Re:Treatment of cellulite. 비만세포의 변형 셀룰라이트 치료법(논문 2개)

[허브향]

Part I. Pathophysiology

 <Cellulite>

⦁caused by the herniation of subcutaneous fat within fibrous connective tissue, leading to a padded or orange peel-like appearance

⦁Cellulite is different from obesity.

Obesity : hypertrophy and hyperplasia of adipose tissue that is not necessarily limited to the pelvis, thighs, or abdominal areas.

cellulite: most commonly found but not limited to the pelvis, thighs, and abdomen.

-> 덧, Obesity는 전체적인 지방세포의 비대와 과증식이라면, cellulite는 여러 다원적인 요소로 인해 subcutaneous fat이 dermis로 protrusion되는 구조적인 변화를 의미함

★ Major factors 

1. STRUCTURAL AND ARCHITECTURAL DIFFERENCES BETWEEN CELLULITE AND ‘‘NORMAL’’ FAT 

1)Connective tissue alteration ; uneven thickness of connective tissue septae,

2)Sexual dimorphic skin architecture: female-irregular and discontinuous dermosubcutaneous interface

                                                   male- smooth and continuous

2. METABOLIC AND BIOCHEMICAL FEATURES OF CELLULITE VERSUS ‘‘NORMAL’’ FAT

1) Adipose tissue in gluteofemoral versus abdominal regions

:The regulation of lipolysis by catecholamines involves AR stimulation of adenylate cyclase via b-ARs and inhibition by a-2 ARs

 The fact that the ratio of a-2 AR to b-AR is higher in the gluteal region than in abdominal adipocytes

2)Cellulite versus ‘‘normal’’ adipose tissue: White, brown, or both?

; ncoupling protein-1 (UCP-1), a protein that is unique to brown adipocytes.  mediating the basic function of brown fat cells—transfer of energy from nutrition to heat. BAT also functions as a protective factor against obesity

★ MINOR FACTORS

 1)Cellulite tissue vascularity ;

deterioration of the dermal vasculature⇨ deposition of hyperpolymerized glycosoaminoglycans (GAGs) in the dermal capillary walls⇨ excessive fluid retention ⇨ Edema ⇨ vascular compression, hypoxia, and capillary neoformation , microhemorrage ⇨

sclerosis of the fibrous septae in the superficial adipose tissue and deep dermis ⇨  cellulite

2)Cellulite and postinflammatory changes

3) Effects of body mass index on cellulite

4) Cellulite grading based on clinical severity

셀룰라이트 part 1 pathphysiology.hwp

part.2 advances and controversies

ATTENUATION OF AGGRAVATING FACTORS 

1) Weight loss

PHYSICAL, MECHANICAL, AND THERMAL METHODS

1) Endermologie

2) Liposuction

3) Subcision 

4) Phosphotidylcholine and mesotherapy

5) Bipolar and unipolar radiofrequency devices 

6)Ultrasound 

7)Lasers for fat removal: Possible role in the treatment of cellulite 

8)Pharmacologic agents

<Herbal products><Retinoic acid and its effect on cellulite adipose tissue><Peroxisome proliferator-activated receptor agonists and their effect on cellulite><Carboxy therapy>

ADVANCES AND NEWER APPROACHES IN THE TREATMENT OF CELLULITE

1)Perilipin A, estrogen-related receptorea, and PPAR-g in adipocyte regulation

2)Conversion of white adipose tissue to brown adipose tissue and vice versa

3 )Selective cryolysis

CONCLUSION

￭ if the volume of herniated adipose tissue in the hypodermis can be reduced

in a selective, predictable, controlled, and safe manner, it might clinically improve cellulite.

￭ increasing the dermal thickness can also potentially strengthen the dermohypodermal junction, thereby reducing adipose tissue herniation.

￭ Understanding the mechanisms governing the acquisition and persistence of white and brown adipocytes can have novel implications in terms of the pathophysiology and therapeutic strategies used in the future for the management of cellulite

셀룰라이트 part 2.hwp

cellulite- a review of its physiology and treatment.hwp