Vulva-vaginal atrophy (VVA) ndi chimodzi mwazotsatira zofala za kusowa kwa estrogen, makamaka pambuyo posiya kusamba.Kafukufuku wambiri adawonetsa zotsatira za hyaluronic acid (HA) pazizindikiro zakuthupi ndi zakugonana zomwe zimagwirizanitsidwa ndi VVA ndipo apeza zotsatira zabwino.Komabe, ambiri mwa maphunzirowa amayang'ana kwambiri kuwunika kwachizindikiro kumayendedwe apamutu.Komabe, HA ndi molekyulu yokhazikika, ndipo ndizomveka kuti imagwira ntchito bwino ngati itabayidwa mu epithelium yowoneka bwino.Desirial® ndiye hyaluronic acid yoyamba yolumikizana ndi mtanda yomwe imaperekedwa kudzera mu jakisoni wakumaliseche.Cholinga cha phunziroli chinali kufufuza zotsatira za jakisoni wambiri wa intravaginal intramucosal wa hyaluronic acid (DESIRIAL®, Laboratoires VIVACY) pa zotsatira zingapo zazikulu zachipatala ndi odwala.
Gulu la maphunziro oyendetsa apakati awiri.Zotsatira zosankhidwa zinaphatikizapo kusintha kwa makulidwe a ukazi wa mucosal, collagen mapangidwe biomarkers, zomera zamaliseche, ukazi pH, chizindikiro cha thanzi la ukazi, zizindikiro za vulvovaginal atrophy ndi kugonana kwa masabata a 8 pambuyo pa jekeseni wa Desirial®.Kuwona kwabwino kwa wodwalayo (PGI-I) sikelo idagwiritsidwanso ntchito kuyesa kukhutira kwa odwala.
Okwana 20 adalembedwa kuchokera pa 19/06/2017 mpaka 05/07/2018.Pamapeto pa phunziroli, panalibe kusiyana pakati pa makulidwe apakati amtundu wa nyini kapena procollagen I, III, kapena Ki67 fluorescence.Komabe, mawu amtundu wa COL1A1 ndi COL3A1 adakula kwambiri (p = 0.0002 ndi p = 0.0010, motsatana).Dyspareunia yomwe idanenedwapo, kuyanika kwa nyini, kuyabwa kwa maliseche, komanso zotupa za ukazi zidachepetsedwanso kwambiri, ndipo miyeso yonse yachiwonetsero cha akazi pakugonana idasinthidwa kwambiri.Malingana ndi PGI-I, odwala 19 (95%) adanena za kusintha kosiyana, komwe 4 (20%) inamva bwino pang'ono;7 (35%) inali yabwino, ndipo 8 (40%) inali yabwino.
Majekeseni ambiri a intravaginal a Desirial® (HA) yolumikizidwa kwambiri ndi mafotokozedwe a CoL1A1 ndi CoL3A1, kusonyeza kuti mapangidwe a collagen adalimbikitsidwa.Kuonjezera apo, zizindikiro za VVA zinachepetsedwa kwambiri, ndipo kukhutira kwa odwala ndi ntchito zogonana zinali bwino kwambiri.Komabe, makulidwe okwana a mucosa ya ukazi sikunasinthe kwambiri.
Vulva-vaginal atrophy (VVA) ndi chimodzi mwazotsatira zofala za kusowa kwa estrogen, makamaka pambuyo posiya kusamba [1,2,3,4].Ma syndromes angapo azachipatala amalumikizidwa ndi VVA, kuphatikiza kuyanika, kuyabwa, kuyabwa, dyspareunia, komanso matenda obwera chifukwa cha mkodzo, omwe amatha kusokoneza kwambiri moyo wa amayi [5].Komabe, kuyambika kwa zizindikiro zimenezi kungakhale kosaoneka bwino ndi kwapang’onopang’ono, ndipo kumayamba kuonekera zizindikiro zina zosiya kusamba zitatha.Malinga ndi malipoti, mpaka 55%, 41%, ndi 15% ya amayi omwe atha msinkhu amavutika ndi kuuma kwa ukazi, dyspareunia, ndi matenda obwerezabwereza mkodzo, motero [6,7,8,9].Komabe, anthu ena amakhulupirira kuti kufala kwenikweni kwa mavutowa ndikwambiri, koma amayi ambiri safuna chithandizo chamankhwala chifukwa cha zizindikiro [6].
