Vol.2, No.12, 1430-1436 (2010) Health
Copyright © 2010 SciRes. Openly accessible at http://www.scirp.org/journal/HEALTH/
Morphological substantiation of application of cellular
technologies for correction of striae
Igor Maiborodin*, Andrey Shevela, Andrey Babko, Vitaly Morozov, Vera Matveeva
Center of New Medical Technologies Institute of Chemical Biology and Fundamental Medicine, Novosibirsk, Russia;
*Corresponding Author: imai@mail.ru
Received 21 August 2010; revised 15 October 2010; accepted 19 October 2010
The possibility of the application of autologic
pluripotent cells from peripheral blood (APCPB)
for correction of striae after pregnancy was
studied. Visually first signs of improvement of
atroph ic scars can be noticed in 6-8 w eeks a fter
injection of APCPB and gradually progress
during 6 months. The atrophy of epithelium,
hyperkeratosis, sclerosis of all dermis layers
with smoothing of papillae, reduction of number
of blood vessels and skin appendages were
found before treatment by method of light mi-
croscopy. In all observations after injection of
APCPB in a connective tissue, which replaces
of dermis, an increase of number of vessels at
the expense of processes of neoangiogenesis,
leukocytic infiltration reduction, thinning and
ordering of arrangement of collagen and elastin
fibers were detected. These results give a ch a nc e
for more successful application of cosmetology
procedures for correction of these defects of
Keywords: Skin Striae after Pregnancy; Atrophy of
Epidermis; Dermal Sclerosis; Pluripotent Cells from
Peripheral Blood; Ne oangiogenesis
Striae distensae or stretch marks—linear atrophic
scars, which are localized mainly on skin of mammary
glands, stomach, hips and buttocks. At the beginning of
the development they are bright pink in color, often with
a bluish shade. This color is due to active vascular inva-
sion—a period of fresh stretch marks, which lasts for
about 6-12 months. Then there is blanch ing of tissue, the
surface becomes shin y, in texture similar to filigree (cig-
arette paper). Striae color is lighter than surrounding
normal skin because scar tissue contains very few mela-
nocytes and melanin. For the same reason, when the
surrounding skin tans, white strips remain [1-3]. From
the medical point of view these scars are completely
harmless, but they are a widespread cosmetic problem.
The treatment of this disease has been a challenge for
clinicians and experimenters for a long time [4].
The pathogenesis of striae is still not completely
known, and possibly linked to changes in structures that
are responsible for elasticity a nd con tractility of the sk in.
These structures are the components of the extracellular
matrix, including fibrillin, elastin and various collagens.
In this process the important role plays decrease of ex-
pression of genes responsible for formation of collagen,
elastin and fibronectin, which, in turn, accompanied by
metabolic imbalance of fibroblasts, in particular
—metabolism of fibrillin in these cells [5-10]. It should
be emphasized that in striae were found signs of chronic
autoimmune disorders, in particular the reaction of “graft
versus host” [11].
In the time of light microscopy study of striae histo-
pathology were obtained data that well-formed elastin
fibers dominate in fresh defects, thickened fibers domi-
nate in the older parts of lesions. Most likely, the elastin
fibers in striae were synthesized again, they gradually
were thickened and their number increased. According to
the data of scanning electron microscopy, unusually
dense and well-developed net of elastin with horizontal
packing of collagen was discovered. Apparently, the
primary target of this pathological process is exactly
elastin fibers [12-14].
According to modern representations, physiological
regeneration of tissue in adult organism and its repara-
tion in case of damage happens with direct participation
of low differentiated cells-precursors or stem cells. The
basic source of stem cells is bone marrow, which in ad-
dition to the basic functionhaemopoetic, is able to
generate precursors of cellular elements of a great num-
ber of tissues in organism.
Besides bone marrow the pluripotent cells were dis-
covered in other tissues of an adult organism—adiposal,
muscular and nerve tissue, and also in peripheral blood
I. Maiborodin et al. / Health 2 (2010) 1430-1436
Copyright © 2010 SciRes. Openly accessible at http://www.scirp.org/journal/HEALTH/
and umbilical cord/placen ta blood. Moreover, it is estab-
lished that depending on a microenvironment the stem
cells are able to get through haemopoetic/mesenchymal
barrier as possess to high plasticity concerning differen-
tiation and transdifferentiation.
