vaccinations with 100 μg intramuscular (IM) vaccinations with mRNA-1273 as the primary vaccination series. Participants previously immunized with ID regimens were randomly assigned (1:1) to receive a fractional ID booster dose (20 μg) or the standard-of-care intramuscular (IM) booster dose (50 μg) of the mRNA-1273 vaccine, 6 months after completing their primary series (ID-ID and ID-IM group, respectively). Participants that had received a full dose IM regimen as the primary series, received the IM standard-of-care booster dose (IM-IM group). In addition, COVID-19 naive individuals aged 18-40 years who had received an IM mRNA vaccine as the primary series were recruited from the general population to receive a fractional ID booster dose (IM-ID group). Immunogenicity was assessed using IgG anti-spike antibody responses and neutralizing capacity against SARS-CoV-2. Cellular immune responses were measured in a sub-group. Safety and tolerability were monitored., Results: In January 2022, 129 participants were included in the study. Fractional ID boosting was safe and well tolerated, with fewer systemic adverse events compared with IM boosting. At day 28 post-booster, anti-spike S1 IgG geometric mean concentrations were 9106 (95% CI, 7150-11 597) binding antibody units (BAU)/mL in the IM-IM group and 4357 (3003-6322) BAU/mL; 6629 (4913-8946) BAU/mL; and 5264 (4032-6873) BAU/mL in the ID-IM, ID-ID, and IM-ID groups, respectively., Discussion: Intradermal boosting provides robust immune responses and is a viable dose-sparing strategy for mRNA COVID-19 vaccines. The favourable side-effect profile supports its potential to reduce vaccine hesitancy. Fractional dosing strategies should be considered early in the clinical development of future mRNA vaccines to enhance vaccine availability and pandemic preparedness., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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- 2024
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21. Mpox vaccination routes: prevalence, correlates and adverse effects of subcutaneous versus intradermal vaccination at a mass vaccination clinic in Sydney, Australia.
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Pollack A, Lo W, Imamura H, and Caterson I
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- Adolescent, Adult, Aged, Female, Humans, Male, Middle Aged, Young Adult, Australia epidemiology, Injections, Intradermal, Injections, Subcutaneous adverse effects, Prevalence, Mass Vaccination, Smallpox Vaccine administration & dosage, Mpox (monkeypox) prevention & control
- Abstract
The Royal Prince Alfred Hospital Mpox Vaccination Clinic opened in response to the 2022 multicountry mpox outbreak. A total of 9500 vaccinations were administered intradermally and subcutaneously during the first 16 weeks of clinic operation. The rate of adverse events was 0.1%. Compared to people who received the vaccine intradermally, those who received it subcutaneously were more likely to be aged 30-39 years (P = 0.047), sexual partners of gay and bisexual men (P < 0.001), eligible for Medicare (P < 0.001) and born in the Philippines (P = 0.01) or Malaysia (P = 0.04)., (© 2024 Royal Australasian College of Physicians.)
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- 2024
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22. One-dose intradermal rabies booster enhances rabies antibody production and avidity maturation.
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Kewcharoenwong C, Freeouf S, Nithichanon A, Petsophonsakul W, Pornprasert S, Khamduang W, Suzuki T, Onodera T, Takahashi Y, and Lertmemongkolchai G
- Subjects
- Thailand, Humans, Injections, Intradermal, Animals, Female, Adult, Male, Young Adult, Antibody Affinity, Middle Aged, Dogs, Pre-Exposure Prophylaxis methods, Adolescent, Post-Exposure Prophylaxis methods, Antibody Formation immunology, Rabies Vaccines immunology, Rabies Vaccines administration & dosage, Rabies prevention & control, Rabies immunology, Antibodies, Viral blood, Immunization, Secondary
- Abstract
The incidence of rabies in Thailand reached its peak in 2018 with 18 human deaths. Preexposure prophylaxis (PrEP) vaccination is thus recommended for high-risk populations. WHO has recently recommended that patients who are exposed to a suspected rabid animal and have already been immunized against rabies should receive a 1-site intradermal (ID) injection of 0.1 mL on days 0 and 3 as postexposure prophylaxis (PEP). In Thailand, village health and livestock volunteers tasked with annual dog vaccination typically receive only a single lifetime PrEP dose and subsequent boosters solely upon confirmed animal bites. However, the adequacy of a single PrEP dose for priming and maintaining immunity in this high-risk group has not been evaluated. Therefore, our study was designed to address two key questions: (1) sufficiency of single-dose PrEP-to determine whether a single ID PrEP dose provides adequate long-term immune protection for high-risk individuals exposed to numerous dogs during their vaccination duties. (2) Booster efficacy for immune maturation-to investigate whether one or two additional ID booster doses effectively stimulate a mature and sustained antibody response in this population. The level and persistence of the rabies antibody were determined by comparing the immunogenicity and booster efficacy among the vaccination groups. Our study demonstrated that rabies antibodies persisted for more than 180 days after cost-effective ID PrEP or the 1st or the 2nd single ID booster dose, and adequate antibody levels were detected in more than 95% of participants by CEE-cELISA and 100% by indirect ELISA. Moreover, the avidity maturation of rabies-specific antibodies occurred after the 1st single ID booster dose. This smaller ID booster regimen was sufficient for producing a sufficient immune response and enhancing the maturation of anti-rabies antibodies. This safe and effective PrEP regimen and a single visit involving a one-dose ID booster are recommended, and at least one one-dose ID booster regimen could be equitably implemented in at-risk people in Thailand and other developing countries. However, an adequate antibody level should be monitored before the booster is administered., (© 2024. The Author(s).)
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- 2024
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23. Phase 1 Open-Label Dose Escalation Trial for the Development of a Human Bacillus Calmette-Guérin Challenge Model for Assessment of Tuberculosis Immunity In Vivo.
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Blazevic A, Edwards RL, Xia M, Eickhoff CS, Hamzabegovic F, Meza KA, Ning H, Tennant J, Mosby KJ, Ritchie JC, Girmay T, Lai L, McCullough M, Beck A, Kelley C, Edupuganti S, Kabbani S, Buchanan W, Makhene MK, Voronca D, Cherikh S, Goll JB, Rouphael NG, Mulligan MJ, and Hoft DF
- Subjects
- Humans, Male, Adult, Female, Young Adult, Mycobacterium bovis immunology, Middle Aged, Mycobacterium tuberculosis immunology, Injections, Intradermal, Adolescent, Dose-Response Relationship, Immunologic, BCG Vaccine immunology, BCG Vaccine administration & dosage, Tuberculosis prevention & control, Tuberculosis immunology
- Abstract
Background: A controlled human infection model for assessing tuberculosis (TB) immunity can accelerate new vaccine development., Methods: In this phase 1 dose escalation trial, 92 healthy adults received a single intradermal injection of 2 × 106 to 16 × 106 colony-forming units of Bacillus Calmette-Guérin (BCG). The primary endpoints were safety and BCG shedding as measured by quantitative polymerase chain reaction, colony-forming unit plating, and MGIT BACTEC culture., Results: Doses up to 8 × 106 were safe, and there was evidence for increased BCG shedding with dose escalation. The MGIT time-to-positivity assay was the most consistent and precise measure of shedding. Power analyses indicated that 10% differences in MGIT time to positivity (area under the curve) could be detected in small cohorts (n = 30). Potential biomarkers of mycobacterial immunity were identified that correlated with shedding. Transcriptomic analysis uncovered dose- and time-dependent effects of BCG challenge and identified a putative transcriptional TB protective signature. Furthermore, we identified immunologic and transcriptomal differences that could represent an immune component underlying the observed higher rate of TB disease incidence in males., Conclusions: The safety, reactogenicity, and immunogenicity profiles indicate that this BCG human challenge model is feasible for assessing in vivo TB immunity and could facilitate the vaccine development process., Clinical Trials Registration: NCT01868464 (ClinicalTrials.gov)., Competing Interests: Potential conflicts of interest. D. F. H. receives personal fees for scientific advisory board service for Moderna and Poolbeg Pharma; M. J. M. performs laboratory research and holds clinical trials contracts with Lilly, Pfizer, and Sanofi and receives personal fees for scientific advisory board service from Merck, Meissa Vaccines, Inc, and Pfizer; N. G. R. receives funding from Merck, Sanofi Pasteur, Pfizer, Lilly, and Quidel to perform clinical research and serves as a safety consultant for ICON and Emmes LCC. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Published
- 2024
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24. Pre-Incisional and Multiple Intradermal Injection of N-Acetylcysteine Slightly Improves Incisional Wound Healing in an Animal Model.
