Vulva-vaginal atrophy (VVA) ndeimwe yemigumisiro yakajairika yekushaikwa kweesrogen, kunyanya mushure mekuenda kumwedzi.Ongororo dzinoverengeka dzakaongorora mhedzisiro yehyaluronic acid (HA) pazviratidzo zvemuviri nezvepabonde zvine chekuita neVVA uye vakawana mhedzisiro inovimbisa.Nekudaro, mazhinji ezvidzidzo izvi akatarisa pane subjective ongororo yechiratidzo mhinduro kune topical formulations.Zvakadaro, HA imorekuru rinogara, uye zvine musoro kuti rinoshanda zvakanyanya kana rakabayiwa mukati meiyo epithelium yepamusoro.Desirial® ndiyo yekutanga-yakabatana hyaluronic acid inopihwa kuburikidza nekuvharirwa mucosal jekiseni.Chinangwa chechidzidzo ichi chaive chekuongorora maitiro emajekiseni akawanda emukati memukati memukati memuchinjiro wakanangana nehyaluronic acid (DESIRIAL®, Laboratoires VIVACY) pane akati wandei makiriniki uye akashumwa nemurwere.
Cohort two-center pilot study.Mhedzisiro yakasarudzwa yaisanganisira kushanduka kwevaginal mucosal thickness, collagen formation biomarkers, vaginal flora, vaginal pH, vaginal health index, zviratidzo zvevulvovaginal atrophy uye kuita zvepabonde mavhiki masere mushure mejojo yeDesirial®.Mhedziso yemurwere yakazara yekuvandudza (PGI-I) chiyero chakashandiswawo kuongorora kugutsikana kwemurwere.
Vese vevatori vechikamu makumi maviri vakatorwa kubva 19/06/2017 kusvika 05/07/2018.Pakupera kwechidzidzo, pakanga pasina mutsauko mune yepakati yakazara yevaginal mucosa ukobvu kana procollagen I, III, kana Ki67 fluorescence.Nekudaro, COL1A1 uye COL3A1 gene kutaura kwakawedzera zvakanyanya (p = 0.0002 uye p = 0.0010, zvichiteerana).Iyo yakashumwa dyspareunia, kuoma kwechikadzi, kukwenya kwenhengo yesikarudzi, uye mabrasions emukadzi zvakaderedzwawo zvakanyanya, uye ese echikadzi basa rekuita index zviyero zvakavandudzwa zvakanyanya.Kubva paPGI-I, varwere ve19 (95%) vakashuma maitiro akasiyana-siyana ekuvandudza, iyo 4 (20%) yakanzwa zvishoma zviri nani;7 (35%) yaive nani, uye 8 (40%) yaive nani.
Multi-point intravaginal injection yeDesirial® (a cross-linked HA) yakanyatsobatanidzwa nekutaura kweCoL1A1 uye CoL3A1, zvichiratidza kuti kuumbwa kwecollagen kwakakurudzirwa.Mukuwedzera, zviratidzo zveVVA zvakaderedzwa zvakanyanya, uye kugutsikana kwevarwere uye nhamba dzekuita zvepabonde dzakavandudzwa zvakanyanya.Zvisinei, kuwanda kwese kwemukati wevaginal mucosa hakuna kuchinja zvakanyanya.
Vulva-vaginal atrophy (VVA) ndeimwe yemigumisiro yakajairika yekushayikwa kweesrogen, kunyanya mushure mekuenda kumwedzi [1,2,3,4].Makiriniki akawanda syndromes anobatanidzwa neVVA, kusanganisira kuoma, kutsamwa, kuputika, dyspareunia, uye zvirwere zvinowanzoitika zvehutachiwana, izvo zvinogona kuva nemigumisiro yakaipa pahutano hwevakadzi [5].Zvisinei, kutanga kwezviratidzo izvi kungava kusinganzwisisike uye zvishoma nezvishoma, uye kwotanga kuoneka pashure pokunge zvimwe zviratidzo zvekuenda kumwedzi zvapera.Maererano nemishumo, kusvika ku55%, 41%, uye 15% yevakadzi postmenopausal vanotambura nekuoma kwechikadzi, dyspareunia, uye kudzokorora urinary tract infections, maererano [6,7,8,9].Zvakangodaro, vamwe vanhu vanotenda kuti kupararira chaiko kwematambudziko aya kwakakwira, asi vakadzi vazhinji havatsvage rubatsiro rwekurapa nekuda kwezviratidzo [6].
