BIOLOGICAL MECHANISMS OF POLY-L-LACTIC ACID IN COLLAGEN BIOSTIMULATION UNDER CONDITIONS OF LIPOATROPHY ASSOCIATED WITH GLP-1 AGONIST USE
DOI:
https://doi.org/10.63330/aurumpub.044-030Keywords:
Poly-L-lactic acid, Collagen biostimulation, Lipoatrophy, GLP-1, Dermal remodelingAbstract
The use of glucagon-like peptide-1 (GLP-1) agonists has become established as an effective therapeutic strategy for the treatment of type 2 diabetes mellitus and obesity, promoting significant weight loss. However, marked reductions in adipose tissue, particularly in facial regions, may cause lipoatrophy characterized by loss of volume, skin laxity, and changes in skin quality. In this context, poly-L-lactic acid (PLLA) stands out as a collagen biostimulator widely used in clinical practice to restore dermal structure and promote facial rejuvenation. This study aims to analyze the biological mechanisms involved in the action of poly-L-lactic acid in collagen biostimulation under conditions of lipoatrophy associated with the use of GLP-1 agonists. This is a narrative literature review based on Brazilian and international scientific articles addressing the interactions among biomaterials, controlled inflammatory responses, tissue remodeling, and skin aging. The findings show that PLLA acts by inducing a subclinical and transient inflammatory response, triggering the activation of macrophages and fibroblasts. This process promotes the release of cytokines and growth factors, such as TGF-β, which stimulate neocollagenesis, particularly of types I and III collagen. Myofibroblasts also participate in the reorganization of the extracellular matrix, contributing to increased dermal firmness and thickness. Under conditions of GLP-1-induced lipoatrophy, which are characterized by a reduction in adipocytes and changes in adipokine signaling, the use of PLLA promotes the structural recovery of the skin, partially compensating for volume loss through the regeneration of connective tissue. It is concluded that poly-L-lactic acid represents an effective and safe therapeutic approach to collagen biostimulation in patients with lipoatrophy associated with GLP-1 agonist use, acting through multiple biological pathways related to inflammation, regeneration, and tissue remodeling. Nevertheless, further controlled clinical studies are required to deepen the understanding of its long-term effects and optimize application protocols.
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