2. AIM
Because of the small efficiency of widely applied
techniques of the treatment of striae has been made an
attempt to correct this pathology with use of cellular
technologies. We demonstrate the morphological de-
scription of several cases from practice.
All actions, starting from material-source for receiv-
ing of pluripotent cells before the procedure of cellular
therapy, were made with observance of existing legal
and ethical standards of Russian Federation, and also
other standard documents and recommendations con-
cerning this area of medicine. The treatment of striae on
stomach skin after pregnancy was performed only after
receiving the informed written approval from patients. In
our work only autologic cells from peripheral blood
were usedas it is more practical and safer as does not
demand of selection of matching “donor-recipient”.
Isolation of a cellular material from autologic blood
received from an elbow vein was performed on the de-
vice for cytoplasmapheresis «Haemonetics» (MCS +, the
USA). This device uses a make-and-break current prin-
ciple through centrifuging chamber which was named
“bell”. There is a division of blood into components in
dependence on weight under the influence of centrifugal
force. Using this system the device is able to isolate any
cellular components from blood at donor or medical
Each component leaving a bell passes through an opti-
cal linear sensor which allows to define optical density of
medium. That makes possible in advance to program
separation of specific components of blood, such as plas-
ma, platelet s, lym phocy t es, granul ocy t es, st em cell s , et c.
The method of flow cytometry was used for the anal-
ysis of stem cell population containing in the received
material. Samples were analyzed on flow cytofluometer
«FACSAria» using FACSDiVa (Becton Dickinson)
We used monoclonal antibodies specific to CD34,
conjugated with FITC; specific to CD38, conjugated
with Cy-Chrome (Becton Dickinson); to antigens to the
surface of human cells; isotypical controls to antibodies
of classes IgG1, IgG2a mice (Becton Dickinson), conju-
gated with FITC and PE, accordingly, under the instruc-
tion of the manufacturer.
According to the completed analysis on flow cytof-
luometer using antibodies to superficial human antigens
CD34 and CD38, the amount of CD34+ cells was 0.2%
and early precurso rs CD34+/CD38 was 0.1% out of total
population of cells. Besides, the quantity of mononuclear
cells in 1 ml was counted using trypan blue. We detected
that 1 ml of the sample, received after c yt op l as ma p h er e si s,
has contained 220 × 106 cells.
The received cellular material, containing autologic
pluripotent cells from peripheral blood (APCPB), was
entered directly after separation procedure into zones of
skin atrophy using following method:
1) Suspension of APCPB was collected into a sterile
syringe in capacity of 5.0 ml with the rubber pump. The
stroke of the syringe pump should be tight but smooth.
2) Before injection the skin was processed by a napkin
made of notwoven material wetted with 0.5% water so-
lution of chlorhexidine.
3) A needle on a syringe replaced with a needle 30G.
Injection was performed in zones of striae linearly retro-
gradually. A needle was entered on all length strictly by
cut upwards or cut downwards A needle was entered on
all length strictly by cut upward s or cut downwards. The
needle cut should not be placed sideways, that not to
injure the skin. During removal of the needle out of the
tissue the pressure upon the pump was made, for filling
skin atrophy by plasma containing autologic AHPCPB.
During procedure the needles were replaced several
times when they became blunt. Anesthesia is not neces-
sary, as the procedure is a little painful (diameter of the
needle is only 0.3 mm).
The samples of skin (epidermis and dermis) size 2 × 2
mm from the front surface of the stomach on border of
normal skin and striae after pregnancy were preserved in
a 4% paraformaldehyde on biphosphate buffer (pH 7.4)
for at least 24 hour, dehydrated in a gradien of ethanol,
lightened in xylene and embedded in histoplast. Micro-
scopic sections of 5-7 microns thick were stained with
hematoxylin and eosin, and studied under a light micro-
scope Axioimager M1 (Carl Zeiss, Germany) with a
magnification of up to 1200 times.