Zomwe zili mu kasamalidwe ka VVA ndi chithandizo chazizindikiro, kuphatikizapo kusintha kwa moyo, osagwiritsa ntchito mahomoni (monga mafuta odzola kumaliseche kapena zonyowa ndi laser) ndi mapulogalamu a mankhwala a mahomoni.Mafuta odzola kumaliseche amagwiritsidwa ntchito makamaka kuti athetse kuuma kwa ukazi panthawi yogonana, kotero sangathe kupereka yankho lothandiza ku zovuta komanso zovuta za zizindikiro za VVA.M'malo mwake, akuti moisturizer ya nyini ndi mtundu wa "bioadhesive" mankhwala omwe amalimbikitsa kusunga madzi, ndipo kugwiritsa ntchito pafupipafupi kumatha kusintha kukwiya kwa ukazi ndi dyspareunia [10].Komabe, izi sizikukhudzana ndi kusintha kwa kuchuluka kwa ukazi wa epithelial maturity index [11].M'zaka zaposachedwa, pakhala pali zifukwa zambiri zogwiritsira ntchito ma radiofrequency ndi laser kuti athetse zizindikiro za m'mimba [12,13,14,15].Komabe, a FDA apereka machenjezo kwa odwala, kutsindika kuti kugwiritsa ntchito njira zoterezi kungayambitse mavuto aakulu, ndipo sikunatsimikizirebe chitetezo ndi mphamvu za zipangizo zogwiritsira ntchito mphamvu pochiza matendawa [16].Umboni wochokera ku meta-kuwunika kwa maphunziro angapo osasinthika umathandizira kuti pakhale chithandizo chamankhwala chapamutu komanso chokhazikika cha mahomoni pochepetsa zizindikiro zokhudzana ndi VVA [17,18,19].Komabe, kafukufuku wochepa adawunika zotsatira zokhazikika za mankhwalawa pambuyo pa miyezi 6 ya chithandizo.Kuphatikiza apo, zotsutsana ndi zosankha zawo ndizomwe zimalepheretsa kugwiritsidwa ntchito kwanthawi yayitali kwamankhwala awa.Choncho, pakufunikabe njira yotetezeka komanso yothandiza yothetsera zizindikiro zokhudzana ndi VVA.
Hyaluronic acid (HA) ndi molekyulu yofunika kwambiri ya matrix a extracellular, omwe amapezeka m'matumbo osiyanasiyana kuphatikiza mucosa yakumaliseche.Ndi polysaccharide yochokera ku banja la glycosaminoglycan, yomwe imagwira ntchito yofunika kwambiri pakusunga madzi bwino ndikuwongolera kutupa, kuyankha kwa chitetezo chamthupi, kupanga zipsera ndi angiogenesis [20, 21].Kukonzekera kwa HA synthetic kumaperekedwa mu mawonekedwe a gels apamutu ndipo ali ndi udindo wa "zida zamankhwala".Kafukufuku wambiri adawonetsa zotsatira za HA pazizindikiro zakuthupi ndi zakugonana zomwe zimagwirizanitsidwa ndi VVA ndipo apeza zotsatira zabwino [22,23,24,25].Komabe, ambiri mwa maphunzirowa amayang'ana kwambiri kuwunika kwachizindikiro kumayendedwe apamutu.Komabe, HA ndi molekyulu yokhazikika, ndipo ndizomveka kuti imagwira ntchito bwino ngati itabayidwa mu epithelium yowoneka bwino.Desirial® ndiye hyaluronic acid yoyamba yolumikizana ndi mtanda yomwe imaperekedwa kudzera mu jakisoni wakumaliseche.