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Pascal W, Smoliński A, Gotowiec M, Wojtkiewicz M, Stachura A, Pełka K, Kopka M, Quinn KP, Woessner AE, Grzelecki D, and Włodarski P
- Subjects
- Animals, Rats, Injections, Intradermal, Disease Models, Animal, Skin drug effects, Skin pathology, Skin injuries, Male, Surgical Wound drug therapy, Surgical Wound pathology, Collagen metabolism, Cicatrix pathology, Cicatrix drug therapy, Wound Healing drug effects, Acetylcysteine pharmacology, Acetylcysteine administration & dosage, Rats, Sprague-Dawley
- Abstract
The objective of this study was to investigate if delivering multiple doses of N-acetylcysteine (NAC) post-surgery in addition to pre-incisional administration significantly impacts the wound healing process in a rat model. Full-thickness skin incisions were carried out on the dorsum of 24 Sprague-Dawley rats in six locations. Fifteen minutes prior to the incision, half of the sites were treated with a control solution, with the wounds on the contralateral side treated with solutions containing 0.015%, 0.03% and 0.045% of NAC. In the case of the NAC treated group, further injections were given every 8 h for three days. On days 3, 7, 14 and 60 post-op, rats were sacrificed to gather material for the histological analysis, which included histomorphometry, collagen fiber organization analysis, immunohistochemistry and Abramov scale scoring. It was determined that scars treated with 0.015% NAC had significantly lower reepithelization than the control at day 60 post-op ( p = 0.0018). Scars treated with 0.045% NAC had a significantly lower collagen fiber variance compared to 0.015% NAC at day 14 post-op ( p = 0.02 and p = 0.04) and a lower mean scar width than the control at day 60 post-op ( p = 0.0354 and p = 0.0224). No significant differences in the recruitment of immune cells and histological parameters were found. The results point to a limited efficacy of multiple NAC injections post-surgery in wound healing.
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- 2024
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25. Effect of Intense Pulsed Light versus Intradermal Tranexamic Acid for the Management of Melasma.
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Asim SA, Iqbal T, Sajid M, and Bhatti S
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- Humans, Adult, Female, Cross-Sectional Studies, Middle Aged, Treatment Outcome, Male, Injections, Intradermal, Pakistan, Antifibrinolytic Agents administration & dosage, Antifibrinolytic Agents therapeutic use, Young Adult, Severity of Illness Index, Tranexamic Acid administration & dosage, Tranexamic Acid therapeutic use, Melanosis therapy, Melanosis drug therapy, Intense Pulsed Light Therapy methods
- Abstract
Objective: To compare the effectiveness of intense pulsed light (IPL) and intradermal tranexamic acid (TXA) in treating melasma., Study Design: A cross-sectional analytical study. Place and Duration of the Study: Department of Dermatology, Dow International Medical College, Dow University Hospital, Karachi, Pakistan, from 15th January to 15th July 2023., Methodology: A total of 62 patients with melasma, aged 20-50 years, were divided into two groups. Group A (32 patients) received IPL (560 nm filter was used) treatment, and Group B (30 patients) received intradermal TXA. Each group underwent four treatment sessions with varying intervals. Melasma area and severity index (MASI) scores were used to compare the effects of treatment., Results: After a 3-month treatment period, both groups showed reduced mMASI scores compared to baseline with a significant initial difference between Group A (8.6 ± 4.2) and Group B (5.4 ± 2.7, p <0.001). However, post-treatment, there was no significant difference in mMASI scores (Group A: 3.8 ± 2.6; Group B: 3.2 ± 2.0, p = 0.29). IPL treatment (Group A) demonstrated a significant reduction in mMASI scores (57.1 ± 19.7) compared to intradermal TXA treatment (Group B, 42.2 ± 18.8, p = 0.0034)., Conclusion: Both IPL and intradermal TXA treatments effectively reduced melasma, with IPL exhibiting superior results. However, post-treatment outcomes converged, emphasising the need for personalised approaches considering the unique characteristics of South East Asian skin., Key Words: Intense pulsed light, Melasma, Intradermal tranexamic acid.
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- 2024
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26. Improved pharmacokinetic and lymphatic uptake of Rose Bengal after transfersome intradermal deposition using hollow microneedles.
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Demartis S, Rassu G, Anjani QK, Volpe-Zanutto F, Hutton ARJ, Sabri AB, McCarthy HO, Giunchedi P, Donnelly RF, and Gavini E
- Subjects
- Animals, Injections, Intradermal, Male, Rats, Sprague-Dawley, Lymph Nodes metabolism, Rats, Microinjections, Fluorescent Dyes administration & dosage, Fluorescent Dyes pharmacokinetics, Rose Bengal administration & dosage, Rose Bengal pharmacokinetics, Needles, Drug Delivery Systems
- Abstract
The lymphatic system is active in several processes that regulate human diseases, among which cancer progression stands out. Thus, various drug delivery systems have been investigated to promote lymphatic drug targeting for cancer therapy; mainly, nanosized particles in the 10-150 nm range quickly achieve lymphatic vessels after an interstitial administration. Herein, a strategy to boost the lymphotropic delivery of Rose Bengal (RB), a hydrosoluble chemotherapeutic, is proposed, and it is based on the loading into Transfersomes (RBTF) and their intradermal deposition in vivo by microneedles. RBTF of 96.27 ± 13.96 nm (PDI = 0.29 ± 0.02) were prepared by a green reverse-phase evaporation technique, and they showed an RB encapsulation efficiency of 98.54 ± 0.09%. In vitro, RBTF remained physically stable under physiological conditions and avoided the release of RB. In vivo, intravenous injection of RBTF prolonged RB half-life of 50 min in healthy rats compared to RB intravenous injection; the RB half-life in rat body was further increased after intradermal injection reaching 24 h, regardless of the formulation used. Regarding lymphatic targeting, RBTF administered intravenously provided an RB accumulation in the lymph nodes of 12.3 ± 0.14 ng/mL after 2 h, whereas no RB accumulation was observed after RB intravenous injection. Intradermally administered RBTF resulted in the highest RB amount detected in lymph nodes after 2 h from the injection (84.2 ± 25.10 ng/mL), which was even visible to the naked eye based on the pink colouration of the drug. In the case of intradermally administered RB, RB in lymph node was detected only at 24 h (13.3 ± 1.41 ng/mL). In conclusion, RBTF proved an efficient carrier for RB delivery, enhancing its pharmacokinetics and promoting lymph-targeted delivery. Thus, RBTF represents a promising nanomedicine product for potentially facing the medical need for novel strategies for cancer therapy., Competing Interests: Declaration of competing interest The authors declare no competitive interest., (Copyright © 2023. Published by Elsevier B.V.)
