Components of the dermis, including fibroblasts, collagen, elastic fibers, glycosaminoglycans and proteoglycans, undergo significant changes during intrinsic and extrinsic aging processes. Previous studies have shown that increased degradation and decreased biosynthesis of collagen leads to a «net deficiency» of collagen, which is characterized by clinical changes such as wrinkles and loss of skin elasticity. Fibroblasts are resident cells of the dermis and are different from mesenchymal cells. They are responsible for the synthesis and degradation of fibrous and amorphous proteins of the extracellular matrix (ECM). Their function and interaction with the environment are important for understanding the molecular mechanism of skin aging. In young skin, fibroblasts adhere to the surrounding intact ECM, which mainly consists of type I collagen. This adherence allows fibroblasts to exert mechanical force on the surrounding ECM, as well as to spread and maintain a normal elongated shape. In aging skin, fibroblast attachment is impaired due to progressive ECM degradation, which leads to a decrease in fibroblast size, decreased elongation and collapse of morphology. Based on the data obtained, it can be assumed that the function of fibroblasts in the skin can be stimulated by enhancing the structural support of the ECM. In this case, it is rational to use collagen replacement therapy. This article describes the mechanism of action of collagen replacement therapy with Linerase and presents clinical cases of combined instrumental and injection cosmetology methods.

Keywords: microfibrillar-associated glycoproteins, tripeptides, equine collagen type I, collagen replacement therapy, Linerase, fibulin, fibrillin, metalloproteinases, extracellular matrix