Chinhu chikuru cheVVA manejimendi kurapwa kwechiratidzo, kusanganisira shanduko yemararamiro, asiri mahomoni (akadai semafuta ekuzora kana moisturizer uye laser kurapwa) uye zvirongwa zvekurapa mahormone.Vaginal lubricant inonyanya kushandiswa kubvisa kuoma kwemukadzi panguva yepabonde, saka havagone kupa mhinduro inoshanda kune kusagara uye kuoma kwezviratidzo zveVVA.Pane zvinopesana, zvinonzi moisturizer yevaginal imhando ye "bioadhesive" chigadzirwa chinogona kukurudzira kuchengetwa kwemvura, uye kushandiswa nguva dzose kunogona kuvandudza kutsamwa kwemukadzi uye dyspareunia [10].Zvakadaro, izvi hazvinei nechokuita nekuvandudzwa kweiyo yakazara vaginal epithelial maturity index [11].Mumakore achangopfuura, pane zvirevo zvakawanda zvekushandisa radiofrequency uye laser kurapa vaginal menopausal zviratidzo [12,13,14,15].Zvakadaro, iyo FDA yakapa yambiro kuvarwere, ichisimbisa kuti kushandiswa kwemaitiro akadaro kunogona kutungamirira kuzviitiko zvakakomba, uye haisati yaona kuchengetedzwa uye kushanda kwemidziyo ine simba mukurapa zvirwere izvi [16].Uchapupu hunobva kumeta-analysis yezvidzidzo zvakati wandei zvinotsigira kushanda kwemusoro uye systemic hormone therapy mukuderedza zviratidzo zvine chekuita neVVA [17,18,19].Zvisinei, nhamba shoma yezvidzidzo yakaongorora mhedzisiro yekurapa kwakadaro mushure memwedzi mitanhatu yekurapa.Uye zvakare, kupesana kwavo uye kusarudzwa kwavo ndekwezvinomisa zvinhu zvekupararira uye kwenguva refu kushandiswa kweiyi nzira dzekurapa.Naizvozvo, pachine kudikanwa kwemhinduro yakachengeteka uye inoshanda yekugadzirisa zviratidzo zvine chekuita neVVA.
Hyaluronic acid (HA) imorekuru rakakosha reextracellular matrix, rinowanikwa mumatishu akasiyana siyana anosanganisira vaginal mucosa.Iyo polysaccharide kubva kumhuri yeglycosaminoglycan, iyo inobata basa rakakosha pakuchengetedza chiyero chemvura nekugadzirisa kuzvimba, kupindurwa kwekudzivirira, mavanga uye angiogenesis [20, 21].Synthetic HA gadziriro inopiwa muchimiro chetopical gels uye ine chimiro che "medical devices".Tsvakurudzo dzinoverengeka dzakaongorora kukanganisa kweHA pane zviratidzo zvemuviri uye zvepabonde zvine chokuita neVVA uye zvakawana migumisiro inovimbisa [22,23,24,25].Nekudaro, mazhinji ezvidzidzo izvi akatarisa pane subjective ongororo yechiratidzo mhinduro kune topical formulations.Zvakadaro, HA imorekuru rinogara, uye zvine musoro kuti rinoshanda zvakanyanya kana rakabayiwa mukati meiyo epithelium yepamusoro.Desirial® ndiyo yekutanga-yakabatana hyaluronic acid inopihwa kuburikidza nekuvharirwa mucosal jekiseni.