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- 2024
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27. Safety and Efficacy of the Modified Vaccinia Ankara-Bavaria Nordic Vaccine Against Mpox in the Real World: Systematic Review and Meta-Analysis.
- Author
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Pang Y, Cao D, Zhu X, Long Q, Tian F, Long X, and Li Y
- Subjects
- Humans, Poxviridae Infections prevention & control, Poxviridae Infections immunology, Vaccinia virus immunology, Vaccinia virus genetics, Vaccination, Injections, Subcutaneous, Injections, Intradermal, Viral Vaccines adverse effects, Viral Vaccines immunology, Viral Vaccines administration & dosage, Orthopoxvirus immunology, Orthopoxvirus genetics, Child, Vaccine Efficacy, Vaccines, Attenuated immunology, Vaccines, Attenuated administration & dosage, Vaccines, Attenuated adverse effects
- Abstract
In May 2022, mpox began to spread worldwide, posing a serious threat to human public health. Modified Vaccinia Ankara-Bavaria Nordic (MVA-BN) is a live attenuated orthopoxvirus vaccine that has been authorized by the U.S. Food and Drug Administration as the vaccine of choice for the prevention of mpox. In this study, we conducted a meta-analysis of all currently published literature on the efficacy and safety of the MVA-BN vaccine in the real world, showing that the MVA-BN vaccine is effective and safe, with efficacy of up to 75% with a single dose and up to 80% with a two-dose vaccine. Meanwhile, we found that subcutaneous injection has lower local and systemic adverse events than intradermal injection, regardless of single- or two-dose vaccination, and subcutaneous injection is better tolerated in children, the elderly, or people with underlying medical conditions. These results have important reference value for clinical practice.
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- 2024
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28. Clinical Anatomy of the Face for Filler and Botulinum Toxin Injection
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Hee-Jin Kim, Kyle K Seo, Hong-Ki Lee, Jisoo Kim, Hee-Jin Kim, Kyle K Seo, Hong-Ki Lee, and Jisoo Kim
- Subjects
- Face, Injections, Intradermal
- Abstract
This book, containing more than 200 cadaveric photos and 200 illustrations, aims to familiarize physicians practicing botulinum toxin type A (BoT-A) and filler injection with the anatomy of the facial mimetic muscles, vessels, and soft tissues in order to enable them to achieve optimum cosmetic results while avoiding possible adverse events. Anatomic considerations of importance when administering BoT-A and fillers are identified and in addition invaluable clinical guidelines are provided, highlighting, for example, the preferred injection points for BoT-A and the adequate depth of filler injection. Unique insights are also offered into the differences between Asians and Caucasians with regard to relevant anatomy. The contributing authors include an anatomist who offers distinctive anatomic perspectives on BoT-A and filler treatments and three expert physicians from different specialties, namely a dermatologist, a plastic surgeon, and a cosmetic physician, who share insights gained during extensive clinical experience in the use of BoT-A and fillers.
- Published
- 2016
29. Botulinum toxin and hyperhidrosis of the amputation stump in war amputees.
- Author
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Mouhli N, Hfaidh M, Abdennadher A, Ben Amor K, Rahali H, Amri K, and Maaoui R
- Subjects
- Humans, Male, Adult, Prospective Studies, Artificial Limbs adverse effects, Injections, Intradermal, Middle Aged, Warfare, Quality of Life, Young Adult, Treatment Outcome, Hyperhidrosis drug therapy, Amputation Stumps, Botulinum Toxins, Type A administration & dosage, Botulinum Toxins, Type A adverse effects, Amputees
- Abstract
Introduction: Stump hyperhidrosis is a common condition after lower limb amputation. It affects the prosthesis use, and the quality of life of patients. Several case reports tried to prove benefit of using Botulinum toxin in its treatment., Aim: This study was to conduct a larger workforce clinical trial and to demonstrate benefits of botulinum toxin injection in the treatment of stump hyperhidrosis., Methods: A prospective study was conducted. War amputees who complained of annoying excessive sweating of the stump were included. They received intradermal injection of botulinum toxin A in the residual limb area in contact with prosthetic socket. Abundance of sweating and degree of functional discomfort associated with it were assessed before, after 3 weeks, 6 and 12 months., Results: Seventeen male patients, followed for post-traumatic limb amputation were included in the study. Discomfort and bothersome in relation to Hyperhidrosis did decrease after treatment (p<0,001). Reported satisfaction after 3 weeks was 73,33%. Improvement of prothesis loosening up after 3 weeks was 72,5% [±15,6]. Mean injection-induced pain on the visual analogue scale was 5.17/10 (±1.58). The mean interval after the onset of improvement was 5.13 days [min:3, max:8]. The mean time of improvement was 10.4 months after the injection [min:6, max:12]. No major adverse events were reported following treatment., Conclusion: Intradermal injections of botulinum toxin in the symptomatic treatment of stump hyperhidrosis are effective and have few adverse effects. It improves the quality of life of our patients thanks to a better tolerance of the prosthesis.
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- 2024
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30. Preliminary nerve block for intradermal facial skin booster injections.
- Author
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Yi KH
- Subjects
- Humans, Injections, Intradermal, Injections, Intramuscular, Skin, Nerve Block
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- 2024
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31. Superior antibody and membrane protein-specific T-cell responses to CoronaVac by intradermal versus intramuscular routes in adolescents.
