Review Highlights Biologic Therapies, Including Defensins and Klotho, for Skin Rejuvenation and Anti-Aging

Cutaneous aging is a complex process characterized by collagen loss, dermal thinning, reduced epidermal turnover, and accumulation of senescent cells. Traditional aesthetic procedures often address superficial symptoms, but recent advances in biologic therapies offer the potential to target the underlying molecular and cellular mechanisms of skin degradation. This shift towards regenerative approaches aims to restore skin health at a fundamental level, moving beyond symptomatic treatment to address the root causes of aging and damage.

This review systematically summarized peer-reviewed evidence on biologic skin improvement, focusing on various therapeutic modalities. The authors emphasized the roles of Klotho, growth factors, exosomes, bioactive peptides (including defensins), sirtuins, and senolytic approaches. The methodology involved presenting mechanistic pathways, discussing reported clinical outcomes, and highlighting practical considerations relevant for facial plastic surgery. The review aimed to synthesize current knowledge and identify synergistic strategies for combining biologic agents with established aesthetic procedures.

The review found compelling evidence for biologic therapies to restore skin health by addressing key aging hallmarks. Stem cell secretomes, growth factors, peptides, and exosomes were identified as potent agents capable of stimulating collagen gene expression, enhancing epidermal turnover, and reducing MMP activity. Specifically, defensins were highlighted for their role as bioactive peptides, while Klotho and sirtuins were noted for their involvement in anti-aging pathways and cellular resilience. Senolytic approaches were also discussed for their potential to selectively eliminate detrimental senescent cells, thereby improving tissue function. The synthesis underscored that these biologics operate at the molecular and cellular level to reverse age-related changes. > The review's central finding emphasizes the significant potential of combining biologic agents with established aesthetic procedures to achieve synergistic and more profound skin rejuvenation outcomes.