Chinangwa cheiyi inotarisirwa kuita maviri-center pilot kudzidza ndeyekuongorora maitiro e-multi-point intravaginal intramucosal majekiseni eiyo chaiyo-yakabatana hyaluronic acid (DESIRIAL®, Laboratoires VIVACY) pamhedzisiro yemhedzisiro yemishumo yekiriniki neyemurwere, uye kuongorora. kugona kwe evaluation yekuongorora Bonde izvi zvabuda.Mhedzisiro yakazara yakasarudzwa pachidzidzo ichi yaisanganisira shanduko muhutemu hwemukati memukadzi, biomarkers yekuvandudzwa kwematishu, flora yemukadzi, vaginal pH uye indekisi yehutano hwemukadzi mavhiki masere mushure mejekiseni reDesirial®.Takayera migumisiro yakataurwa nevarwere vanoverengeka, kusanganisira kuchinja kwekuita zvepabonde uye chiyero chekuzivisa kwezviratidzo zvine chokuita neVVA panguva imwe chete nenguva.Pakupera kwechidzidzo, chirwere chemurwere chese chekuvandudza (PGI-I) chikamu chakashandiswa kuongorora kugutsikana kwevarwere.
Huwandu hwekudzidza hwaive nevakadzi vepashure (makore maviri kusvika gumi mushure mekuenda kumwedzi) avo vakaendeswa kukiriniki yekuenda kumwedzi vaine zviratidzo zvekusagadzikana kwemukadzi uye / kana dyspareunia yechipiri kusvika pakuoma kwemukadzi.Vakadzi vanofanira kunge vari ≥ makore 18 uye <70 makore uye vane BMI <35.Vatori vechikamu vakabva kune imwe yezvikamu zve2 (Centre Hospitaler Régional Universitaire, Nîmes (CHRU), France neKaris Medical Center (KMC), Perpignan, France).Vakadzi vanoonekwa sevanokodzera kana vari chikamu chechirongwa cheinishuwarenzi yehutano kana kubatsirwa kubva kuhurongwa hweinishuwarenzi yehutano, uye vanoziva kuti vanogona kutora chikamu mu8-vhiki yakarongwa yekutevera nguva.Vakadzi vaipinda mune zvimwe zvidzidzo panguva iyoyo vakanga vasingakodzeri kutorwa.≥ Stage 2 apical pelvic organ prolapse, stress urinary incontinence, vaginismus, vulvovaginal kana urinary tract infection, hemorrhagic or neoplastic genital maronda, mamota anoenderana nehomoni, kubuda ropa kunhengo yesikarudzi yezvisingazivikanwe etiology, porphyria inodzokororwa, isingadzoreki pfari, angina pectoris conductor , rheumatic fever, kuvhiyiwa kwevulvovaginal kana urogynecological yapfuura, hemostatic disorders, uye katsika kekuumba mavanga ehypertrophic zvaionekwa senzira yokusabatanidzwa.Vakadzi vanotora antihypertensive, steroidal uye isiri-steroidal anti-inflammatory drugs, anticoagulants, maantidepressants makuru kana aspirin, uye inozivikanwa yeanesthetics yemuno yakabatana neHA, mannitol, betadine, lidocaine, amide kana Vakadzi vasingawirirani kune chero cheanobatsira mumushonga uyu. vanoonekwa sevasingakodzeri kuita chidzidzo ichi.