- Author
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Rosa Duque JS, Cheng SMS, Cohen CA, Leung D, Wang X, Mu X, Chung Y, Lau TM, Wang M, Zhang W, Zhang Y, Wong HHW, Tsang LCH, Chaothai S, Kwan TC, Li JKC, Chan KCK, Luk LLH, Ho JCH, Li WY, Lee AMT, Lam JHY, Chan SM, Wong WHS, Tam IYS, Mori M, Valkenburg SA, Peiris M, Tu W, and Lau YL
- Subjects
- Adolescent, Child, Female, Humans, Male, Antibodies, Viral immunology, Antibodies, Viral blood, Immunogenicity, Vaccine, Injections, Intradermal, Injections, Intramuscular, SARS-CoV-2 immunology, Vaccines, Inactivated, COVID-19 prevention & control, COVID-19 immunology, COVID-19 Vaccines immunology, COVID-19 Vaccines administration & dosage, T-Lymphocytes immunology
- Abstract
Background: Optimising the immunogenicity of COVID-19 vaccines to improve their protection against disease is necessary. Fractional dosing by intradermal (ID) administration has been shown to be equally immunogenic as intramuscular (IM) administration for several vaccines, but the immunogenicity of ID inactivated whole severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at the full dose is unknown. This study (NCT04800133) investigated the superiority of antibody and T-cell responses of full-dose CoronaVac by ID over IM administration in adolescents., Methods: Participants aged 11-17 years received two doses of IM or ID vaccine, followed by the 3rd dose 13-42 days later. Humoral and cellular immunogenicity outcomes were measured post-dose 2 (IM-CC versus ID-CC) and post-dose 3 (IM-CCC versus ID-CCC). Doses 2 and 3 were administered to 173 and 104 adolescents, respectively., Results: Spike protein (S) immunoglobulin G (IgG), S-receptor-binding domain (RBD) IgG, S IgG Fcγ receptor IIIa (FcγRIIIa)-binding, SNM [sum of individual (S), nucleocapsid protein (N), and membrane protein (M) peptide pool]-specific interleukin-2 (IL-2)
+ CD4+ , SNM-specific IL-2+ CD8+ , S-specific IL-2+ CD8+ , N-specific IL-2+ CD4+ , N-specific IL-2+ CD8+ and M-specific IL-2+ CD4+ responses fulfilled the superior and non-inferior criteria for ID-CC compared to IM-CC, whereas IgG avidity was inferior. For ID-CCC, S-RBD IgG, surrogate virus neutralisation test, 90% plaque reduction neutralisation titre (PRNT90), PRNT50, S IgG avidity, S IgG FcγRIIIa-binding, M-specific IL-2+ CD4+ , interferon-γ+ CD8+ and IL-2+ CD8+ responses were superior and non-inferior to IM-CCC. The estimated vaccine efficacies were 49%, 52%, 66% and 79% for IM-CC, ID-CC, IM-CCC and ID-CCC, respectively. The ID groups reported more local, mild adverse reactions., Conclusion: This is the first study to demonstrate superior antibody and M-specific T-cell responses by ID inactivated SARS-CoV-2 vaccination and serves as the basis for future research to improve the immunogenicity of inactivated vaccines., (© 2023. The Author(s).)- Published
- 2024
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32. A Hollow Microneedle Equipped with a Micropillar for Improved Needle Insertion and Injection of Drug Solution.
- Author
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Futaki M, Inamura K, Nishimura T, Niitsu T, Tojo T, Sugibayashi K, and Todo H
- Subjects
- Rats, Animals, Microinjections, Injections, Intradermal, Needles, Membranes, Artificial, Administration, Cutaneous, Skin, Drug Delivery Systems methods
- Abstract
Purpose: Hollow-type microneedles (hMNs) are a promising device for the effective administration of drugs into intradermal sites. Complete insertion of the needle into the skin and administration of the drug solution without leakage must be achieved to obtain bioavailability or a constant effect. In the present study, several types of hMN with or without a rounded blunt tip micropillar, which suppresses skin deformation, around a hollow needle, and the effect on successful needle insertion and administration of a drug solution was investigated. Six different types of hMNs with needle lengths of 1000, 1300, and 1500 µm with or without a micropillar were used., Methods: Needle insertion and the disposition of a drug in rat skin were investigated. In addition, the displacement-force profile during application of hMNs was also investigated using a texture analyzer with an artificial membrane to examine needle factors affecting successful insertion and administration of a drug solution by comparing with in vivo results., Results: According to the results with the drug distribution of iodine, hMN
1300 with a micropillar was able to successfully inject drug solution into an intradermal site with a high success rate. In addition, the results of displacement-force profiles with an artificial membrane showed that a micropillar can be effective for depth control of the injected solution as well as the prevention of contact between the hMN pedestal and the deformed membrane., Conclusion: In the present study, hMN1300S showed effective solution delivery into an intradermal site. In particular, a micropillar can be effective for depth control of the injected solution as well as preventing contact between the hMN pedestal and the deformed membrane. The obtained results will help in the design and development of hMNs that ensure successful injection of an administered drug., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)- Published
- 2024
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33. Intradermal Injection of Hybrid Complexes of High- and Low-Molecular-Weight Hyaluronan: Where Do We Stand and Where Are We Headed in Regenerative Medicine?
- Author
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Humzah D, Molina B, Salti G, Cigni C, Bellia G, and Grimolizzi F
- Subjects
- Injections, Intradermal, Wound Healing, Hydrogels therapeutic use, Hyaluronic Acid, Regenerative Medicine
- Abstract
Hyaluronic acid (HA) is a remarkably multifaceted biomacromolecule, playing a role in regulating myriad biological processes such as wound healing, tissue regeneration, anti-inflammation, and immunomodulation. Crosslinked high- and low-molecular-weight hyaluronic acid hydrogels achieve higher molar concentrations, display slower degradation, and allow optimal tissue product diffusion, while harnessing the synergistic contribution of different-molecular-weight hyaluronans. A recent innovation in the world of hyaluronic acid synthesis is represented by NAHYCO
® Hybrid Technology, a thermal process leading to hybrid cooperative hyaluronic acid complexes (HCC). This review summarizes the current literature on the in vitro studies and in vivo applications of HCC, from facial and body rejuvenation to future perspectives in skin wound healing, dermatology, and genitourinary pathologies.- Published
- 2024
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34. Adverse Reactions After Intradermal Vaccination With JYNNEOS for Mpox in Korea.
- Author
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Lim SY, Jung YM, Kim Y, Kim G, Jeon J, Chin B, and Kim MK
- Subjects
- Humans, Republic of Korea epidemiology, Vaccination adverse effects, Injections, Intradermal, Mpox (monkeypox), Vaccines, Smallpox Vaccine adverse effects
- Abstract
In response to the Mpox domestic epidemic, South Korea initiated a nationwide vaccination program in May 2023, administering a 0.1 mL intradermal dose of JYNNEOS (Modified Vaccinia Ankara vaccine, Bavarian Nordic) to a high-risk group. To investigate the adverse reactions after intradermal JYNNEOS vaccination, an anonymous online survey was conducted at the National Medical Center from May 22 to July 31, 2023. Overall, 142 individuals responded. Over 80% of the respondents reported local reactions of predominantly mild severity. The predominant local reactions were pruritus, redness, and swelling; their incidence rates after the first dose were 66.2%, 48.1%, and 49.4%, respectively; the corresponding rates after the second dose were 69.2%, 60.6%, and 53.8%. Fewer respondents reported systemic symptoms. The most common systemic symptom was fatigue, the incidence rates of which after the first and second doses were 37.7% and 24.6%, respectively. Overall, the intradermally administered JYNNEOS vaccine appeared well tolerated., Competing Interests: The authors have no conflicts of interest to declare., (© 2024 The Korean Academy of Medical Sciences.)
- Published
- 2024
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- View/download PDF
35. Simple Yet Effective-Sterile Water Injections to Treat Labor Pain in the Transport Environment.
- Author
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Schuelke F and Brendt P
- Subjects
- Pregnancy, Female, Humans, Adult, Injections, Intradermal, Pain Management, Water, Labor Pain drug therapy
- Abstract
Sterile water injections (SWI) is a nonpharmacologic pain relief option to treat back pain in labor. This case report describes and discusses the use of SWI in the context of an obstetric retrieval of a 29-year-old woman who was transferred by the Royal Flying Doctor Service South Eastern Section. It provides an overview of SWI, discusses the relevance for medical transport, and offers suggestions for medical transport professionals., Competing Interests: Declaration of Competing Interest The author(s) have no relevant disclosures. There was no grant funding or financial support for this manuscript., (Copyright © 2023 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.)
