Percutaneous Interstitial Nd:YAG Laser Therapy For Axillary Osmidrosis And Mechanism Research

Background and Objectives:In recent years,the clinical research of percutaneous interstitial Nd:YAG laser in treating axillary osmidrosis has been increasing,and it is expected to become a safe and effective treatment.The laser-tissue interaction of percutaneous interstitial Nd:YAG laser and apocrine sweat gland only stays on the simply heating effect,further research is exetremely scarce,especially the mechanism on a cellular and molecular level.Which limit the application of this vivo implantable laser.In this study,Nd:YAG laser will be used to treat the apocrine in an in vivo pig model.The apocrine secretion function,histopathology of apocrine,AR and Apo-D level of apocrine cell will be evaluated.This technique will have a huge market prospects,considerable economic and social benefitsMethods:Three healthy adult miniature pigs were selected.Three rows were marked on the back of each pig,with 8 square areas of 2 cm x 2 cm each.Based on the results of the effects of various powers on the skin tissue of pigs in the pre-experiment,the power that caused necrosis of the skin tissue was excluded Finally,three consecutive energy mode parameters of 5W pulse,10W pulse,and 10W were selected.Skin on the back of pigs was exposed to pulsed Nd:YAG laser irradiation at 5W or 10 W,or continuous Nd:YAG laser irradiation at 10 W.Samples were taken one hour,one week,and one month after treatment for histology,Western blotting,and real-time quantitative polymerase chain reaction(qRT-PCR)analysis.It is used to analyze the effects of percutaneous interstitial Nd:YAG laser irradiation on the apocrine glands and functional protein involved in odor production(apolipoprotein[ApoD],androgen receptor[AR])in the subcutaneous tissue of a pigResults:1.Macroscopic in vivo observations:After irradiation at 10 W in pulsed mode,at one hour,there was obvious erythema,After irradiation at 10 W in continuous mode,at one hour,there were erythematous eruptions.One month after irradiation,pig skin squares were free of erythema,blisters,necrosis,and abnormal pigmentation and appeared similar to controls.2.Histology and immunohistochemical analysis:After irradiation of pig skin,there was obvious thermal damage to apocrine glands.In the 5W pulsed laser irradiation group,the apocrine sweat glands changed significantly at 1 hour after laser irradiation,and returned to normal by 1 week.The 10W laser irradiation group had a larger change,and the change in the continuous mode was more obvious,and there were significant differences compared with the control group.At the same time,it can be seen from the observation of collagen and fat that all three experimental groups have slight collagen alignment disorder and fat dissolution.With the weakening of the laser effect,it gradually recovered,and there was no significant difference compared with the control group.One hour after irradiation,the morphology of the apocrine glands had changed from a rounded to an irregular shape.One week and one month after irradiation,the apocrine glands became rounded,glandular cells were shorter,and the glandular cavity was larger.One hour,one week,and one month after irradiation at 5 W and 10 W in pulsed or continuous mode,there were no obvious changes in fat cell distribution or collagen around the apocrine glands compared to controls Immunohistochemical staining was used to detect ApoD protein in pig skin.One month after irradiation,ApoD was detected mainly in the cytoplasm of apocrine cells and the interstitial spaces of apocrine glands.Quantification of immunohistochemical staining one month after irradiation at 10 W in continuous mode showed a significant decrease in ApoD expression in apocrine glands compared to controls,and there were significant differences in ApoD expression between treatments.3.Western blotting analysis:Western Blotting analysis was used to detect ApoD and AR protein levels in pig skin.There were significant decreases in ApoD and AR protein levels compared to controls one month after irradiation at 10 W in continuous mode.There were significant differences in ApoD and AR protein levels between treatments one month after irradiation at 5 W and 10 W in pulsed or continuous mode(P<0.05).4.Real-time PCR analysis:RT-PCR of ApoD and AR expression levels in pig skin was performed to confirm the results of the Western Blotting analysis.There were significant decreases in ApoD and AR expression levels compared to controls one month after irradiation at 10 W in continuous mode.There were significant differences in ApoD and AR expression levels between treatments one month after irradiation at 5 W and 10 W in pulsed or continuous mode(P<0.04).Conclusions:In this paper,pigs are used as experimental animal models.Through a series of studies,it has been shown that percutaneous interstitial Nd:YAG laser can not only destroy the apocrine sweat glands at the cytological level through photothermal effects,but also destroy the proteins ApoD and AR.The production of the scent undermines the pathway of underarm odor at the molecular level to achieve the effect of treating axillary osmidrosis.It is a safe and effective treatment.At the same time,when the energy mode is 10W continuous,the laser affects the apocrine sweat glands and axillary odor-related proteins more severely,and the damage is more thorough.