Pakutanga, vakadzi vakakumbirwa kuti vapedze iyo Female Sexual Function Index (FSFI) [26] uye shandisa 0-10 yekuona analog scale (VAS) kuunganidza ruzivo rwakabatana neVA zviratidzo (dyspareunia, kuoma kwevaginal, vaginal abrasions, uye kubatwa kwepabonde. ) ruzivo.Kuongorora kusati kwapindira kwaisanganisira kutarisa pH yemukadzi, uchishandisa Bachmann Vaginal Health Index (VHI) [27] yekuongorora kliniki yemukadzi, Pap smear yekuongorora maruva emudzimai, uye mucosal biopsy.Eresa iyo vaginal pH padhuze neyakarongwa jekiseni saiti uye mumukadzi fornix.Kune maruva emukadzi, Nugent mamakisi [28, 29] inopa chishandiso kuyera iyo yevaginal ecosystem, uko 0-3, 4-6 uye 7-10 mapoinzi anomiririra yakajairika flora, yepakati flora uye vaginosis, zvichiteerana.Kuongororwa kwese kwemaruva emukadzi kunoitwa muBacteriology Dhipatimendi reCHRU muNimes.Shandisa maitiro akajairwa evaginal mucosal biopsy.Ita 6-8 mm punch biopsy kubva munzvimbo yeakarongwa jekiseni saiti.Zvinoenderana neukobvu hweiyo basal layer, iyo yepakati layer uye yekumusoro layer, mucosal biopsy yakaongororwa histologically.Biopsy inoshandiswawo kuyera COL1A1 uye COL3A1 mRNA, ichishandisa RT-PCR uye procollagen I uye III immunotissue fluorescence seyakatsiva yekutaura kwecollagen, uye fluorescence yemucherechedzo wekuwedzera Ki67 seyakatsiva mucosal mitotic chiitiko.Kuongororwa kweGenetic kunoitwa neBioAlternatives laboratory, 1bis rue des Plantes, 86160 GENCAY, France (chibvumirano chiripo pakukumbira).
Kana imwe yekutanga sampuli uye zviyero zvapedzwa, muchinjiko-yakabatanidzwa HA (Desirial®) inobaiwa neimwe ye2 yakadzidziswa nyanzvi maererano neyakajairwa protocol.Desirial® [NaHa (sodium hyaluronate) cross-linked IPN-Senge 19 mg/g + mannitol (antioxidant)] ijekiseni HA gel risiri remhuka, rinoshandiswa kamwe chete uye rakaputirwa muSirinji yakagara yaiswa (2 × 1 ml. )Ichi chishandiso chekurapa cheKirasi III (CE 0499), chinoshandiswa mujekiseni remukati mevakadzi, rinoshandiswa kuita biostimulation uye kudzoreredza mvura kwemucosal pamusoro penhengo yesikarudzi (Laboratoires Vivacy, 252 rue Douglas Engelbart-Archamps Technopole, 74160 Archamps, France).Anenge majekiseni gumi, rimwe nerimwe 70-100 µl (0.5-1 ml yese), anoitwa pamitsetse 3-4 yakachinjika munzvimbo yetriangular yemashure emadziro echikadzi, hwaro hwaro huri pamwero weiyo posterior vaginal. madziro, uye apex pa2 cm kumusoro (mufananidzo 1).
Kupera-kwe-chidzidzo kuongororwa kwakarongerwa mavhiki masere mushure mekunyoresa.Evaluation parameters yevakadzi yakafanana neiyo yekutanga.Mukuwedzera, varwere vanodiwawo kuti vapedze iyo Overall Improving Impression (PGI-I) Satisfaction Scale [30].
Tichifunga nezvekushaikwa kwedata rekutanga uye chimiro chemutyairi wetsvagiridzo, hazvigoneke kuitisa yepamutemo yekutanga saizi saizi kuverenga.Nokudaro, chiyero chakanaka chemuenzaniso wehuwandu hwevarwere ve20 yakasarudzwa zvichienderana nekwanisi yezvikamu zviviri zvinotora chikamu uye yakanga yakakwana kuti iwane kuenzanisa kunonzwisisika kwemaitiro akarongwa emigumisiro.Kuongorora kwenhamba kwakaitwa pachishandiswa SAS software (9.4; SAS Inc., Cary NC), uye kukosha kwakaiswa pa5%.Iyo Wilcoxon yakasaina chinzvimbo bvunzo yakashandiswa kune zvinoramba zvichiitika uye bvunzo yeMcNemar yakashandiswa kumhando dzakasiyana siyana kuyedza shanduko pamavhiki masere.