- Published
- 2024
- Full Text
- View/download PDF
36. Egg microneedles for transdermal vaccination of inactivated influenza virus.
- Author
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Kang G, Kim M, Lee Y, Yang H, Seong BL, and Jung H
- Subjects
- Animals, Mice, Injections, Intradermal, Vaccination methods, Skin, Drug Delivery Systems, Influenza Vaccines, Orthomyxoviridae
- Abstract
The use of dissolving microneedles (DMNs) is a drug delivery technique in which drug dissolution occurs once it is administered into the skin. The skin is a remarkable site for vaccination due to its significant immunologic properties. Compared to the traditional hypodermic intramuscular (IM) injection, vaccination via DMN does not require cold chains and allows for minimal invasive drug delivery. On account of the significance of skin vaccination, preceding studies have been conducted to elucidate the importance of the DMN technology in vaccination. Most of these studies focused on formulations that maintain the activity of the vaccine, so formulations designed to be specific to the mechanical properties of the microneedle could not be used together independently. In this study, we have developed influenza vaccine loaded egg microneedles (EMN) and characterized the specificity of layer-specific functions of EMN by distinguishing between formulations that can maintain the activity of the vaccine and have the mechanical strength. By the use of in vitro tests such as ELISA and SRID assays, we quantitively evaluated the antigen activity of the formulation candidates to be 87% and 91%, respectively. In vivo tests were also conducted as mouse groups were inoculated with the formulation constructed into egg microneedles (FLU-EMN) to determine the protective efficacy against infection. The results demonstrated that FLU-EMN with functionalized formulations successfully enabled protective immune response even with a fractional dose compared to IM injection.
- Published
- 2024
- Full Text
- View/download PDF
37. Boostability after single-visit pre-exposure prophylaxis with rabies vaccine: a randomised controlled non-inferiority trial.
- Author
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Overduin LA, Koopman JPR, Prins C, Verbeek-Menken PH, De Pijper CA, Eblé PL, Heerink F, van Genderen PJJ, Grobusch MP, and Visser LG
- Subjects
- Adult, Humans, Antibodies, Viral, Antibodies, Neutralizing, Vaccination, Post-Exposure Prophylaxis, Injections, Intradermal, Rabies Vaccines, Rabies prevention & control, Pre-Exposure Prophylaxis
- Abstract
Background: After rabies pre-exposure prophylaxis (PrEP) vaccination, scarcely available rabies immunoglobulins are not required for post-exposure prophylaxis (PEP). However, PrEP is not sufficiently accessible as it is cost-intensive and time-intensive. This study investigates whether rabies PrEP schedules can be shortened to one visit, removing some of these barriers., Methods: In a block-randomised (2:2:2:1) controlled, multicentre non-inferiority trial, healthy adult travellers (aged 18-50 years and >50 years) were randomly assigned to (A) single-visit intramuscular (1·0 mL); (B) single-visit intradermal (0·2 mL); (C) standard two-visit intramuscular (1·0 mL; day 0 and 7) PrEP; or (D) no rabies vaccination. 6 months later, participants received simulated intramuscular rabies PEP (1·0 mL; day 0 and 3). Rabies virus neutralising antibody (RVNA) concentrations were measured repeatedly. The primary outcome was the fold increase in geometric mean RVNA concentrations between day 0 and 7 after simulated PEP for all participants. The two main comparisons of this primary outcome are between the standard two-visit schedule and the one-visit intramuscular schedule, and between the standard two-visit schedule and the one-visit intradermal schedule. The non-inferiority margin was 0·67. This study is registered with EudraCT, 2017-000089-31., Findings: Between May 16, 2018, and March 26, 2020, 288 healthy adult travellers were randomly assigned and 214 participants were evaluated for the primary outcome. Single-visit intramuscular rabies PrEP induced an anamnestic antibody response non-inferior compared with the two-visit intramuscular schedule; single-visit intradermal PrEP did not. The fold increases in the single-visit intramuscular and the single-visit intradermal schedule were 2·32 (95% CI [1·43-3·77]) and 1·11 (0·66-1·87) times as high as the fold increase in the standard schedule, respectively. No vaccine-related serious adverse events were observed. Adverse events related to vaccination were mostly mild., Interpretation: Single intramuscular rabies vaccination can effectively prime travellers (aged 18-50 years), and potentially other populations, and could replace current standard two-visit rabies vaccination as PrEP., Funding: ZonMW., Translation: For the Dutch translation of the abstract see Supplementary Materials section., Competing Interests: Declaration of interests LAO and LGV are conducting a study sponsored by Bavarian Nordic, the manufacturer of the Rabipur vaccine. Bavarian Nordic had no role in designing, conducting, analysing, or reporting the trial on which this manuscript reports. All other authors declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved.)
- Published
- 2024
- Full Text
- View/download PDF
38. Toward facial rejuvenation; A clinical trial to assess the efficacy of nano fat grafting on wrinkles.
- Author
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Akbari F, Hadibarhaghtalab M, Parvar SY, Dehghani S, and Namazi MR
- Subjects
- Female, Humans, Male, Injections, Intradermal, Injections, Adipose Tissue transplantation, Rejuvenation, Skin Aging
- Abstract
Introduction: With increasing age, patients' facial volume decrease. For this reason, nano fat grafting has recently gained popularity as adjunctive treatment to facial rejuvenation procedures. However, few quantitative studies have been conducted to investigate the impact of nano fat on facial wrinkles., Aims: In the present study, authors aim to investigate the therapeutic effect of intradermal injection of nano fat on fine facial wrinkles and assess their changes over 7 months of follow-up., Methods: In this randomized trial, 15 patients with fine facial wrinkles were enrolled. The fat was harvested from the abdomen and processed into nano fat. Nano fat was injected into the facial wrinkles intradermally with a needle of 27 gauge. The patients were evaluated before and 7 months postinjection utilizing Visio face 1000D (CK electronic, manufactured in Germany); and four parameters of wrinkles (area, volume, depth, and percent area) were evaluated before and after the nano fat injection., Results: Our evaluation with Visio face showed that nano fat injection was significantly reduced the volume, area, depth, and percent area of wrinkles after 7 months of follow-up without serious long-lasting adverse effects. Moreover, wrinkles with higher percent area, depth and volume loss show greater improvement after the treatment. Our results also indicate that males and females equally benefit from this treatment except for the percent area parameter that was improved more significantly in male patients., Conclusion: Our study showed that intradermal injection of nano fat significantly decreases the volume, area, depth, and percent area of fine facial wrinkles. Further quantitative studies with control groups and larger sample sizes are required., (© 2023 The Authors. Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.)
- Published
- 2024
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39. Management of primary plantar hyperhidrosis with botulinum toxin type A: A retrospective case series of 129 patients.
