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Aesthetic Medicine
Aesthetic Medicine


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The ‘Yamanaka’ Factor: creating beauty through science

Beauty and symmetry are aesthetic ambitions that are part of human nature, with optimal health often aligned with beauty

Beauty and symmetry are aesthetic ambitions that are part of human nature, with optimal health often aligned with beauty.

Beauty is also a term used by mathematicians and theoretical physicists to describe an elegant theory. Often decades or, indeed, centuries of work and complex mathematics can be simplified to an elegant equation or theory that is almost intuitively understood. A classic example of this is Einstein’s universally known E=MC squared.

In biology, we see the same developments of ‘beautiful theories’ that can break down complex formulas and theorems to essential nuggets of ‘truth’.

One of the clearest examples of this is in my beloved area of molecular biology: decades of X-ray crystallographic work and interpretation eventually led to the understanding of DNA having the elegant form of a double helix. Further work elucidated that the DNA double helix is a series of four molecules in a variety of sequential combinations, denoted as A, T, G and C.

Genes ‘within’ this structure code have a combination of three of the molecules that denote an amnio acid – chains of which are proteins – hence the term, genes code for proteins.

Of course, in reality, there is a bit more to it, but this does exemplify how, as our journey to understand evolves, we often seek to create simple or ‘beautiful’ explanations for the phenomena we observe.

Another example is more current and takes the core principles of molecular biology and advances them into the fascinating sphere of regenerative medicine.

This example is the search for the ‘factors’ that would enable pioneering molecular biologists to take a fully differentiated cell, such as a skin or muscle cell, and reverse it back to a state known as a pluripotent stem cell, whereby it can once again be encouraged to differentiate into a different cell type. This ‘passage’ of pluripotency in a human cell is referred to as an induced human pluripotent stem cell (ihPSC). Hundreds of factors were theoretically considered and practically experimented with.

Regenerative medicine combines the cutting edge of molecular biology and also the realm of nanobiology as a subspecialty, which is still in its infancy

Incredibly, by 2006, these great efforts were distilled to just four transcription factors by a scientist named Shinya Yamanaka and his team. They are therefore eponymously known as the Yamanaka Factors – such a ‘beautiful’ and ‘elegant’ summation of all that time and work.

REGENERATIVE MEDICINE

Regenerative medicine is no different from the above examples in that, over time, through deeper understanding, we seek to simplify and create beautiful elegance in our approach to regenerative medicine treatments.

Two technologies growing in popularity in recent years are platelet rich plasma (PRP) treatment and the use of growth factors.

At Daly Medical Group, we use PRP for a variety of indications including, but not limited to, managing hair loss along with our bespoke topical hair treatments, improving skin quality, especially when combined with microneedling, and improving symptoms of erectile dysfunction.In so doing, as with other colleagues in the field, we are aware of the significant number of growth factors; more than 30 are well characterised and there are many more. In fact, PRP by definition contains platelets as a main component. These contain more than 1,100 different proteins, with numerous posttranslational modifications, resulting in over 1,500 protein-based bioactive factors.

These factors include immune system messengers, growth factors, enzymes and their inhibitors, as well as other factors which can participate in tissue repair and wound healing, with local targeted release.

The second technology is the burgeoning use of specific recombinant growth factors. An example of these are those produced by regenerative growth factor company, SkinGenuity. Their products contain a clever use of carefully chosen growth factors, to be used in certain tissues and for particular indications, including hair and skin regeneration and vaginal rejuvenation.

Depending on the exact requirements for optimal repair and regeneration, my colleagues and I have considered: is one technology better than the other? And if we understood each aspect of PRP more fully, and could replicate that with recombinant growth factors, would that be the best option in the future?

These are of course questions that are being actively researched, but the full answer remains elusive. Will time provide the beauty and elegance to the theory and practical application of these two technologies, with the future perhaps involving ever more use of ‘targeted’ growth factors? For now, in my opinion, these are complementary technologies.

Fascinating new areas are emerging. An example of this are exosomes which are secreted vesicles containing protein growth factors and signalling cytokines, along with various messenger-RNAs and micro-RNAs derived from the body’s own stem cells that can be optimised and used potentially as therapeutic regenerative treatments! However, a further discussion on that will have to wait for the next article.

One final thought, regenerative medicine combines the cutting edge of molecular biology and, given the size of some biological particles that we are dealing with, also encompasses the realm of nano-biology as a subspecialty, which is still in its infancy. The future is exciting.

Dr Stuart Daly is a GP and founder and clinical director of Daly Medical Group specialising in regenerative medicine, lifestyle and AGA hair loss. Before discovering his love for medicine, he achieved a first-class honours degree from King’s College London in molecular biology. It is these combined passions that led Dr Daly into the field of regenerative aesthetic/lifestyle medicine. dalymedicalgroup.com.

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This article appears in the June 2022 Issue of Aesthetic Medicine


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COPIED
This article appears in the June 2022 Issue of Aesthetic Medicine