Extracellular Matrix Modulation: Optimizing Skin Care and Rejuvenation Procedures

matrix (Figure 1). During this process, the fragmentation of collagen and elastin, which would normally stimulate neocollagenesis and renewed matrix (through the action of these matrikines), lose their stimulatory capacity in the environment of “gummed up” matrix and senescent fibroblasts resulting in less procollagen stimulation and formation. The approach to renewed matrix regeneration through rejuvenation techniques of skin resurfacing or long-term skin maintenance programs must consider these ongoing destructive processes to optimize aesthetic outcomes.

In current practice, almost no concerted effort has been made to sequentially and synergistically approach ECM modulation, clearance, or a “skin bed preparation” program that would prepare the skin (pre-conditioning) for optimizing wound healing and neocollagenesis and neoelastogenesis from resurfacing procedures or in general, in the maintenance of skin health.

Alastin Regenerating Skin Nectar™ with TriHex Technology™ utilizes an innovative peptide combination to support matrix remodeling. The formulation was specifically designed to enhance procedure outcomes by optimizing the skin both pre- and post-procedure. The stimulation of key healing and regenerative processes by ECM modulation and remodeling serves as the mechanism for “skin bed preparation” and improves skin responsiveness to treatment. Immediately post-treatment, Alastin Regenerating Skin Nectar™ strengthens the compromised tissue and minimizes post-treatment side effects. Gene expression studies on Alastin formulations have confirmed the relevant MMP, TIMP, decorin, dermatopontin, elastin, and collagen upregulation. Elastin and collagen upregulation have been confirmed histologically in the ECM following pre-conditioning with 3 weeks of topical application of the Alastin product (no procedure performed; Figure 3b). In vitro studies (cited later) have demonstrated that a period of 14-21 days is ideal for pre-conditioning and modulating the ECM. In addition, multiple clinical cases have demonstrated less downtime and excellent symptomatic relief when used in conjunction with resurfacing procedures.

Similar to how the chronic wound healing process benefits from wound bed preparation before therapeutic intervention, treatment of chronic aging of the skin may be improved with a “skin bed preparation” to optimize rejuvenation procedures and skin maintenance programs. This involves introducing agents that can combat stress-induced oxidation, proteasome dysfunction, and non-enzymatic cross linkages involved in glycation end products, to collectively modulate this damaged ECM, and upregulate neocollagenesis and elastin production. Agents of particular interest are matrikines, peptides originating from the fragmentation of matrix proteins, which exhibit a wide range of biological activities relating to matrix modulation.¹² Peptides of this type (tripeptide and hexapeptide) are incorporated in ALASTIN â„¢ Skin Nectar with TriHexâ„¢ technology (ALASTIN Skincare, Inc., Carlsbad, CA), which is designed to target ECM modulation with a goal of optimizing results following invasive and non-invasive dermal rejuvenating procedures. Additionally,