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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medalphabet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский алфавит</journal-title><trans-title-group xml:lang="en"><trans-title>Medical alphabet</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2078-5631</issn><issn pub-type="epub">2949-2807</issn><publisher><publisher-name>ООО «Альфмед»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.33667/2078-5631-2025-23-108-112</article-id><article-id custom-type="elpub" pub-id-type="custom">medalphabet-4670</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Статьи</subject></subj-group></article-categories><title-group><article-title>Гиалуроновая кислота в коррекции возрастных изменений кожи: оптимальные физико‑химические характеристики, модификации и персонализированные стратегии</article-title><trans-title-group xml:lang="en"><trans-title>Hyaluronic acid in the improvement of skin aging: optimal physicochemical characteristics, modifications, and personalized strategies</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0005-4494-0170</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Михайлова</surname><given-names>Н. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Mikhailova</surname><given-names>N. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Михайлова Наталья Павловна, к.м.н., старший научный сотрудник</p><p>Москва </p></bio><bio xml:lang="en"><p>Mikhailova Natalya P., PhD Med, senior researcher</p><p>Moscow</p></bio><email xlink:type="simple">mikhailova@martinex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0001-3227-4415</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Знатдинов</surname><given-names>Д. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Znatdinov</surname><given-names>D. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Знатдинов Дамир Ильдусович, научный сотрудник</p><p> Москва </p></bio><bio xml:lang="en"><p>Znatdinov Damir I., researcher </p><p>Moscow</p></bio><email xlink:type="simple">znatdinov@martinex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2559-1719</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Петрий</surname><given-names>М. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Petriy</surname><given-names>M. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Петрий Марина Александровна, к.м.н., ассистент кафедры дерматовенерологии и косметологии; врач‑дерматовенеролог, косметолог клиники «Ланцетъ‑Центр», ООО «Делайт‑Ланцет»</p><p> Москва </p></bio><bio xml:lang="en"><p>Petriy Marina A., PhD Med, assistant at Dept of Dermatovenerology and Cosmetology; dermatovenerologist, cosmetologist at Lancet-Center Clinic,Delight‑Lancet LLC </p><p>Moscow</p></bio><email xlink:type="simple">marina0301nikolaeva@gmail.com</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0009-1829-6747</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Борзова</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Borzova</surname><given-names>I. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Борзова Ирина Владимировна, к.м.н., старший научный сотрудник</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Borzova Irina V., PhD Med, senior researcher </p><p>Saint Petersburg</p></bio><email xlink:type="simple">iv.borzova06@gmail.com</email><xref ref-type="aff" rid="aff-3"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>АНО «Международный научно-исследовательский центр инновационных технологий Мартинекс»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Martinex International Research Center for Innovative Technologies</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБУ ДПО «Центральная государственная медицинская академия» Управления делами Президента Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Central State Medical Academy of the Administrative Department of the President of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>АННО ВО Научно-исследовательский центр «Санкт-Петербургский Институт биорегуляции и геронтологии»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Saint Petersburg Institute of Bioregulation and Gerontology</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>11</day><month>11</month><year>2025</year></pub-date><volume>1</volume><issue>23</issue><issue-title>Дерматология (2)</issue-title><fpage>108</fpage><lpage>112</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Михайлова Н.П., Знатдинов Д.И., Петрий М.А., Борзова И.В., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Михайлова Н.П., Знатдинов Д.И., Петрий М.А., Борзова И.В.</copyright-holder><copyright-holder xml:lang="en">Mikhailova N.P., Znatdinov D.I., Petriy M.A., Borzova I.