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      Drug Design, Development and Therapy (submit here)

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      A Call to Action by the Italian Mesotherapy Society on Scientific Research


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          Mesotherapy (local intradermal therapy, LIT) is a technique used to slowly spread drugs in tissues underlying the site of injection to prolong the pharmacological effect with respect to intramuscular injection. Recommendations for proper medical use of this technique have been made for pain medicine and rehabilitation, chronic venous disease, sport medicine, musculoskeletal disorders, several dermatological conditions, skin ageing, and immune-prophylaxis. Although mesotherapy is considered a valid technique, unresolved questions remain, which should be answered to standardize methodology and dosing regimen as well as to define the right indications in clinical practice. New randomized controlled trials are needed to test single products (dose, frequency of administration, efficacy and safety). Even infiltration of substances for dermo-cosmetic purposes must be guided by safety and efficacy tests before being proposed by mesotherapy. In this article, we put forth a preclinical and clinical research plan and a health technology assessment as a call to action by doctors, researchers and scientific societies to aid national health authorities in considering mesotherapy for prevention, treatment and rehabilitation paths.

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          Most cited references36

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          Fighting against Skin Aging

          As the most voluminous organ of the body that is exposed to the outer environment, the skin suffers from both intrinsic and extrinsic aging factors. Skin aging is characterized by features such as wrinkling, loss of elasticity, laxity, and rough-textured appearance. This aging process is accompanied with phenotypic changes in cutaneous cells as well as structural and functional changes in extracellular matrix components such as collagens and elastin. In this review, we summarize these changes in skin aging, research advances of the molecular mechanisms leading to these changes, and the treatment strategies aimed at preventing or reversing skin aging.
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            Specialized cutaneous Schwann cells initiate pain sensation

            An essential prerequisite for the survival of an organism is the ability to detect and respond to aversive stimuli. Current belief is that noxious stimuli directly activate nociceptive sensory nerve endings in the skin. We discovered a specialized cutaneous glial cell type with extensive processes forming a mesh-like network in the subepidermal border of the skin that conveys noxious thermal and mechanical sensitivity. We demonstrate a direct excitatory functional connection to sensory neurons and provide evidence of a previously unknown organ that has an essential physiological role in sensing noxious stimuli. Thus, these glial cells, which are intimately associated with unmyelinated nociceptive nerves, are inherently mechanosensitive and transmit nociceptive information to the nerve.
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              Intradermal, epidermal and transcutaneous vaccination: from immunology to clinical practice.

              The dermis and epidermis are alternative sites for prophylactic vaccination that have received renewed interest in recent years, not only because of the ease of access to the skin, but also its unique immunological properties. This review discusses the characteristics of the skin, current knowledge on skin immunity and clinical experience with cutaneous immunization against infectious diseases, with a special focus on intradermal immunization. The most widely accepted paradigm explaining the efficacy of cutaneous immunization is reviewed and recent research suggesting where this paradigm may need some refinement is highlighted. Clinical investigations that have concentrated on the intradermal route to vaccinate against influenza, rabies or hepatitis B support the current knowledge on skin immunity and, when combined with recent progress made in the development of user-friendly injection systems, have stimulated the ongoing clinical development of novel vaccines.

                Author and article information

                Drug Des Devel Ther
                Drug Des Devel Ther
                Drug Design, Development and Therapy
                12 July 2021
                : 15
                : 3041-3047
                [1 ]Primary Care Unit, ASL RM 1 , Rome, Italy
                [2 ]Unit of Physical Medicine and Rehabilitation, G. D’ Annunzio University of Chieti-Pescara, Department of Oral Medical Science and Biotechnology (DSMOB) , Chieti, Italy
                [3 ]“San Marco” Hospice and Palliative Care , Latina, Italy
                [4 ]Member of the Italian Society of Mesotherapy , Rome, Italy
                [5 ]Unit of Rheumatology, San Pietro Fatebenefratelli Hospital , Rome, Italy
                [6 ]Physical Medicine and Rehabilitation Unit, IRCCS, Catholic University of Sacred Heart , Rome, Italy
                [7 ]Section of Anaesthesia, Intensive Care, and Pain Medicine, University Hospital Santa Maria Della Misericordia , Perugia, Italy
                [8 ]Pain Centre “Enzo BorzomatI”, University Hospital of Rome “Policlinico Umberto I” , Rome, Italy
                [9 ]Anaesthesiology Department, University Hospital Careggi , Florence, Italy
                [10 ]Pain Therapy Unit, S. Spirito Nuovo Regina Margherita Hospital , Rome, Italy
                [11 ]Department of Clinical Science and Translational Medicine, Tor Vergata University , Rome, Italy
                [12 ]Department of Vascular Surgery, Limb Salvage and Diabetic Foot, IDI-IRCCS , Rome, Italy
                Author notes
                Correspondence: Massimo Mammucari Primary Care Unit, Local Health, ASL RM 1 , Rome, 00165, ItalyTel +39-06-61560695 Email massimo.mammucari@libero.it
                Author information
                © 2021 Mammucari et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                : 21 May 2021
                : 22 June 2021
                Page count
                Figures: 3, References: 37, Pages: 7
                Funded by: not supported with funding;
                This article was not supported with funding.

                Pharmacology & Pharmaceutical medicine
                mesotherapy,intradermal therapy,research plan
                Pharmacology & Pharmaceutical medicine
                mesotherapy, intradermal therapy, research plan


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