A Comparative Study on Adipose-Derived Mesenchymal Stem Cells Secretome Delivery Using Microneedling and Fractional CO₂ Laser for Facial Skin Rejuvenation

Abstract

Background

The efficacy of adipose-derived mesenchymal stem cells (ADMSCs) secretome for skin aging has been established, yet no studies hitherto directly investigated the best administration method for such purpose.

Purpose

We aimed to compare microneedling (MN) versus fractional CO₂ laser (FL) as methods of delivery for ADMSCs secretome in the treatment of aging skin.

Patients and Methods

A single-blind, randomized split-face clinical trial was conducted on 30 Indonesian women (aged 35–59 years old) with signs of facial cutaneous senescence. Their initial aging status was assessed by dermoscopy photoaging scale (DPAS) and Janus-III measurement system. In the second and fourth weeks, all participants were treated with both MN and FL, followed by the application of a four-fold concentrated ADMSC secretome. The assignment of which side of the face received MN or FL was done by computer-based randomization. Skin parameters were reevaluated on the fourth and sixth weeks, along with patient satisfaction, level of comfort, preference for administration techniques, and also adverse events experienced during the study. Appropriate statistical analyses were subsequently performed at a significance level of 0.05.

Results

Significant improvements in total DPAS and wrinkles were found in the MN and FL groups at the end of the trial. In contrast, no statistical differences in all parameters were observed between groups in the fourth and sixth weeks. FL scored higher than MN for satisfaction and preference, but lower in terms of comfort. Pain, burning sensation, and itch were the side effects experienced by subjects upon treatment. Two patients had prolonged reddish skin succeeding FL treatment, which relieved with moisturizer application.

Conclusion

Both MN and FL yielded comparable results for improving several skin aging features. However, subjective preference for ADMSCs secretome administration method may differ when considering satisfaction, comfort, and possible adverse events.

Keywords:

• adipose-derived mesenchymal stem cells
• fractional CO₂ laser
• microneedling
• secretome
• skin rejuvenation

Data Sharing Statement

Due to the subjects’ data during the clinical trial are properties of Dr. Cipto Mangunkusumo Hospital health medical records and referring to the Ministry of Health Republic of Indonesia Regulation number 18 (2022) about health information system, the authors are unable to share individual participant data.

Acknowledgments

Our deepest gratitude goes to Prof. Jeanne Adiwinata Pawitan; Isabella Kurnia Liem; Ines Soepinarko Putri; and Tri Kurniawati from Stem Cell Medical Technology Integrated Service Installation - Dr. Cipto Mangunkusumo Hospital for providing the ADMSCs secretome used in this study. We also thanked Bianca Christabel Sudarma; Maria Olivia Angeline Wijanto; Syifa Larasati; and Noer Kamila for assisting with the clinical trial; Prof. Muchtarruddin Mansyur for the statistical analysis; and Stephen Akihiro Wirya for proofreading the manuscript.

Disclosure

This clinical study received a grant from the Kedaireka-Matching Fund 2022 program, which was supported by the Ministry of Education, Culture, Research, and Technology, Republic of Indonesia and PT. Kimia Farma, Tbk with contract number 271/PKS/WRIII-DISTP/UI/2022. Shannaz Nadia Yusharyahya has an intellectual property rights (Indonesia) patent pending to (on progress). Lili Legiawati has an intellectual property right (Indonesia) patent pending to (on progress). The authors report no other conflicts of interest in this work.