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-alphabet.com/jour/article/view/4670">https://www.med-alphabet.com/jour/article/view/4670</self-uri><abstract><p>Гиалуроновая кислота (ГК) – ключевой биополимер в инъекционной косметологии, регулирующий процессы регенерации, воспаления и гидратации тканей. Её функциональная полиморфность, обусловленная вариабельностью молекулярной массы (ММ), пространственной организации и взаимодействий с рецепторами, определяет двойственность биологических эффектов. Такая дихотомия делает ГК центральным объектом исследований вбиомедицине и косметологии, где управление её свойствами открывает пути кперсонализированным терапевтическим стратегиям. Современная инъекционная косметология сталкивается с вызовами, связанными с ограничениями в использовании нативной гиалуроновой кислоты и традиционных филлеров на основе сшитой ГК. Быстрая биодеградация нативной ГК под действием активных форм кислорода, азота, а также гиалуронидаз дополнительно снижает долгосрочный эффект. Несмотря на способность корректировать объёмные дефекты, филлеры для контурной пластики не воздействуют на патогенетические механизмы старения, а их применение сопряжено с риском побочных реакций из‑за остаточного содержания кросс‑линкеров. Эти проблемы актуализируют поиск инновационных подходов к стабилизации полимера, контролю его ММ и интеграции биоактивных компонентов для синергии объемной коррекции и биохимического воздействия. Перспективу представляют методы твердофазной модификации ГК – механохимическое сшивание с биорегуляторами, исключающее токсичные реагенты и обеспечивающее контролируемую доставку активов. Актуальность работы обусловлена необходимостью перехода от симптоматической коррекции к патогенетически обоснованным вмешательствам в инъекционной косметологии. Несмотря на обширный спектр существующих препаратов, выбор оптимальных форм ГК часто основывается на эмпирических данных, что приводит к вариативности результатов и риску осложнений. Систематизация современных научных данных о влиянии молекулярной массы, постсинтетических модификаций и рецепторного взаимодействия ГК на эффективность процедур является ключевым шагом для перехода к патогенетически обоснованным протоколам, минимизирующим риск нежелательных явлений.</p></abstract><trans-abstract xml:lang="en"><p>Hyaluronic acid (HA) is a key biopolymer in injection cosmetology, regulating processes of tissue regeneration, inflammation, and hydration. Its functional polymorphism, determined by variability in molecular weight (MW), spatial organization, and receptor interactions, defines the duality of its biological effects. This dichotomy positions HA as a central focus of research in biomedicine and cosmetology, where controlling its properties opens pathways to personalized therapeutic strategies. Modern injection cosmetology faces challenges related to limitations in the use of native hyaluronic acid and traditional cross‑linked HA fillers. Rapid biodegradation of native HA by reactive oxygen and nitrogen species, as well as hyaluronidases, further diminishes long‑term efficacy. Despite their ability to correct volume deficits, dermal fillers do not address the pathogenetic mechanisms of aging, and their application carries risks of adverse reactions due to residual cross‑linker content. These problems highlight the need for innovative approaches to polymer stabilization, MW control, and the integration of bioactive components to synergize volumetric correction with biochemical impact. Solid‑phase modification methods for HA hold promise – specifically, mechanochemical cross‑linking with bio‑regulators, which eliminates toxic reagents and ensures controlled delivery of active agents. The relevance of this work stems from the necessity to transition from symptomatic correction to pathogenetically‑grounded interventions in injection cosmetology. Despite the broad spectrum of existing preparations, the selection of optimal HA forms is often based on empirical data, leading to variable outcomes and complication risks. Systematizing current scientific evidence on the influence of HA molecular weight, post‑synthetic modifications, and receptor interactions on procedural efficacy is a crucial step towards establishing pathogenetically‑grounded protocols that minimize the risk of complications.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>гиалуроновая кислота</kwd><kwd>инъекционная косметология</kwd><kwd>молекулярная масса</kwd><kwd>твердофазная модификация</kwd><kwd>anti‑age терапия</kwd></kwd-group><kwd-group xml:lang="en"><kwd>hyaluronic acid</kwd><kwd>injection cosmetology</kwd><kwd>molecular weight</kwd><kwd>solid‑phase modification</kwd><kwd>anti‑age therapy</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Marinho A, Nunes C, Reis S. Hyaluronic Acid: A Key Ingredient in the Therapy of Inflammation. Biomolecules. 2021 Oct 15; 11 (10): 1518. DOI: 10.3390/biom11101518. 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