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NCT Number: NCT07637188

PLLA-LASYNPRO™ Injections for Skin Laxity Treatment

This single-center, open-label, intra-subject controlled proof-of-concept clinical study will evaluate the histological and clinical effects of Poly-L-lactic Acid (PLLA) LASYNPRO™ (Juläine) injections for treatment of skin laxity in patients requiring post-bariatric surgery. Fifteen participants will be enrolled. Each participant will serve as his or her own control, with one thigh treated with PLLA LASYNPRO™ and the contralateral thigh left untreated.

Participants will receive 3 injections in the treated thigh over approximately 3 months, followed by planned post-bariatric plastic surgery at 3, 6, or 9 months after the last injection, depending on assigned group. During surgery, tissue samples from treated and untreated areas will be collected for histological evaluation. A follow-up visit will occur approximately 30 days after surgery.

The primary endpoint is comparison of collagen type I and collagen type III between treated and untreated areas. Secondary endpoints include histological comparison of elastic fibers, stromal cell populations, inflammatory biomarkers, cell proliferation markers, and assessment of stretch marks, as well as safety. An exploratory endpoint is assessment of post-operative scar healing.

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Key information

Conditions

Skin Laxity Congenital, Hereditary, and Neonatal Diseases and Abnormalities Connective Tissue Diseases Cutis Laxa Genetic Diseases, Inborn Skin Diseases Skin Diseases, Genetic Skin and Connective Tissue Diseases

Age range

18 year–60 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Azienda Ospedaliero Universitaria Senese

Siena, Italy

Location status: Recruiting

Location contact

R.Cuomo

CONTACT

[email protected]

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Male or female aged ≤ 60 years
  • Previous bariatric surgery (one anastomosis gastric bypass)
  • Stable weight for at least 6 months prior to baseline
  • Post-weight loss skin laxity and ptosis requiring surgery
  • ΔBMI ≥ 7 defined as the change in BMI from scheduled bariatric surgery to baseline
  • BMI ≤ 30
  • Pittsburgh scale rating ≥10
  • Ability to give written informed consent
  • Willing to participate in the study and attending the visits

Exclusion criteria

  • Skin infection or skin inflammation status
  • Acute or chronic skin disease
  • ΔBMI < 7 defined as the change in BMI from scheduled bariatric surgery to baseline
  • BMI > 30
  • Male or female aged 60 > years
  • Pregnancy and lactating; if a female is of childbearing potential, she should have a negative pregnancy test and should use a highly effective method to avoid pregnancy for the duration of the trial
  • Any clinically significant findings, as determined by the investigator, from laboratory tests and individual patient's medical history, that may contraindicate post-bariatric surgery for the patient
  • History of allergies to any of the constituents of the product
  • Haemorrhagic disease or under anticoagulant therapy
  • Have a known history of or susceptibility to keloid formation or hypertrophic scarring
  • Immune deficiencies

Treatment and study plan

PLLA Injection

Device

Three injections

Primary outcomes

  1. The primary objective of the study is to evaluate the histological effects of PLLA LASYNPRO™ JULÄINE injections in the cutaneous tissue of patients requiring post-bariatric surgery for skin laxity.

    Time frame: Group 1 (6 months from baseline visit), Group 2 (9 months from baseline visit), Group 3 (12 months from baseline visit)

    Comparison of collagen type I and type III between treated and not treated areas

Secondary outcomes

  1. Density of elastic fibres in JULÄINE treated vs non-treated areas

    Time frame: Group 1 ( 6 months from baseline), Group 2 (9 months from baseline), Group 3 (12 months from baseline)

    Histological evaluation and comparison between JULÄINE treated and non-treated areas of: Density of elastic fibres (Massons's trichrome staining and Van Gieson staining for elastic fibres).

    Unit of Measure: % stained Area

  2. Percentage of fragmented elastic fibres (elastolysis) in JULÄINE treated vs non-treated areas

    Time frame: Group 1 ( 6 months from baseline), Group 2 (9 months from baseline), Group 3 (12 months from baseline)

    Histological evaluation and comparison between JULÄINE treated and non-treated areas of:

    -Presence and percentage of fragmented elastic fibres (elastolysis): quantitative count of the area occupied by elastic fibres as well as the number of intact and fragmented fibres.

    Unit of Measure:% of Total Fibers

  3. Stromal cell population in JULÄINE treated vs non-treated areas

    Time frame: Group 1 ( 6 months from baseline), Group 2 (9 months from baseline), Group 3 (12 months from baseline)

    Histological evaluation and comparison between JULÄINE treated and non-treated areas of:

    -Stromal cell population evaluated as the percentage of single cell populations/mm2.

    Unit of Measure: percentage of single cell populations per mm².