Cholinga cha kafukufuku woyembekezeredwa wapakatikati ndikuwunika momwe jakisoni wa intravaginal intravaginal intramucosal acid (DESIRIAL®, Laboratoires VIVACY) amakhudzira zotsatira zazikulu za malipoti angapo azachipatala ndi odwala, ndikuwunika. kuthekera kwa kuwunika Kugonana zotsatirazi.Zotsatira zonse zomwe zasankhidwa pa phunziroli zinaphatikizapo kusintha kwa makulidwe a nyini, zizindikiro za kusinthika kwa minofu, zomera za ukazi, pH ya ukazi ndi ndondomeko ya thanzi la ukazi patatha masabata a 8 pambuyo pa jekeseni wa Desirial®.Tinayesa zotsatira zomwe zinanenedwa ndi odwala angapo, kuphatikizapo kusintha kwa ntchito zogonana ndi chiwerengero cha malipoti a zizindikiro zokhudzana ndi VVA panthawi yomweyo.Pamapeto pa phunzirolo, malingaliro onse a wodwalayo (PGI-I) anagwiritsidwa ntchito poyesa kukhutira kwa odwala.
Chiwerengero cha kafukufukuyu chinali ndi amayi omwe adasiya kusamba (zaka 2 mpaka 10 atasiya kusamba) omwe adatumizidwa ku chipatala chosiya kusamba ndi zizindikiro za kusokonezeka kwa ukazi ndi / kapena dyspareunia yachiwiri mpaka kuuma kwa ukazi.Azimayi ayenera kukhala ≥ zaka 18 ndi <70 zaka ndipo akhale ndi BMI <35.Ophunzirawo adachokera kumodzi mwa zigawo za 2 (Centre Hospitaler Régional Universitaire, Nîmes (CHRU), France ndi Karis Medical Center (KMC), Perpignan, France).Azimayi amaonedwa kuti ndi oyenerera ngati ali mbali ya ndondomeko ya inshuwalansi ya umoyo kapena kupindula ndi ndondomeko ya inshuwalansi ya umoyo, ndipo amadziwa kuti akhoza kutenga nawo mbali pa nthawi yotsatila yokonzekera masabata a 8.Azimayi omwe ankachita nawo maphunziro ena panthawiyo sanali oyenerera kulembedwa.≥ Gawo 2 la kufalikira kwa chiwalo cham'chiuno, kupsinjika kwa mkodzo, kutsekula m'mimba, vulvovaginal kapena mkodzo thirakiti, zotupa zam'mimba kapena neoplastic, zotupa zomwe zimadalira mahomoni, kutuluka kwa maliseche kwa etiology yosadziwika, porphyria mobwerezabwereza, khunyu kosalamulirika, angina pectoris conduction. , rheumatic fever, opaleshoni yam'mbuyo ya vulvovaginal kapena urogynecological, matenda a hemostatic, ndi chizolowezi chopanga zipsera za hypertrophic zinkaonedwa ngati njira zopatulapo.Azimayi omwe amamwa mankhwala a antihypertensive, steroidal ndi non-steroidal anti-inflammatory, anticoagulants, antidepressants kapena aspirin, komanso mankhwala opha anthu am'deralo olumikizidwa ndi HA, mannitol, betadine, lidocaine, amide kapena Akazi omwe sakugwirizana ndi chilichonse mwazothandizira mankhwalawa. amaonedwa kuti ndi osayenera kuchita kafukufukuyu.