Patient O., 28 years old, (pregnancy was 4.5 years
ago), visually the first signs of improvement of atrophic
cicatrices appeared in 6-8 weeks after the injection of
AHPCPB. In 6 months filling striae from inside was well
visible (Figures 1-4). In the first place we noticed that
the color of striae approached the color of normal skin.
Thus “old” atrophic striae which did not acquire sun tan,
approached the color of normal skin and started to ac-
quire sun tan (Figure 2). The depth of tissue retraction
decreases. At this stage the changes of ski n were visible.
If initially skin was atrophic, thinned, at compression
easily gathers in folds and looks like wrinkled cigarette
paper (Figure 3), after 6 months it became more dense,
I. Maiborodin et al. / Health 2 (2010) 1430-1436
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Figure 1. Abdominal skin of the patient O. with numerous
linear atrophic scars before treatment.
Figure 2. Status of stretch marks in 6 months after the in-
troduction of APCPB. The color of the stretch mark is
much closer to the color of the surrounding skin, in some
areas there is pigmentation as a result of sun tan.
Figure 3. Abdominal skin with stretch marks after pregnancy
before using APCPB. Skin is atrophic, thinned, at compression
easily gathers in folds and looks like wrinkled cigarette paper.
Figure 4. 6 months after using AHPCPB the skin becomes
more dense, looks thicker, the striae become narrower.
looked thicker. Perhaps, because of the improvement of
surrounding skin the striae looked narrower (Figure 4).
In the time of histological study of striae of this pa-
tient, which was taken before the procedure of treatment
by APCPB, were noted an atrophy and thinning of epi-
thelium, hy perkerat osis, fl atteni ng of papil lae and smoothing
of papillary layer in dermis, and almost total absence of
reticular layer which was replaced with connective tissue
with a chaotic arrangement of fibers and a small amount
of blood vessels with perivascular leukocytic infiltration
with prevalence of lymphocytes and macrophages. The
type of vessels cannot always be identified due to expressed
sclerotic and inflammatory changes (Figures 5, 6).
In the study of biopsy from the edge of the defect
within 1 month after the injection of APCPB were also
found the above mentioned changes (atrophy of the epi-
thelium and hyperkeratosis, flattening and smoothing of
the dermal papillae, sclerosis of the reticular layer).
However, the severity of sclerotic changes in the dermis
was somewhat less, there was formation and order of
collagen fibers in the reticular layer, where was signifi-
cantly more blood vessels and drastically was reduced
degree of perivascular leukocyte infiltration. Also were
found young blood vessels with very thin walls, it was
not always possible to trace the endothelial line. Red
blood cells were present not only in these vessels, but
were also located around vessels (Figures 7, 8). These
newly formed blood vessels were not even remotely
similar to the granulations, an d therefore the assumption
of the induction of inflammation in tissues after APCPB
injection sh ould be rejected.
4 months after the injection of APCPB the atrophic
changes in the epidermis became more pronounced,
completely vanished skin appendages and smoothed
papillae, but one can note the appearance of melanocytes.
Signs of edema were more significant, there were cavi
I. Maiborodin et al. / Health 2 (2010) 1430-1436
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Figure 5. The results of morphological study of stretch marks
of the patient O. before treatment. Atrophy and thinning of the
epithelium, hyperkeratosis, flattening of the papillary layer in
dermis. Reticular layer is replaced by connective tissue with
randomly distributed fibers and a small amount of blood ves-
sels with perivascular leukocytic infiltration. Hematoxylin and
eosin. Magnification × 40.
Figure 6. The fragment of Figure 5. Chaotic arrangement of
fibers in the intercellular matrix of connective tissue in dermis.
In cytogram of perivascular leukocytic infiltrates the lympho-
cytes and macrophages are dominate. Magnification × 400.
ties with fluid, an expansion of the components of the
lymphatic vessels was found. Scar connective tissue in
the reticular layer of the dermis looked friable. The
number of vessels decreased slightly, but still remained
more than in initial conditions. The vessels became larg-
er and sclerosis of their walls can be noted. By that time
there were again appeared perivascular leukocytic infil-
tration with a predominance of lymphocytes. Young
vessels with thin walls were still present in the dermis
(Figur es 9, 10).