  4. Presence of Demodex in JULÄINE treated vs non-treated areas

    Time frame: Group 1 ( 6 months from baseline), Group 2 (9 months from baseline), Group 3 (12 months from baseline)

    Presence of etiological agents related to inflammation (PAS: Demodex) Unit of Measure: Positive/negative

  5. Presence of etiological agents of inflammation (CD68, CD3, CD20) in JULÄINE treated vs non-treated areas

    Time frame: Group 1 ( 6 months from baseline), Group 2 (9 months from baseline), Group 3 (12 months from baseline)

    Histological evaluation and comparison between JULÄINE treated and non-treated areas of:

    -Presence of following antibodies: CD68 (macrophages); CD3 and CD20 (lymphocytes).

    Unit of Measure: Cells count/ mm2

  6. Presence of etiological agents of inflammation ( Vimentin, CD34,) in JULÄINE treated vs non-treated areas

    Time frame: Group 1 ( 6 months from baseline), Group 2 (9 months from baseline), Group 3 (12 months from baseline)

    -Presence of the following antibodies: Vimentin and CD34 (stroma) Unit of Measure: %

  7. Presence of Ki-67 as marker of cell proliferation in JULÄINE-treated and non-treated areas

    Time frame: Group 1 ( 6 months from baseline), Group 2 (9 months from baseline), Group 3 (12 months from baseline)

    Presence of Ki-67 as marker of cell proliferation. Unit of measure: percentage of Ki-67-positive cells (%)

  8. Presence of fibrilline, elastine, emilin-1 and collagen type IV and VII in JULÄINE vs non-treated areas

    Time frame: Group 1 (6 months from baseline), Group 2 (9 months from baseline), Group 3 (12 months from baseline)

    Histological evaluation and comparison between JULÄINE treated and non-treated areas of:

    • presence of fibrilline
    • presence of elastine
    • presence of emilin-1
    • presence of collagen type IV and VII. Unit of Measure: % Area

  9. Other inflammatory biomarkers (CD80, CD86, CD40, MHC-II, TLR4; CD11b+, CD14+, TNF-α if inflammatory status) in JULÄINE vs non-treated areas

    Time frame: Group 1 (6 months from baseline), Group 2 (9 months from baseline), Group 3 (12 months from baseline)

    Histological evaluation and comparison between JULÄINE treated and non-treated areas of:

    -Other inflammatory biomarkers such as: CD80 (B7-1), CD86 (B7-2), CD40, MHC-II, TLR4 and in case of an inflammatory status also: CD11b+ CD14+, and TNF-α.

    Unit of Measure: Cells count/ mm2 for each biomarker

  10. Investigator-rated improvement of atrophic skin changes in proximity to stretch marks in the JULÄINE-treated thigh compared to baseline, assessed on standardised photographs using a 5-point Global Aesthetic Improvement scale (-1 to +3)

    Time frame: Through study completion, an average of 1 year

    Standardised digital photographs of the JULÄINE-treated thigh are acquired from baseline (Visit 1, before the first injection) through to the end of the study. The investigator compares baseline vs post-treatment photographs side-by-side and rates the change in atrophic skin changes in proximity to stretch marks on a 5-point Global Aesthetic Improvement scale: -1 = worsened (deterioration vs baseline); 0 = no change; +1 = slight improvement; +2 = moderate improvement; +3 = marked improvement. Subjects with no visible stretch marks or atrophic skin changes in the treated area at baseline are classified as Not Applicable and excluded from the analysis.

  11. Evaluation of safety of PLLA LASYNPRO™ JULÄINE

    Time frame: Through study completion, an average of 1 year

    Safety (AEs, SAEs, SADEs)

Other outcomes

  1. Proportion of subjects by post-operative wound appearance category (well healed / mild inflammation / dehiscence / infection / other) in the JULÄINE-treated thigh compared to the untreated thigh, assessed on physical examination

    Time frame: 30 days from post-bariatric surgery for each group

    At the follow-up visit (Visit 5, 30 days after post-bariatric surgery and biopsy) the investigator performs a physical examination of the surgical wound on both the JULÄINE-treated thigh and the contralateral untreated thigh (intra-subject control). Wound appearance is classified by the investigator into one of the following categories: well healed, mild inflammation, dehiscence, infection, or other (specified). The outcome is reported as the number and proportion of subjects in each wound-appearance category, separately for the treated thigh and the untreated thigh.

Study contacts

Contact information is provided by the study sponsor or research team.

A.Piovani (Evidence Generation Project Manager)

CONTACT

[email protected]

+39 0249530047

Sponsors and collaborators

Lead sponsor

Nordberg Medical Italy srl

Industry

Collaborators

  • Evidilya S.r.l.

Registry information

Official study title

Evaluation of Histological Outcomes Following Poly-L-lactic Acid (PLLA) LASYNPRO™ Injections for Skin Laxity Treatment in Patients Requiring Post Bariatric Surgery: A Proof-of-Concept Clinical Study

Acronym: Juläine

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Jun 9, 2026
Registry last updated
Jun 9, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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