Tsvagiridzo iyi yakabvumidzwa neComité d'ethique du CHU Carémeau de Nimes (ID-RCB: 2016-A00124-47, protocol code: LOCAL/2016/PM-001).Vese vatori vechikamu muchidzidzo vakasaina fomu remvumo rakanyorwa rinoshanda.Pakushanya kwe2 kudzidza uye 2 biopsies, varwere vanogona kuwana muripo unosvika mazana maviri emaEuro.
Huwandu hwevatori vechikamu makumi maviri vakatorwa kubva 19/06/2017 kusvika 05/07/2018 (varwere vasere kubva kuCHRU uye gumi nevaviri kubva kuKMC).Hapana chibvumirano chinotyora a priori inclusion/exclusion criteria.Majekiseni ese aive akachengeteka uye akanzwika uye akapedzwa mukati memaminitsi makumi maviri.Mamiriro evanhu uye ekutanga evakapinda muchidzidzo anoratidzwa muTable 1. Pakutanga, 12 kubva pavakadzi makumi maviri (60%) vakashandisa marapirwo ezviratidzo zvavo (6 hormonal uye 6 non-hormonal), nepo pavhiki 8 chete varwere 2. (10%) vakanga vachiri kubatwa seizvi (p = 0.002).
Migumisiro yemigumisiro yemigumisiro yekliniki uye yemurwere inoratidzwa muTable 2 uye Tafura 3. Mumwe murwere akaramba W8 vaginal biopsy;mumwe murwere akaramba W8 vaginal biopsy.Naizvozvo, vatori vechikamu 19/20 vanogona kuwana yakazara histological uye genetic analysis data.Kuenzaniswa neD0, pakanga pasina misiyano muhupamhi hwepakati hwepakati yevaginal mucosa pavhiki 8. Zvisinei, iyo yepakati basal layer thickness yakawedzera kubva ku70.28 kusvika ku83.25 microns, asi kuwedzera uku kwakanga kusingaverengeki (p = 0.8596).Pakanga pasina misiyano yenhamba mu fluorescence yeprocollagen I, III kana Ki67 isati yatanga uye mushure mekurapa.Zvakadaro, COL1A1 uye COL3A1 gene kutaura kwakawedzera zvakanyanya (p = 0.0002 uye p = 0.0010, zvichiteerana).Pakanga pasina shanduko yakakosha yenhamba, asi yakabatsira kuvandudza maitiro emaruva emukadzi mushure mejekiseni reDesirial® (n = 11, p = 0.1250).Saizvozvowo, pedyo nenzvimbo yejekiseni (n = 17) uye yevaginal fornix (n = 19), iyo yevaginal pH kukosha yaidawo kuderera, asi kusiyana uku kwakanga kusiri kwenhamba (p = p = 0.0574 uye 0.0955) (Tafura 2) .
Vese vatori vechikamu muchidzidzo vanogona kuwana mhinduro dzakashumwa nemurwere.Maererano nePGI-I, mumwe mubatanidzwa (5%) akashuma pasina kuchinja mushure mejojo, asi varwere vakasara ve19 (95%) vakashuma maitiro akasiyana-siyana ekuvandudza, ayo 4 (20%) akanzwa zvishoma zviri nani;7 (35%) iri nani, 8 (40%) iri nani.Iyo inonzi dyspareunia, kuoma kwechikadzi, kukwenya kwenhengo, mabrasions, uye FSFI yakazara zvibodzwa pamwe nechishuwo chavo, lubrication, kugutsikana, uye marwadzo zviyero zvakaderedzwawo zvakanyanya (Tafura 3).