Pachiyambi, amayi adafunsidwa kuti amalize FSFI (FSFI) [26] ndikugwiritsa ntchito 0-10 visual analog scale (VAS) kuti atenge zambiri zokhudzana ndi zizindikiro za VA (dyspareunia, kuuma kwa ukazi, kuyabwa kwa ukazi, ndi kuyabwa kwa maliseche. ) chidziwitso.Kuwunika kusanachitike kunaphatikizapo kuyang'ana pH ya ukazi, pogwiritsa ntchito Bachmann Vaginal Health Index (VHI) [27] pakuwunika kwachipatala kwa nyini, Pap smear kuyesa zomera za ukazi, ndi maliseche a mucosal biopsy.Yezerani pH ya nyini pafupi ndi malo opangira jakisoni komanso mu nyini ya fornix.Kwa zomera za ukazi, chiwerengero cha Nugent [28, 29] chimapereka chida chowerengera chilengedwe cha ukazi, kumene 0-3, 4-6 ndi 7-10 mfundo zimayimira zomera zachibadwa, zomera zapakati ndi vaginosis, motero.Kuwunika konse kwa zomera za ukazi kumachitika mu Dipatimenti ya Bacteriology ya CHRU ku Nimes.Gwiritsani ntchito njira zovomerezeka za vaginal mucosal biopsy.Pangani nkhonya ya 6-8 mm kuchokera kudera lomwe mwakonzekera jekeseni.Malingana ndi makulidwe a basal wosanjikiza, wosanjikiza wapakati ndi wosanjikiza pamwamba, mucosal biopsy inayesedwa histologically.Biopsy imagwiritsidwanso ntchito kuyeza COL1A1 ndi COL3A1 mRNA, pogwiritsa ntchito RT-PCR ndi procollagen I ndi III immunotissue fluorescence monga surrogate ya collagen expression, ndi fluorescence wa proliferation marker Ki67 monga surrogate kwa mucosal mitotic ntchito.Kuyesa kwa majini kumachitidwa ndi labotale ya BioAlternatives, 1bis rue des Plantes, 86160 GENCAY, France (mgwirizano ukupezeka mukapempha).
Zitsanzo zoyambira ndi miyeso ikamalizidwa, HA (Desirial®) yolumikizidwa pamtanda imayikidwa ndi mmodzi mwa akatswiri ophunzitsidwa bwino a 2 malinga ndi ndondomeko yoyenera.Desirial® [NaHa (sodium hyaluronate) yolumikizidwa IPN-Monga 19 mg/g + mannitol (antioxidant)] ndi jekeseni ya HA gel osakhala yanyama, kuti igwiritsidwe ntchito kamodzi ndi kupakidwa mu Syringe yodzaza kale (2 × 1 ml). ).Ndi chipangizo chachipatala cha Class III (CE 0499), chomwe chimagwiritsidwa ntchito popanga jakisoni wa intramucosal mwa amayi, chomwe chimagwiritsidwa ntchito popanga biostimulation ndi kubwezeretsa madzi m'thupi la mucosal pamwamba pa maliseche (Laboratoires Vivacy, 252 rue Douglas Engelbart-Archamps Technopole, 74160 Archamps, France).Pafupifupi jakisoni 10, 70-100 µl iliyonse (0.5-1 ml yonse), amachitidwa pa mizere yopingasa 3-4 pagawo lachitatu la khoma lakumbuyo kwa nyini, m'munsi mwake pamlingo wa nyini yakumbuyo. khoma, ndi pamwamba pa 2 cm pamwamba (chithunzi 1).
Kuwunika komaliza kwa phunziro kumakonzedwa kwa masabata a 8 pambuyo polembetsa.Zoyezera za amayi ndizofanana ndi zomwe zayambira.Kuphatikiza apo, odwala amafunikiranso kuti amalize Scale Yokhutiritsa ya Overall Improving Impression (PGI-I) [30].
Poona kusowa kwa deta komanso momwe kafukufukuyu akuyendera, n'zosatheka kuwerengera kukula kwachitsanzo choyambirira.Choncho, kukula kwachitsanzo choyenera kwa odwala onse a 20 anasankhidwa malinga ndi mphamvu za magawo awiri omwe akugwira nawo ntchito ndipo zinali zokwanira kuti apeze kulingalira koyenera kwa zotsatira zomwe zaperekedwa.Kusanthula kwachiwerengero kunachitika pogwiritsa ntchito mapulogalamu a SAS (9.4; SAS Inc., Cary NC), ndipo mlingo wofunikira unayikidwa pa 5%.Mayeso a Wilcoxon omwe adasaina adagwiritsidwa ntchito pazosintha mosalekeza ndipo mayeso a McNemar adagwiritsidwa ntchito pamitundu yosiyanasiyana kuyesa kusintha kwa masabata 8.