In skin biopsy of patient M., 22 years old (pregnancy
2.5 years ago), before treatment were found atrophy of
Figure 7. Biopsy from the edge of the defect within 1 month
after the injection of APCPB: atrophy of the epithelium,
hyperkeratosis, flattening of the dermal papillae, appendages of
the skin are absent. The severity of sclerotic transformation of
the reticular layer of the dermis is reduced, the fibers of inter-
cellular substance became thinner and arranged in parallel. The
number of vessels increased. Hematoxylin and eosin. Magnifi-
cation × 40.
Figure 8. The fragment of Figure 7. Drastic reduction of peri-
vascular leukocytic infiltration. In the connective tissue the
newly-formed blood vessels with thin walls are present , where
nuclei of endothelial cells are very rare. Red blood cells are
located not only in vessels but also perivascular. Magnification
× 400.
the epithelium, hyperkeratosis, and almost complete ab-
sence of all layers of the dermispapillary and reticular,
and complete absence of skin appendages: hair follicles,
sudoriferous and sebaceous glands. The dermis was re-
placed with scar connective tissue with edema and a
small amount of blood vessels, around which the perivas-
cular leukocytic infiltration with a predominance of
lymphocytes and a large number of neutrophils was
I. Maiborodin et al. / Health 2 (2010) 1430-1436
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In the study of biopsy specimen from the edge of the
Figure 9. Striae area in 4 months after injection APCPB.
Atrophic changes and hyperkeratosis of the epidermis are more
pronounced. Skin appendages vanished completely and papil-
lae are smoothed. Instead of scar connective tissue in the reti-
cular layer of the dermis there is friable connective tissue
where significant signs of edema and expansion of the compo-
nents of the lymphatic vessels are noted. The number of ves-
sels is decreased, but the vessels became larger and have scle-
rosed walls with perivascular leukocytic infiltration. Hematox-
ylin and eosin. Magnification × 40.
Figure 10. The fragment of Figure 9. The newly-formed blood
vessels with thin walls and red cells located in the connective
tissue on the place of reticular layer of dermis. In these vessels
the endothelial lining can be seen along the full length, the
remaining layers of the wall (muscle, adventitia) are absent.
Magnification × 400.
defect 6 weeks after the introduction of APCPB were
also found atrophy of the epidermis and hyperkeratosis,
but the severity of atrophy was significantly less. Also
skin appendages and all layers of the dermis were absent.
However, there was a formatting and some ordering of
collagen fibers in the connective tissue on the place of
dermis, there was significantly more vessels, reduced the
severity of edema and the degree of perivascular leuko-
cyte infiltration. In cytogram of such small infiltrates the
lymphocytes and macrophages dominated.
In 5 months after treatment, sclerosis of the dermis
was still decreased. The number of vessels decreased,
but the remaining vessels were large. Leukocytic infil-
trates around the vessels were present again and ap-
peared signs of edema.
Patient S., 30 years old (pregnancy 9 years ago): in
skin before the injection of APCPB were found hyper-
keratosis, atrophy of the papillary and reticular layers of
the dermis and smoothing, to almost complete disap-
pearance, of dermal papillae. Also hair follicles, sudori-
ferous and sebaceous glands were absent completely.
The dermis was replaced by scar connective tissue with
a chaotic arrangement of thick fibers and large cavities
with a transparent content and a small amount of blood
vessels, around which were noted perivascular edema
and leukocytic infiltration with a predominance of macro-
In the study of biopsy specimen from the edge of the
defect in 6 weeks after the injections of APCPB there
were found almost normal skin structureepidermis,
papillary and reticular layers of the dermis. In this case,
only hyperkeratosis, small lymphocytic-macrophage infil-
tration of the vascular walls, a moderate perivascular and
tissue edema attracted attention. Also the number of
small vessels increased.
Thus, all patients had similar initial state o f skin striae
after pregnancy, (of course, the severity of the skin
changes was different) and was consistent with the lite-
rature data devoted to the description of “old” striae,
which are characterized by the thinning of the connec-
tive tissue stroma, which leads to the formation of lines
of atrophied skin, and the presence of a large number of
thickened elastin fibers [5,6,8,13].