- Author
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Tsiogka A, Agiasofitou E, Tsimpidakis A, Kontochristopoulos G, Stratigos A, and Gregoriou S
- Subjects
- Male, Female, Humans, Adult, Retrospective Studies, Injections, Intradermal, Treatment Outcome, Botulinum Toxins, Type A therapeutic use, Hyperhidrosis drug therapy
- Abstract
Background/objectives: To date, scientific data on the efficacy of botulinum toxin type A (BoNT-A) for primary plantar hyperhidrosis (PPH) are mainly derived from case reports and small case series. Herein, we sought to assess the efficacy and safety of BoNT-A for PPH on a large series of patients., Methods: Medical records of patients who were referred to the outpatient department for hyperhidrosis of a tertiary care hospital and received BoNT-A for PPH from March 2003 until December 2022 were reviewed., Results: A total of 129 patients [12 males, 117 females; median age 32 years (range, 16-72)] were included in the study, after excluding 24 patients with insufficient documented follow-up data. Most patients [115 (89.1%)] received onabotulinumtoxin-A, nine (7.0%) abobotulinumtoxin-A and five (3.9%) both in subsequent sessions. The mean number of sessions was 2.02 [standard deviation (SD), 2.29] and the mean duration of response 6.16 months (SD, 4.01). The percentage of response, as evaluated by Minor's test, was 71.67%, 63.44%, 47.78% and 34.13% after 1, 3, 6 and 9 months, respectively. Most patients were satisfied (21.7%) or very satisfied (58.9%) with the treatment. No serious side effects were reported., Conclusions: The results of this retrospective study suggest that BoNT-A is an effective and safe treatment option for PPH., (© 2023 Australasian College of Dermatologists.)
- Published
- 2024
- Full Text
- View/download PDF
40. Novel Delivery Systems for Transdermal and Intradermal Drug Delivery
- Author
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Ryan F. Donnelly, Thakur Raghu Raj Singh, Ryan F. Donnelly, and Thakur Raghu Raj Singh
- Subjects
- Injections, Intradermal, Drug delivery systems, Transdermal medication
- Abstract
This research book covers the major aspects relating to the use of novel delivery systems in enhancing both transdermal and intradermal drug delivery. It provides a review of transdermal and intradermal drug delivery, including the history of the field and the various methods employed to produce delivery systems from different materials such as device design, construction and evaluation, so as to provide a sound background to the use of novel systems in enhanced delivery applications. Furthermore, it presents in-depth analyses of recent developments in this exponentially growing field, with a focus on microneedle arrays, needle-free injections, nanoparticulate systems and peptide-carrier-type systems. It also covers conventional physical enhancement strategies, such as tape-stripping, sonophoresis, iontophoresis, electroporation and thermal/suction/laser ablation Discussions about the penetration of the stratum corneum by the various novel strategies highlight the importance of the application method. Comprehensive and critical reviews of transdermal and intradermal delivery research using such systems focus on the outcomes of in vivoanimal and human studies. The book includes laboratory, clinical and commercial case studies featuring safety and patient acceptability studies carried out to date, and depicts a growing area for use of these novel systems is in intradermal vaccine delivery. The final chapters review recent patents in this field and describe the work ongoing in industry.
- Published
- 2015
41. Intradermal Injection of Poly-d, l-Lactic Acid Using Microneedle Fractional Radiofrequency for Acne Scars: An Open-Label Prospective Trial
- Author
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Jin Hyeok, Hyeong, Joon Woo, Jung, Suk Bae, Seo, Hong Seok, Kim, and Kwang Ho, Kim
- Subjects
Cicatrix ,Injections, Intradermal ,Acne Vulgaris ,Humans ,Surgery ,Lactic Acid ,Prospective Studies ,Dermatology ,General Medicine - Abstract
Treatment with filler injections using a microneedle fractional radiofrequency (MFRF) device is a promising modality with proven efficacy for acne scar treatment.To investigate the efficacy and histologic differences of intradermal injection of a filler (poly-d, l-lactic acid, PDLA) using an MFRF device for the treatment of acne scars.Patients with acne scars on both cheeks were included. Poly-d, l-lactic acid was injected via the MFRF device every 4 weeks for a total of 4 sessions. Patients were evaluated using the grading system for acne scars before each session, as well as personal satisfaction. For histologic evaluation, 2 patients (who consented) underwent a skin biopsy from the upper arm before and after the same single session.After the final session, the acne scar grading (échelle d'évaluation clinique des cicatrices d'acné) scale and visual analog scale for evaluation of satisfaction showed improvement compared with initial assessment (36.99% and 79.65% respectively [p.001, respectively]). For histologic evaluation, biodegradation of PDLA materials and increase in collagen and elastic fibers were observed after 5 months of treatment.Intradermal injection of PDLA using the MFRF device could be used as an effective treatment with fewer side effects in acne scar patients with Fitzpatrick skin type III-IV.
- Published
- 2022
42. Induction of potent antitumor immunity by intradermal <scp>DNA</scp> injection using a novel needle‐free pyro‐drive jet injector
- Author
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Shinya Inoue, Izuru Mizoguchi, Jukito Sonoda, Eri Sakamoto, Yasuhiro Katahira, Hideaki Hasegawa, Aruma Watanabe, Yuma Furusaka, Mingli Xu, Toshihiko Yoneto, Naoki Sakaguchi, Kazuhiro Terai, Kunihiko Yamashita, and Takayuki Yoshimoto
- Subjects
Cancer Research ,COVID-19 Vaccines ,Injections, Intradermal ,Ovalbumin ,COVID-19 ,DNA ,General Medicine ,CD8-Positive T-Lymphocytes ,Mice, Inbred C57BL ,Mice ,Oncology ,Immunoglobulin G ,Vaccines, DNA ,Humans ,Animals - Abstract
The current success of mRNA vaccines against COVID-19 has highlighted the effectiveness of mRNA and DNA vaccinations. Recently, we demonstrated that a novel needle-free pyro-drive jet injector (PJI) effectively delivers plasmid DNA into the skin, resulting in protein expression higher than that achieved with a needle syringe. Here, we used ovalbumin (OVA) as a model antigen to investigate the potential of the PJI for vaccination against cancers. Intradermal injection of OVA-expression plasmid DNA into mice using the PJI, but not a needle syringe, rapidly and greatly augmented OVA-specific CD8
- Published
- 2022
43. Platelet‐rich plasma versus carboxytherapy in the treatment of periorbital dark circles: A split‐face study
- Author
-
Samar M, El-Tahlawi, Marwa M, Fawzy, Zeinab, El Maadawi, Sara M, Yasen, and Nesreen M, Aboraia
- Subjects
Treatment Outcome ,Injections, Intradermal ,Patient Satisfaction ,Platelet-Rich Plasma ,Hyperpigmentation ,Quality of Life ,Humans ,Dermatology - Abstract
Periorbital hyperpigmentation is a recurrent problem in dermatologic clinics that affect the patients' quality of life and their psychological status. Platelet-rich plasma (PRP) may serve as a source of different growth factors which may reduce the pigmentation in this problem. Carboxytherapy is carbon dioxide infusion into human tissue for therapeutic purposes.To evaluate and compare the clinical efficacy of PRP and carboxytherapy in the treatment of periorbital dark circles (PODC). Histopathological evaluation was also done.Split-face study of 23 patients with PODC treated with PRP at the right side and carboxytherapy at the left side. Patients received four sessions; one session/week. Final follow-up evaluation was done 3 months after the last session by clinical and histopathological assessment.PRP showed significant better response (p = 0.002), shorter downtime, and tolerable side effects than caboxytherapy. Reduction in area percent of melanin after PRP injections showed 46.6% improvement, while after carboxytherapy, it showed only 14.3% improvement.The present study showed that PRP is more effective and tolerable than caboxytherapy in the treatment of PODC.