Kafukufukuyu adavomerezedwa ndi Comité d'ethique du CHU Carémeau de Nimes (ID-RCB: 2016-A00124-47, protocol code: LOCAL/2016/PM-001).Onse omwe adachita nawo kafukufuku adasaina fomu yovomerezeka yovomerezeka.Pa maulendo awiri ofufuza ndi ma biopsies awiri, odwala amatha kulandira chipukuta misozi mpaka 200 Euros.
Anthu okwana 20 adalembedwa ntchito kuyambira pa 19/06/2017 mpaka 05/07/2018 (odwala 8 ochokera ku CHRU ndi odwala 12 ochokera ku KMC).Palibe mgwirizano womwe umaphwanya mfundo zophatikizira / zopatula.Njira zonse za jakisoni zinali zotetezeka komanso zomveka ndipo zidamalizidwa mkati mwa mphindi 20.Maonekedwe a chiwerengero cha anthu omwe adachita nawo kafukufukuyu akuwonetsedwa mu Table 1. Poyambirira, amayi 12 mwa 20 (60%) adagwiritsa ntchito mankhwalawa chifukwa cha zizindikiro zawo (6 hormonal ndi 6 non-hormonal), pamene pa sabata 8 odwala awiri okha. (10%) adachitidwabe chonchi (p = 0.002).
Zotsatira za zotsatira za lipoti lachipatala ndi odwala zikuwonetsedwa mu Table 2 ndi Table 3. Wodwala wina anakana W8 biopsy ya ukazi;wodwala winayo anakana W8 biopsy ya kumaliseche.Chifukwa chake, otenga nawo gawo 19/20 atha kupeza zonse za histological and genetic analysis data.Poyerekeza ndi D0, panalibe kusiyana pakati pa makulidwe apakati a mucosa ya nyini pa sabata la 8. Komabe, makulidwe apakati a basal wosanjikiza anawonjezeka kuchokera ku 70.28 mpaka 83.25 microns, koma kuwonjezeka kumeneku sikunali kofunika kwambiri (p = 0.8596).Panalibe kusiyana kowerengera mu fluorescence ya procollagen I, III kapena Ki67 isanayambe kapena itatha chithandizo.Komabe, mawu amtundu wa COL1A1 ndi COL3A1 adakula kwambiri (p = 0.0002 ndi p = 0.0010, motsatana).Panalibe kusintha kwakukulu kowerengera, koma kunathandizira kusintha kachitidwe ka maluwa a ukazi pambuyo pa jekeseni wa Desirial® (n = 11, p = 0.1250).Mofananamo, pafupi ndi malo a jekeseni (n = 17) ndi vaginal fornix (n = 19), pH mtengo wa ukazi umakondanso kuchepa, koma kusiyana kumeneku sikunali kofunika kwambiri (p = p = 0.0574 ndi 0.0955) (Table 2). .
Onse ochita nawo kafukufuku ali ndi mwayi wopeza zotsatira zomwe zafotokozedwa ndi odwala.Malingana ndi PGI-I, mmodzi wa ophunzira (5%) adanena kuti palibe kusintha pambuyo pa jekeseni, pamene odwala 19 otsala (95%) adanena za kusintha kosiyana, komwe 4 (20%) inamva bwino;7 (35%) ndi abwino, 8 (40%) ndi abwino.Zomwe zimanenedwa za dyspareunia, kuyanika kwa nyini, kuyabwa kwa maliseche, kuvulala kwa nyini, ndi kuchuluka kwa FSFI komanso chikhumbo chawo, mafuta, kukhutitsidwa, ndi zowawa zinachepetsedwanso kwambiri (Table 3).