Pfungwa inotsigira chidzidzo ichi ndeyokuti majekiseni akawanda eDesirial® pamadziro emashure emukadzi anokobvura mucosa yemukadzi, yepasi yepH yemukadzi, inovandudza maruva emudzimai, inokonzera collagen kuumbwa uye kunatsiridza zviratidzo zveVA.Takakwanisa kuratidza kuti varwere vose vakashuma kuvandudzwa kwakakosha, kusanganisira dyspareunia, kuoma kwechikadzi, mabrasions, uye kuputika kwepabonde.VHI neFSFI zvakagadziridzwawo zvakanyanya, uye nhamba yevakadzi vanoda mamwe marapirwo ekudzora zviratidzo zvavo yakaderedzwawo zvakanyanya.Zvisineyi, zvinokwanisika kuunganidza ruzivo nezvese zvabuda zvakatarwa pakutanga uye kukwanisa kupa mapindiro kune vese vakapinda muchidzidzo.Pamusoro pezvo, 75% yevatori vechikamu mukudzidza vakashuma kuti zviratidzo zvavo zvakavandudzwa kana kuti zvaive nani pakupera kwechidzidzo.
Zvisinei, pasinei nekuwedzera kuduku kwehuwandu hwehuwandu hwebasal layer, isu hatina kukwanisa kuratidza kukosha kwehuwandu hwehuputi hwemukati.Kunyange zvazvo chidzidzo chedu chisina kukwanisa kuongorora kushanda kweDesirial® mukuvandudza mucosal mucosal thickness, tinotenda kuti zvigumisiro zvakakosha nokuti kutaura kweCoL1A1 uye CoL3A1 zviratidzo zvakawedzera zvakanyanya muW8 zvichienzaniswa neD0.Zvinoreva collagen kukurudzira.Nekudaro, pane dzimwe nyaya dzekufunga usati wafunga kushandiswa kwayo mukutsvaga kweramangwana.Chekutanga, inguva ye8-vhiki yekutevera ipfupi kwazvo kuratidza kuvandudzwa kwehupamhi hwemucosal?Kana nguva yekutevera yakareba, shanduko dzakaonekwa munheyo yepasi inogona kunge yakaitwa mune mamwe mapeji.Chechipiri, iyo histological ukobvu hwemucosal layer inoratidza kuvandudzwa kwetishu?Iyo histological evaluation yevaginal mucosal ukobvu haingofungidzire basal layer, iyo inosanganisira iyo yakagadziridzwa tishu inosangana neiyo iri pasi inobatanidza tishu.
Isu tinonzwisisa kuti nhamba diki yevatori vechikamu uye kushaikwa kweiyo priori yakarongeka saizi ndiyo mipimo yetsvakiridzo yedu;zvisinei, ese ari maviri maitiro akajairwa echidzidzo chekuyedza.Nechikonzero ichi tinodzivisa kuwedzera zvatinenge tawana kuzvirevo zvehutano hwekiriniki kana kusashanda.Nekudaro, imwe yemabhenefiti makuru ebasa redu nderekuti inotibvumidza kuburitsa data kune akati wandei mhedzisiro, izvo zvichatibatsira kuverengera yakamisikidzwa saizi saizi yeramangwana deterministic research.Uye zvakare, mutyairi wendege anotitendera kuti tiedze hurongwa hwedu hwekutora, churn rate, kugona kwekuunganidza sampuli uye kuongororwa kwemhedzisiro, iyo ichapa ruzivo kune chero rimwe basa rine hukama.Chekupedzisira, nhevedzano yemhedzisiro yatakaongorora, kusanganisira chinangwa chekiriniki mhedzisiro, biomarkers, uye murwere-zvakashumwa zvawanikwa zvakaongororwa pachishandiswa matanho akasimbiswa, ndiwo masimba makuru ekutsvagisa kwedu.
Desirial® ndiyo yekutanga-yakabatana hyaluronic acid inopihwa kuburikidza nekuvharirwa mucosal jekiseni.Kuti uunze chigadzirwa kuburikidza neiyi nzira, chigadzirwa chinofanirwa kunge chine fluidity yakakwana kuitira kuti chigone kubaiwa zviri nyore mune yakasarudzika dense yekubatanidza tishu ichichengetedza hygroscopicity yayo.Izvi zvinowanikwa nekugadzirisa saizi yemamorekuru egel uye chiyero cheiyo gel-cross-linking kuti ive nechokwadi chepamusoro gel concentration uchichengetedza yakaderera viscosity uye elasticity.
