Their clinical effectiveness is well-established, but there is a lack of a synthesis of their mechanisms of action. This research concluded that PLLA, PDLLA, PCL, and CaHA each elicit distinct yet overlapping inflammatory and cytokine-mediated cascades that culminate in robust neocollagenesis and tissue remodeling.
Relevant if you're working with glycolic acid, lactic acid, pha for aging.
If you're targeting aging, this research supports adding glycolic_acid to your AM/PM routine. Effective concentration range: 4.7–28.6% based on this study. Timeline to expect: 24 months based on study duration.
If you're targeting aging, this research supports adding lactic_acid to your AM/PM routine. Effective concentration range: 4.7–28.6% based on this study. Timeline to expect: 24 months based on study duration.
Translated from this study's findings, not a personal prescription. Pair with your existing protocol and your practitioner's guidance.
1. Cureus. 2026 Apr 27;18(4):e107800. doi: 10.7759/cureus.107800. eCollection 2026 Apr. Mechanisms of Cytokine Modulation and Inflammatory Cascade in Bio-stimulatory Skin Rejuvenation: A Comprehensive Literature Review of Poly-L-Lactic Acid, Calcium Hydroxyapatite, Polycaprolactone, and Poly-D, L-Lactic Acid. Flores Rodríguez JC(1)(2), Rosengaus Leizgold FE(3), Cárdenas Sicilia N(4), Porras Zamora BM(5)(6), Merino Arellano R(7), Rico Macías NM(8)(9), Cabello Martínez SS(10)(11).
1. Cureus. 2026 Apr 27;18(4):e107800. doi: 10.7759/cureus.107800. eCollection 2026 Apr. Mechanisms of Cytokine Modulation and Inflammatory Cascade in Bio-stimulatory Skin Rejuvenation: A Comprehensive Literature Review of Poly-L-Lactic Acid, Calcium Hydroxyapatite, Polycaprolactone, and Poly-D, L-Lactic Acid. Flores Rodríguez JC(1)(2), Rosengaus Leizgold FE(3), Cárdenas Sicilia N(4), Porras Zamora BM(5)(6), Merino Arellano R(7), Rico Macías NM(8)(9), Cabello Martínez SS(10)(11). Author information: (1)Aesthetic and Regenerative Medicine, Clínica Aura, Monterrey, MEX. (2)Aesthetic and Regenerative Medicine, Sociedad Mexicana de Investigación en Medicina Estética (SOMIME), Monterrey, MEX. (3)Aesthetic and Facial Plastic Surgery, Ultimate Medica, Mexico City, MEX. (4)Aesthetic and Regenerative Medicine, The Youth Conspiracy, Mexico City, MEX. (5)Aesthetic and Regenerative Medicine, Consultorio Particular Dra. Brenda Mariel Porras Zamora, Mexico City, MEX. (6)Aesthetic and Regenerative Medicine, Sociedad Mexicana de Investigación en Medicina Estética (SOMIME), Mexico City, MEX. (7)Plastic Surgery, TecSalud, San Pedro Garza García, MEX. (8)Aesthetic and Regenerative Medicine, Clínica Nuria Rico, Tijuana, MEX. (9)Aesthetic and Regenerative Medicine, Sociedad Mexicana de Investigación en Medicina Estética (SOMIME), Tijuana, MEX. (10)Aesthetic, Regenerative, and Anti-Aging Medicine, Universidad Autónoma de Nuevo León, Monterrey, MEX. (11)Aesthetic, Regenerative, and Anti-Aging Medicine, Sociedad Mexicana de Investigación en Medicina Estética (SOMIME), Monterrey, MEX. Biostimulatory fillers, such as poly-L-lactic acid (PLLA), poly-D,L-lactic acid (PDLLA), polycaprolactone (PCL), and calcium hydroxyapatite (CaHA), have transformed aesthetics by promoting neocollagenesis through regulated inflammatory and cytokine-driven cascades. Their clinical effectiveness is well-established, but there is a lack of a synthesis of their mechanisms of action. The proposed comprehensive narrative literature review synthesized the contemporary evidence on the cytokine-modulating mechanisms and pathways of inflammatory responses induced by PLLA, PDLLA, PCL, and CaHA. The study design is a narrative literature review, which is performed using a systematic approach based on PRISMA 2020 guidelines. As a comprehensive literature review incorporating heterogeneous and predominantly non-comparative study designs, a formal risk-of-bias assessment using standardized tools was not