Lingaliro lochirikiza phunziroli ndiloti majekeseni angapo a Desirial® pakhoma lakumbuyo kwa nyini adzakhuthala mucosa ya nyini, pH ya nyini yotsika, kusintha maluwa a ukazi, kupanga mapangidwe a collagen ndikusintha zizindikiro za VA.Tinatha kusonyeza kuti odwala onse adanena za kusintha kwakukulu, kuphatikizapo dyspareunia, kuuma kwa nyini, zilonda zam'mimba, ndi kuyabwa kwa maliseche.VHI ndi FSFI zakonzedwanso kwambiri, ndipo chiwerengero cha amayi omwe amafunikira njira zina zochiritsira kuti athetse zizindikiro zawo chachepetsedwa kwambiri.Momwemonso, ndizotheka kusonkhanitsa zambiri zazotsatira zonse zomwe zatsimikiziridwa koyambirira ndikupereka njira zothandizira onse omwe atenga nawo mbali mu kafukufukuyu.Kuphatikiza apo, 75% ya omwe adachita nawo kafukufuku adanenanso kuti zizindikiro zawo zidayenda bwino kapena zidakhala bwino pakutha kwa phunzirolo.
Komabe, ngakhale kuwonjezeka pang'ono kwa pafupifupi makulidwe a basal wosanjikiza, sitinathe kutsimikizira kwambiri makulidwe okwana mucosa ukazi.Ngakhale kuti phunziro lathu silinathe kuyesa mphamvu ya Desirial® pokonza makulidwe a mucosal ya vaginal, timakhulupirira kuti zotsatira zake ndizofunika chifukwa mawu a CoL1A1 ndi CoL3A1 adawonjezeka kwambiri mu W8 poyerekeza ndi D0.Amatanthauza kukondoweza kwa collagen.Komabe, pali zinthu zina zofunika kuziganizira musanagwiritse ntchito kafukufuku wamtsogolo.Choyamba, kodi nthawi yotsatiridwa ya masabata 8 ndi yochepa kwambiri kuti iwonetsetse kusintha kwa makulidwe a mucosal?Ngati nthawi yotsatiridwa ndi nthawi yayitali, zosintha zomwe zadziwika muzitsulo zoyambira zikhoza kukhazikitsidwa m'magulu ena.Kachiwiri, kodi makulidwe a histological a mucosal layer akuwonetsa kusinthika kwa minofu?The histological asses of vaginal mucosal makulidwe saganizira kwenikweni wosanjikiza woyambira, womwe umaphatikizapo minofu yosinthika yomwe imakhudzana ndi minofu yolumikizira.
Timamvetsetsa kuti chiwerengero chochepa cha otenga nawo mbali komanso kusowa kwa kukula kwachitsanzo choyambirira ndizochepa pa kafukufuku wathu;Komabe, zonsezi ndizomwe zimayenderana ndi kafukufuku woyesa.Ichi ndichifukwa chake timapewa kupititsa patsogolo zomwe tapeza ku zonena kuti ndizovomerezeka kapena zosavomerezeka.Komabe, ubwino umodzi waukulu wa ntchito yathu ndikuti umatithandiza kupanga deta pazotsatira zingapo, zomwe zingatithandize kuwerengera kukula kwachitsanzo kwa kafukufuku wamtsogolo.Kuphatikiza apo, woyendetsa ndegeyo amatilola kuyesa njira yathu yolembera anthu, kuchuluka kwa churn, kuthekera kwa kusonkhanitsa zitsanzo ndi kusanthula zotsatira, zomwe zingapereke chidziwitso cha ntchito ina iliyonse yokhudzana.Pomaliza, mndandanda wazotsatira zomwe tidawunika, kuphatikiza zotsatira zachipatala, zowunikira, ndi zotsatira zoperekedwa ndi odwala zomwe zidawunikidwa pogwiritsa ntchito njira zovomerezeka, ndizo mphamvu zazikulu za kafukufuku wathu.
Desirial® ndiye hyaluronic acid yoyamba yolumikizana ndi mtanda yomwe imaperekedwa kudzera mu jakisoni wakumaliseche.Kuti apereke mankhwalawa kudzera munjira iyi, mankhwalawa amayenera kukhala ndi madzi okwanira kuti azitha kubayidwa mosavuta mu minofu yapadera yolumikizana ndikusunga hygroscopicity.Izi zimatheka ndi kukhathamiritsa kukula kwa mamolekyu a gel osakaniza ndi mlingo wa gel cross-linking kuonetsetsa ndende mkulu gel osakaniza ndi kukhala otsika mamasukidwe akayendedwe ndi elasticity.