- Published
- 2022
44. Intradermal delivery of mRNA using cryomicroneedles
- Author
-
Jinming Yu, Chaiyaporn Kuwentrai, Hua-Rui Gong, Renhao Li, Bao-zhong Zhang, Xuansheng Lin, Xiaolei Wang, Jian-Dong Huang, and Chenjie Xu
- Subjects
Injections, Intradermal ,Vaccination ,Biomedical Engineering ,COVID-19 ,General Medicine ,Biochemistry ,Biomaterials ,Mice ,Drug Delivery Systems ,Needles ,Animals ,RNA, Messenger ,Molecular Biology ,Biotechnology - Abstract
Microneedles can realize the intradermal and transdermal delivery of drugs. However, most conventional microneedles made of metal, polymer and ceramics are unsuitable for the delivery of mRNA drugs that are fragile and temperature-sensitive. This study explores the usage of cryomicroneedles (CryoMNs) for the intradermal delivery of mRNA molecules. Taking luciferase mRNA as an example, we first optimize the formulation of CryoMNs to maximize mRNA stability. Later, in the mouse model, we compare the delivery efficiency with the conventional subcutaneous injection for both the luciferase mRNA and COVID-19 Comirnaty mRNA vaccines, where CryoMNs delivered mRNA vaccines successfully induce specific B-cell antibody, neutralizing activity and T-cell responses. STATEMENT OF SIGNIFICANCE: mRNA vaccines are fragile and temperature-sensitive, so they are mainly delivered by intramuscular injection that often causes pain and requires clinical expertise to immunize patients. Microneedles permit convenient, fast and safe vaccination. However, existing microneedle platforms are ineffective to protect the integrity of mRNA vaccines in fabrication, storage, and administration. This work utilizes cryomicroneedles (CryoMNs) technology to intradermally deliver mRNA. In the mouse model, CryoMNs are compared with the subcutaneous injection for the delivery efficiency of both the luciferase mRNA and COVID-19 Comirnaty mRNA vaccines, where CryoMNs delivered mRNA vaccines successfully produce specific B-cell antibodies, T-cell responses, and neutralizing activity. This work is expected to provide a new delivery strategy for the emerging mRNA therapeutics.
- Published
- 2022
45. Clinical trial: intra dermal hepatitis B vaccination with topical imiquimod versus intra muscular hepatitis B vaccination in patients with inflammatory bowel disease
- Author
-
Kwan‐Lung Ko, Yuk‐Fai Lam, Ka‐Shing Cheung, Ivan Fan‐Ngai Hung, and Wai K. Leung
- Subjects
Adult ,Male ,Imiquimod ,Injections, Intradermal ,Hepatology ,Vaccination ,Gastroenterology ,Hepatitis B ,Inflammatory Bowel Diseases ,Injections, Intramuscular ,Chronic Disease ,Humans ,Female ,Hepatitis B Vaccines ,Pharmacology (medical) ,Hepatitis B Antibodies - Abstract
Efficacy with conventional intra muscular (IM) hepatitis B vaccination in patients with inflammatory bowel disease (IBD) is suboptimal.To compare the immunogenicity of intradermal (ID) hepatitis B vaccination after topical imiquimod pre-treatment with IM hepatitis B vaccination in patients with IBD.Adult IBD patients with no evidence of hepatitis B infection or immunity (negative to HBsAg/anti-HBc/anti-HBs) were randomised 1:1 to receive either ID hepatitis B vaccine with topical imiquimod pre-treatment to injection site (ID-Imq) or IM hepatitis B vaccine with aqueous cream pre-treatment (IM-Aq) at 0, 1 and 6 months. Patients and investigators were blinded to the randomisation and intervention. The primary endpoint was seroprotection rate at 12-month, defined as percentage of subjects with anti-HBs ≥10 mIU/ml.Between September 2019 and December 2020, 104 patients with IBD (68% male; 50% Crohn's) enrolled, and 53 assigned to ID-Imq group. The percentage of patients using steroids, immunomodulators or biologics at randomisation was 15%, 55% or 22%, respectively. Seroprotection rate at 12 months was significantly higher in the ID-Imq group than the IM-Aq group (91% vs 69%; OR 4.39, 95% CI 1.47-13.11). Multivariate analysis showed that ID vaccine with topical imiquimod and higher albumin level were associated with a higher seroprotection rate. The safety profile was similar but local reactions were more common in the ID-Imq group.Intradermal hepatitis B vaccination with topical imiquimod pre-treatment is safe and offers superior seroprotection to conventional IM administration in patients with IBD.
- Published
- 2022
46. Longitudinal Assessment of Facial Hyperhidrosis Management: Evaluating the Utility and Quality of Life Improvements following Botulinum Toxin Injection.
- Author
-
Prodan-Barbulescu C, Castiglione L, Burtic SR, Murariu M, Reddy S, Rosca O, Bratosin F, Melania Fizedean C, Krupyshev P, and Enatescu I
- Subjects
- Adult, Humans, Treatment Outcome, Quality of Life, Injections, Intradermal, Hyperhidrosis diagnosis, Hyperhidrosis drug therapy, Botulinum Toxins, Type A therapeutic use
- Abstract
Facial hyperhidrosis is a debilitating condition that can severely impact the quality of life. This study aimed to assess the long-term utility of Botulinum toxin type A therapy (BTA) for facial hyperhidrosis and its impact on quality of life over a one-year period. Conducted at the Pius Brinzeu Clinical Emergency Hospital in Timisoara, Romania, this longitudinal observational study involved 77 adult patients with primary facial hyperhidrosis. Participants received two sessions of Botulinum toxin injections (50 U IncoBTX-A each) and were evaluated at baseline, 6 months, and 12 months using the Hyperhidrosis Disease Severity Scale (HDSS), WHOQOL-BREF, Dermatology Life Quality Index (DLQI), and a bespoke survey. The study demonstrated significant reductions in HDSS scores from 3.6 ± 0.5 to 1.2 ± 0.8 post-treatment, sustained at 1.3 ± 0.6 at 12 months ( p -value < 0.001). DLQI scores markedly decreased from 24.8 ± 4.2 to 6.2 ± 2.1 post-treatment, stabilizing at 6.5 ± 2.5 at 12 months ( p -value < 0.001). Sweat production significantly dropped from 0.75 g ± 0.15 to 0.18 g ± 0.07 per 15 min ( p -value < 0.001). WHOQOL-BREF scores improved notably in the mental domain from 66.7 ± 6.1 to 70.8 ± 5.2 at 12 months ( p -value < 0.001), with physical and social domains also showing significant improvements. Correlation analysis revealed strong negative correlations between DLQI total score and HDSS (rho = -0.72, p -value < 0.001) and sweat production (rho = -0.68, p -value < 0.001). Regression analysis indicated significant predictors for DLQI total score, including HDSS (B Coefficient = -3.8, p -value < 0.001) and sweat production (B Coefficient = -2.2, p -value < 0.001). BTA therapy significantly improved the quality of life in facial hyperhidrosis patients, with lasting effects on symptom severity, sweat production, and quality of life domains. The correlation and regression analyses further substantiated the treatment's impact on both physical and psychological aspects. These findings advocate Botulinum toxin as a viable long-term treatment for facial hyperhidrosis.
