Advances in Aesthetic Dermatology. Volume IV

Description

Welcome to Volume IV of the series Modern Anti-Aging Strategies, a comprehensive exploration of the cutting-edge science, technologies, and clinical trials shaping the future of dermatologic rejuvenation and skin longevity.
This volume examines 55 clinical trials spanning gene therapy, epigenetic reprogramming, injectable biologics, energy-based devices, mechanical stimulation, and regenerative approaches. It bridges foundational molecular biology with real-world clinical applications, offering readers an evidence-based roadmap through the most promising interventions for preventing and reversing skin aging.
Core Content Highlights
• Genes Involved in Skin Aging An in-depth review of key genetic players (MYO16, p53, MC1R, TGFBRs, and others) identified through genome-wide association studies that influence wrinkling, sagging, pigmentation, and elasticity.
• Mechanisms Activated or Deactivated in Skin Aging Detailed analysis of oxidative stress, inflammaging, MMP activation, senescence, angiogenesis, and the deactivation of DNA repair, antioxidant defenses, and mitochondrial biogenesis.
• How Skin Aging Occurs: The Step-by-Step Process A chronological breakdown from early telomere shortening and intrinsic changes to extrinsic acceleration by UV, pollution, and lifestyle factors, culminating in structural and visible manifestations.
• Gene Therapy Exploration of viral vector platforms (HSV-1 dominance, AAV limitations), successes in genodermatoses (Vyjuvek, Zevaskyn), and emerging aesthetic candidates (KB301/KB304). Includes preclinical highlights like GeneSkin (mRNA-based) and the MRBL platform.
• Epigenetic Reprogramming Full vs. partial reprogramming, Yamanaka factors (OSKM → OSK), epigenetic drift, and the information theory of aging. Focus on preclinical and emerging human applications for skin rejuvenation.
• Chemical Reprogramming & RNA-Based Approaches Small-molecule cocktails for epigenetic resetting and transient mRNA delivery for collagen stimulation—safer, regulatory-friendly alternatives to gene therapy.
• CRISPR and Precision Gene Editing Overview of CRISPR-Cas9, base editing, prime editing, and CRISPRa/i, with comparisons to gene therapy and RNA approaches. Current status: mostly preclinical for skin.
• Current Landscape and Geographic Trends Global distribution of trials (U.S. dominance, limited activity in China/Japan/Russia/Europe for aging skin) and regulatory barriers.
• Emerging Cosmetic and Aesthetic Candidates (Phase 2 Projected to 2028) 15+ promising therapies in the pipeline, including gene-based collagen restoration, JAK inhibitors, exosome therapies, and next-generation botulinum toxins.
• Contemporary Clinical Trials Across Therapeutic Categories
o Injectable Therapies: HA/polynucleotide fillers (JUVÉDERM VOLUMA XC, Plenhyage XL, Jalucomplex)
o Botulinum Toxin Optimization (e.g., reconstitution with sodium bicarbonate)
o Energy-Based Devices: Fractional lasers, radiofrequency (TempSure, FlexSure, BTL-785F), microfocused ultrasound (Ultherapy PRIME)
o Microneedling, Micro-Coring, and Mechanical Stimulation (Straberi Epistamp, Nebulyft, Cytrellis, Ellacor)
o Threads and Sutures (PDO, PLLA, PCL)
o Photobiomodulation, Topicals, and Supplements
o Regenerative and Biological Approaches (exosomes, stem cells, peptides)
• Table of 55 Clinical Trials A comprehensive reference table summarizing trial identifiers, sponsors, interventions, primary endpoints, status, and key findings (where available).
• Resources Curated references, databases, and further reading for clinicians, researchers, and enthusiasts.

This volume serves as both a scientific deep-dive and a practical guide, equipping readers with the latest evidence on how to intervene in skin aging at the molecular, cellular, and clinical levels. From gene therapy pioneers to mechanical micro-coring and beyond, Volume IV captures the most advanced strategies poised to redefine aesthetic dermatology in the coming decade.