Kafukufuku wambiri adawonetsa zotsatira zopindulitsa za HA, zomwe zambiri sizikhala zochepa za RCTs, poyerekeza HA ndi mitundu ina ya mankhwala (makamaka mahomoni) [22,23,24,25].The HA mu maphunzirowa inkayendetsedwa kumaloko.HA ndi molekyulu yokhazikika yodziwika ndi kuthekera kwake kofunikira kwambiri kukonza ndi kunyamula madzi.Ndi zaka, kuchuluka kwa amkati hyaluronic asidi mu nyini mucosa amachepetsa kwambiri, ndi makulidwe ake ndi vascularization komanso kuchepa, potero kuchepetsa plasma exudation ndi kondomu.Mu phunziro ili, tawonetsa kuti jekeseni ya Desirial® ikugwirizana ndi kusintha kwakukulu kwa zizindikiro zonse zokhudzana ndi VVA.Zotsatirazi zikugwirizana ndi kafukufuku wam'mbuyomu wopangidwa ndi Berni et al.Monga gawo la chilolezo cha Desirial® regulatory (zosadziwika-zowonjezera) (Fayilo Yowonjezera 1).Ngakhale kuti ndizongopeka chabe, ndizomveka kuti kusintha kumeneku ndi kwachiwiri kuti athe kubwezeretsa kusamutsidwa kwa plasma kumaliseche a epithelial pamwamba.
Gelisi ya HA yolumikizidwa ndi mtanda yasonyezedwanso kuti imawonjezera kaphatikizidwe ka mtundu wa I collagen ndi elastin, motero kumawonjezera makulidwe a minofu yozungulira [31, 32].Mu phunziro lathu, sitinatsimikizire kuti fluorescence ya procollagen I ndi III ndi yosiyana kwambiri pambuyo pa chithandizo.Komabe, mawu amtundu wa COL1A1 ndi COL3A1 adakula kwambiri.Choncho, Desirial® ikhoza kukhala ndi zotsatira zolimbikitsa pakupanga collagen mu nyini, koma maphunziro akuluakulu omwe ali ndi nthawi yayitali amafunika kutsimikizira kapena kutsutsa izi.
Kafukufukuyu amapereka deta yoyambira ndi kukula kwake komwe kungachitike pazotsatira zingapo, zomwe zingathandize kuwerengera kukula kwa zitsanzo zam'tsogolo.Kuphatikiza apo, kafukufukuyu adatsimikizira kuthekera kwa kusonkhanitsa zotsatira zosiyanasiyana.Komabe, ikuwunikiranso nkhani zingapo zomwe ziyenera kuganiziridwa mosamala pokonzekera kafukufuku wamtsogolo pankhaniyi.Ngakhale Desirial® ikuwoneka kuti ikuthandizira kwambiri zizindikiro za VVA ndi ntchito yogonana, njira yake yochitira zinthu sizidziwika bwino.Monga momwe tingawonere kuchokera ku mawu ofunikira a CoL1A1 ndi CoL3A1, zikuwoneka kuti pali umboni woyambirira kuti umalimbikitsa kupanga kolajeni.Komabe, procollagen 1, procollagen 3 ndi Ki67 sanapeze zotsatira zofanana.Chifukwa chake, zolembera za histological ndi biological ziyenera kufufuzidwa mu kafukufuku wamtsogolo.
Majekeseni ambiri a intravaginal a Desirial® (HA) yolumikizidwa kwambiri ndi mafotokozedwe a CoL1A1 ndi CoL3A1, akuwonetsa kuti amalimbikitsa mapangidwe a collagen, amachepetsa kwambiri zizindikiro za VVA, ndipo amagwiritsa ntchito mankhwala ena.Kuphatikiza apo, kutengera kuchuluka kwa PGI-I ndi FSFI, kukhutira kwa odwala ndi ntchito yogonana kunakula kwambiri.Komabe, makulidwe okwana a mucosa ya ukazi sikunasinthe kwambiri.
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Nthawi yotumiza: Oct-26-2021