- Published
- 2024
- Full Text
- View/download PDF
47. Injectable platelet-rich fibrin for treatment of female pattern hair loss.
- Author
-
Sharma S, Vhadra B, Quinlan DJ, Shatta B, and Hassan H
- Subjects
- Humans, Female, Adult, Middle Aged, Injections, Intradermal, Cosmetic Techniques, Hair Follicle, Patient Satisfaction, Alopecia therapy, Alopecia drug therapy, Platelet-Rich Fibrin
- Abstract
This case series evaluated use of injectable platelet rich fibrin (termed i-PRF+) for the treatment of female pattern hair loss (FPHL). Eleven individuals underwent 3-monthly intradermal injections of i-PRF+ using a mesotherapy gun. The mean number of hair follicles containing hairs per unit area improved at 3- and 6-months follow-up ( p < .001), and all participants had a negative hair pull test. Hair volume and thickness, and patient-reported outcome scores also improved at follow-up ( p < .001). Adverse effects were minor and self-limited. A series of three i-PRF+ injection sessions were effective for the treatment of FPHL, as shown by improved hair analysis parameters and patient self-assessment scores.
- Published
- 2024
- Full Text
- View/download PDF
48. Intradermal Naked DNA Vaccination by DNA Tattooing for Mounting Tumor-Specific Immunity in Stage IV Melanoma Patients: A Phase I Clinical Trial.
- Author
-
Geukes Foppen MH, Rohaan MW, Borgers JSW, Philips D, Vyth-Dreese F, Beijnen JH, Nuijen B, van den Berg JH, and Haanen JBAG
- Subjects
- Humans, Middle Aged, Female, Male, Injections, Intradermal, Aged, Adult, Skin Neoplasms immunology, MART-1 Antigen immunology, CD8-Positive T-Lymphocytes immunology, Vaccination methods, Treatment Outcome, HLA-A2 Antigen immunology, Epitopes, T-Lymphocyte immunology, Melanoma immunology, Melanoma therapy, Vaccines, DNA administration & dosage, Vaccines, DNA immunology, Cancer Vaccines administration & dosage, Cancer Vaccines immunology, Cancer Vaccines therapeutic use, Tattooing, Neoplasm Staging
- Abstract
Introduction: Naked DNA vaccination could be a powerful and safe strategy to mount antigen-specific cellular immunity. We designed a phase I clinical trial to investigate the toxicity of naked DNA vaccines encoding CD8+ T-cell epitope from tumor-associated antigen MART-1 in patients with advanced melanoma., Methods: This dose escalating phase Ia clinical trial investigates the toxicity and immunological response upon naked DNA vaccines encoding a CD8+ T-cell epitope from the tumor-associated antigen MART-1, genetically linked to the gene encoding domain 1 of subunit-tetanus toxin fragment C in patients with advanced melanoma (inoperable stage IIIC-IV, AJCC 7th edition). The vaccine was administrated via intradermal application using a permanent make-up or tattoo device. Safety was monitored according to CTCAE v.3.0 and skin biopsies and blood samples were obtained for immunologic monitoring., Results: Nine pretreated, HLA-A*0201-positive patients with advanced melanoma expressing MART-1 and MHC class I, with a good performance status, and adequate organ function, were included. With a median follow-up of 5.9 months, DNA vaccination was safe, without treatment-related deaths. Common treatment-emergent adverse events of any grade were dermatologic reactions at the vaccination site (100%) and pain (56%). One patient experienced grade 4 toxicity, most likely related to tumor progression. One patient (11%) achieved stable disease, lasting 353 days. Immune analysis showed no increase in vaccine-induced T cell response in peripheral blood of 5 patients, but did show a MART-1 specific CD8+ T cell response at the tattoo administration site. The maximum dose administered was 2 mg due to lack of clinical activity., Conclusion: We showed that the developed DNA vaccine, applied using a novel intradermal application strategy, can be administered safely. Further research with improved vaccine formats is required to show possible clinical benefit of DNA vaccination., (© 2024 The Author(s). Published by S. Karger AG, Basel.)
- Published
- 2024
- Full Text
- View/download PDF
49. Systematic review of mesotherapy: a novel avenue for the treatment of hair loss.
- Author
-
Gupta AK, Polla Ravi S, Wang T, Talukder M, Starace M, and Piraccini BM
- Subjects
- Humans, Alopecia drug therapy, Minoxidil therapeutic use, Treatment Outcome, Injections, Intradermal, Mesotherapy adverse effects
- Abstract
Mesotherapy is a technique by which lower doses of therapeutic agents and bioactive substances are administered by intradermal injections to the skin. Through intradermal injections, mesotherapy can increase the residence time of therapeutic agents in the affected area, thus allowing for the use of lower doses and longer intervals between sessions which may in turn improve the treatment outcome and patient compliance. This systematic review aims to summarize the current literature that evaluates the efficacy of this technique for the treatment of hair loss and provides an overview of the results observed. Of the 416 records identified, 27 articles met the inclusion criteria. To date, mesotherapy using 6 classes of agents and their combinations have been studied; this includes dutasteride, minoxidil, growth factors or autologous suspension, botulinum toxin A, stem cells, and mesh solutions/multivitamins. While several studies report statistically significant improvements in hair growth after treatment, there is currently a lack of standardized regimens. The emergence of adverse effects after mesotherapy has been reported. Further large-scale and controlled clinical trials are warranted to evaluate the utility of mesotherapy for hair loss disorders.
- Published
- 2023
- Full Text
- View/download PDF
50. Antigen-loaded flagellate bacteria for enhanced adaptive immune response by intradermal injection.
- Author
-
Tao F, Ye Q, Chen Y, Luo L, Xu H, Xu J, Feng Z, Wang C, Li T, Wen Y, Hu Y, Dong H, Zhao X, and Wu J
- Subjects
- Mice, Animals, Injections, Intradermal, Dendritic Cells, Antigens, Adaptive Immunity, Bacteria, Vaccines, Melanoma therapy
- Abstract
Since the skin limits the distribution of intradermal vaccines, a large number of dendritic cells in the skin cannot be fully utilized to elicit a more effective immune response. Here, we loaded the antigen to the surface of the flagellate bacteria that was modified by cationic polymer, thus creating antigen-loaded flagellate bacteria (denoted as 'FB-Ag') to overcome the skin barrier and perform the active delivery of antigen in the skin. The FB-Ag showed fast speed (∼0.2 μm s
-1 ) and strong dendritic cell activation capabilities in the skin model in vitro. In vivo, the FB-Ag promoted the spread of antigen in the skin through active movement, increased the contact between Intradermal dendritic cells and antigen, and effectively activated the internal dendritic cells in the skin. In a mouse of pulmonary metastatic melanoma and in mice bearing subcutaneous melanoma tumor, the FB-Ag effectively increased antigen-specific therapeutic efficacy and produced long-lasting immune memory. More importantly, the FB-Ag also enhanced the level of COVID-19 specific antibodies in the serum and the number of memory B cells in the spleen of mice. The movement of antigen-loaded flagellate bacteria to overcome intradermal constraints may enhance the activation of intradermal dendritic cells, providing new ideas for developing intradermal vaccines., Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests., (Copyright © 2023. Published by Elsevier B.V.)- Published
- 2023
- Full Text
- View/download PDF
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