Due to thinning and sclerosis of the dermis, which
remains over a long period of time, its blood supply is
disturbed. As a result of vascular disturbance there is no
proper nutrition and oxygenation of cells. There are
formed leukocytic infiltrates for lysis of nonviable tissue.
Scar changes gradually pr ogress, and all stru ctures of the
dermis, as the result of fibroblasts functional d isturbance
[5-10,13], with time are replaced by randomly arranged
thick fibers of collagen and elastin.
After the introduction of APCPB the edema of the
dermis and atrophy of the epithelium may become stronger
or weaker. However, after the procedure, in all observa-
tions in the connective tissue on the place of dermis
there is an increase of number of vessels, thinning and
ordering of distribution of collagen and elastin fibers.
I. Maiborodin et al. / Health 2 (2010) 1430-1436
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Apparently, injected cells somehow stimulate the
growth of blood vessels, perhaps participate in this
process because of the presence of pluripotent cells
which were already stimulated to differentiate into en-
dothelial or pericytal directions. After increasing the
number of vessels, especially the “young” with thin
walls, metabolic processes in the diseased tissues are
improve. As a result of optimizing cond itions of life and
functioning of the fibroblasts and tissue leukocytes the
metabolism of extracellular matrix components of the
connective tissue of the dermis intensifies, there is a re-
juvenation of collagen and elastin fibers, which is mani-
fested in the appearance of finer structures and ordering
their location [13]. Also , wh en metabolism impro v es and
therefore the volume of nonviable tissue reduces, perivas-
cular infiltration and its activity are decreased.
It should be noted that in the remote period of up to 5
months after the introduction of APCPB the number of
vessels somewhat is decreased, but their size still re-
mains bigger than original. The processes of neoangi-
ogenesis at this time does not stop and is quite active,
evidence of that can be the presence of wide blood ves-
sels with thin walls even at this period.
As a re sult of these therapeu tic procedur es some po si-
tive aesthetic results were obtained due to the fact that
stretch marks appear not as “sunken, hollow”, become
narrower. In addition, the state of the surrounding skin
improves, it becomes denser. Making this procedure, we
did not attempt to achiev e a significant therapeutic effect,
which manifests itself in full or partial disappearance of
skin defects. Use of cellular technology improved the
microcirculation in “old” stretch marks. The scars, ex-
isting for many years, according to the morphological
pattern following the introduction of APCPB, in particu-
lar, in number and size of vessels, in appearance fibers
of extracellular matrix of the dermis, are similar to
“young” scar.
After rejuvenation of the stretch marks it is possible to
perform some cosmetic procedures (mechanical, chemi-
cal or laser microdermabrasion (grinding) of the skin),
aimed at making these scars to less visible or even com-
pletely to eliminate them, as only fresh stretch marks,
which appeared less than a year ago, can be corrected
effectively [15,16].
Despite the fact that there are possibilities to struggle
against stretch marks such as laser grinding, and peeling
with the use of corrosive acids and microdermabrasion,
as well as their combinations, the prevention of stretch
marks is difficult process, but this is more effective than
treatment of already existing stretch marks [17-19].
Thereby, in abdominal skin striae after pregnancy,
completed several years ago, were found atrophy of the
epithelium, hyperkeratosis and sclerosis of all layers of
the dermis with smoothing of papillae, the decrease of
number of blood vessels and skin appendages. After the
introduction of APCPB the first visual signs of im-
provement of appearance of atrophic scars were detected
in 6-8 weeks. In 6 months there is well visible th e filling
of scars from the inside, the color of stretch marks be-
come closer to the color of normal skin, the “old”
atrophic scars begin to get sun tan. The depth of the
sunken tissue is reduced, scar skin becomes more dense,
less thinned on appearance. According to morphological
data after the application of APCPB the edema of the
dermis and atrophy of the epithelium may become
stronger or weaker. But in all cases in the connective
tissue on the place of dermis there is increasing of num-
ber of blood vessels due to the process of neoangiogene-
sis, reducing the degree of leukocytic infiltration, thin-
ning and ordering distribution of collagen and elastin
fibers, which enables more successful application of
cosmetic procedures for the correction of skin defects.
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