Tsvakurudzo dzinoverengeka dzakaongorora migumisiro inobatsira yeHA, yakawanda iyo isiri pasi peRCTs, kuenzanisa HA nemamwe maitiro ekurapa (kunyanya mahomoni) [22,23,24,25].Iyo HA mune zvidzidzo izvi yaiitwa munharaunda.HA imokurukuru inogadzika inoratidzirwa nekugona kwayo kwakakosha kugadzirisa nekutakura mvura.Nezera, chiyero che endogenous hyaluronic acid mu mucosa yevaginal inoderera zvakanyanya, uye ukobvu hwayo uye vascularization inodererawo, nokudaro kuderedza plasma exudation uye lubrication.Muchidzidzo ichi, takaratidza kuti jekiseni reDesirial® rinosanganiswa nekuvandudzwa kukuru mune zvese zvine chekuita neVVA zviratidzo.Izvi zvakawanikwa zvinopindirana neongororo yapfuura yakaitwa naBerni et al.Sechikamu cheDesirial® regulatory mvumo (isina kuziviswa-yekuwedzera ruzivo) (Yakawedzera Faira 1).Kunyange zvazvo kungofungidzira chete, zvinonzwisisika kuti kuvandudzwa uku kuri kwechipiri kune mukana wekudzorera kuendeswa kweplasma kune vaginal epithelial surface.
Muchinjikwa-yakabatana HA gel yakaratidzwawo kuwedzera kuumbwa kwerudzi rweI collagen uye elastin, nokudaro ichiwedzera kuwanda kwematishu akapoteredza [31, 32].Muchidzidzo chedu, hatina kuratidza kuti fluorescence yeprocollagen I uye III yakasiyana zvikuru mushure mekurapa.Zvakadaro, COL1A1 uye COL3A1 gene kutaura kwakawedzera zvakanyanya.Nokudaro, Desirial® inogona kuva nemigumisiro inokurudzira pakuumbwa kwe collagen mumudzimai, asi zvidzidzo zvakakura nekutevera kwenguva refu zvinodiwa kuti zvisimbise kana kuramba izvi zvingaitika.
Ichi chidzidzo chinopa dhata yekutanga uye saizi inogona kuitika kune akati wandei mhedzisiro, izvo zvichabatsira mune ramangwana sampuli saizi kuverenga.Pamusoro pezvo, chidzidzo ichi chakaratidza kugona kwekuunganidza mhedzisiro dzakasiyana.Nekudaro, inoburitsawo nyaya dzakati wandei dzinoda kunyatsotariswa pakuronga tsvakiridzo yeramangwana munzvimbo iyi.Kunyange zvazvo Desirial® ichiita seinovandudza zviratidzo zveVVA uye basa repabonde, maitiro ayo ekuita haana kujeka.Sezvingaonekwa kubva mukutaura kwakakosha kweCoL1A1 uye CoL3A1, zvinoita sekunge kune humbowo hwekutanga hwekuti inokurudzira kuumbwa kwecollagen.Zvakangodaro, procollagen 1, procollagen 3 uye Ki67 haina kuita zvakafanana.Naizvozvo, ekuwedzera histological uye biological mamaki anofanirwa kuongororwa mukutsvaga kweramangwana.
Multi-point intravaginal injection yeDesirial® (a cross-linked HA) yakanyatsobatanidzwa nekutaura kweCoL1A1 uye CoL3A1, zvichiratidza kuti inokurudzira kuumbwa kwecollagen, inoderedza zvakanyanya zviratidzo zveVVA, uye inoshandisa dzimwe nzira dzokurapa.Mukuwedzera, zvichibva paPGI-I uye FSFI zvibodzwa, kugutsikana kwevarwere uye kuita zvepabonde kwakavandudzwa zvikuru.Zvisinei, kuwanda kwese kwemukati wevaginal mucosa hakuna kuchinja zvakanyanya.
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Nguva yekutumira: Oct-26-2021