lipoteichoic-acid and Granuloma

Hyaluronic acid is a safe dermal filler, but sometimes late granuloma is generated. This adverse effect is an inflammatory process, and its causes are not clear. Late granuloma generation could be due to the reaction to residual components of the bacterial wall present into hyaluronic acid, such as lipoteichoic acid (LTA). Other possibility is hyaluronic acid degraded could be trigger this inflammatory reaction.. Study possible molecular mechanism that could be implicated into the late granuloma formation. We wonder whereas inflammatory response activation is triggered by lower molecular weight hyaluronic acid or Gram-positive bacterial components as LTA.. We analyzed one adverse case generated by hyaluronic acid injections. Our study with one nodule through chemical and immunofluorescence histologic technics.. In this case, observe a late granuloma without infectious process. Histological analysis shown few large Langerhans cells around fillers and multiple immunological cells infiltrated. Immunofluorescent study shown immunological cells (CD45 positives cells) with high TLR2 expression (hyaluronic acid and LTA receptor).. The difficulty of obtaining biopsy samples of nodules implies that the number of cases analyzed is very low.. New model is proposed in which weight of hyaluronic acid and LTA could be able to trigger inflammation. This process could be mediated by TLR2 expressed in infiltrated immune cells.

Topics: Dermal Fillers; Granuloma; Humans; Hyaluronic Acid; Inflammation; Molecular Weight; Toll-Like Receptor 2

Gram-positive bacterial DNA is frequently detectable in gallbladder bile of primary biliary cirrhosis (PBC) patients. To advance these findings, lipoteichoic acid (LTA) of gram-positive bacteria with high antigenicity was examined in liver specimens and bile from PBC patients and controls.. LTA was examined by Western blotting in the gallbladder bile from 15 PBC, 11 cholecystolithiasis and six normal subjects, and by immunohistochemistry in liver specimens from 16 PBC, six primary sclerosing cholangitis (PSC), eight chronic viral hepatitis C (CVH-C) and five normal subjects.. In the gallbladder bile, there was no significant difference in the positive rate of LTA between PBC and controls. LTA-containing mononuclear cells were frequently detected in the portal tracts, particularly around the bile ducts and in hepatic sinusoids in PBC, while they were infrequent or occasional in control livers. These LTA-containing cells were sinusoidal endothelial cells and Kupffer cells, and portal monocytes, which frequently expressed scavenger receptor class B type 1.. LTA derived from bacterial fragments may reach the bile, not only in the diseased state but also under normal conditions. Such LTA may be involved in the development and progression of portal tract lesions, particularly bile duct lesions, in PBC.

Topics: Adult; Aged; Bile; Bile Ducts, Intrahepatic; Case-Control Studies; CD36 Antigens; Female; Gram-Positive Bacteria; Granuloma; Humans; Immunohistochemistry; Lipopolysaccharides; Liver; Liver Cirrhosis, Biliary; Male; Membrane Proteins; Microscopy, Immunoelectron; Middle Aged; Receptors, Immunologic; Receptors, Lipoprotein; Receptors, Scavenger; Scavenger Receptors, Class B; Teichoic Acids