performed; however, study limitations were considered qualitatively. It matched the identified mechanistic processes with clinical outcomes and safety profiles. The review included 22 clinical studies published from 1stJanuary 2010 to 28th February 2026, comprising randomized controlled trials, cohort studies, and quasi-experimental designs. Extracted data were systematically categorized into six predefined domains: acute inflammatory profile, macrophage polarization, fibroblast extracellular matrix (ECM) response, angiogenesis, clinical outcomes, and adverse events based on thematic analysis of study endpoints. All four biostimulators elicit a controlled inflammatory response characterized by macrophage infiltration and, in some cases, foreign-body giant cell formation. PLLA and PDLLA promote a transition from pro-inflammatory to pro-regenerative M2 macrophage phenotypes, driving sustained upregulation of Type I and III collagen, elastin, and angiogenesis. PCL induces durable neocollagenesis lasting up to 24 months, supported by neovascularization. CaHA stimulates fibroblast activity and ECM production, with a more pronounced early inflammatory gene signature than PLLA. Clinically, all biostimulators achieve significant and sustained improvements in wrinkle severity, skin quality, and volume restoration, with high patient satisfaction rates. Adverse events were predominantly mild and transient, with nodule formation being most notable with PLLA (4.7-28.6%). The study concluded that PLLA, PDLLA, PCL, and CaHA each elicit distinct yet overlapping inflammatory and cytokine-mediated cascades that culminate in robust neocollagenesis and tissue remodeling. Understanding these mechanistic differences enables clinicians to tailor treatment selection and protocols to achieve optimal, durable aesthetic outcomes with favorable safety profiles. Copyright © 2026, Flores Rodríguez et al. DOI: 10.7759/cureus.107800 PMCID: PMC13214704 PMID: 42211639 Conflict of interest statement: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.
Original source →Wounds continue to represent a significant public health challenge globally. In recent years, Astragalus mongholicus Bunge, a traditional Chinese botanical drug utilized for wound treatment, has garnered increasing research attention. However, the therapeutic efficacy and safety of this natural botanical drug on wound healing remain poorly understood.
Friedreich's ataxia is a rare, chronic, progressive, neurodegenerative condition affecting multiple organ systems, including neurological, musculoskeletal, cardiac, and endocrine systems, and is marked by low cardiopulmonary fitness. We tested the effect of exercise and NAD+ precursor supplementation with nicotinamide riboside, which have each shown benefits in animal and early clinical studies, on cardiopulmonary fitness in individuals with Friedreich's ataxia. This 12-week, outpatient, phase 2, single-site (Children's Hospital of Philadelphia, Philadelphia, PA, USA), randomised, 2 × 2 factorial clinical trial recruited individuals aged 10-40 years with an ejection fraction of 45% or greater who were able to exercise.
Recent preclinical studies have shown that nicotinamide adenine dinucleotide (NAD+) plays a critical role in molecular mechanisms of axon degeneration, and reductions in NAD+ levels are associated with axonal degeneration. Nicotinamide riboside (NR) is a safe and widely available pyridine-nucleoside form of vitamin B3 and is an NAD+ precursor. To investigate if oral supplementation of synthetic NR can act as a therapeutic agent to prevent degeneration of small somatic sensory axons innervating the skin or promote regeneration of these same fibers in humans, we utilized a validated experimental model of cutaneous nerve degeneration and regeneration and conducted a placebo-controlled, double-blinded Phase 2 study.
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