New strategy to reverse signs of aging. September 22, 2015 Manhattan Beach, LA, CA

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New strategy to reverse signs of aging September 22, 2015 Manhattan Beach, LA, CA

Chronological aging Photoaging Skin Aging Genetic External/Internal factors : pollution, foods, alcohol, tobacco, emotions

Strategies to reverse skin aging Skin Aging Anti-aging cream Plastic surgery Make-up and photoshop

Strategies to reverse skin aging Skin Aging Anti-aging cream Plastic surgery Make-up and photoshop

Strategies to reverse skin aging Skin Aging Anti-aging cream Plastic surgery Make-up and photoshop

Physiological changes with age Young skin Hyper- or hypopigmentation Seborrheic keratoses Dry, scaly skin Increase in skin fragility (barrier function) Increase in roughness, wrinkles Laxity Easy bruising Decrease immune function Mature skin AGING

Skin changes with age SC Epidermis DEJ Dermis Hypodermis Flaky Thick Wavy Low Stratum corneum Epidermis Thickness = proper skin barrier Keratinocytes, Mc: proliferation, maturation Proteoglycans synthesis Dermal Epidermal junction Dermis/epidermis cohesion Dermis level ECM component (collagens, elastin..) MMPs activities Immune functions Hypodermis level Subcutaneous fat Adipose derived stem cells/growth factor Compact Thin Flat AGING

Our strategy to reverse skin aging SC Epidermis DEJ Dermis Hypodermis +/- Progerin Flaky Thick Wavy Low Stratum corneum Compact Epidermis Thickness = proper skin barrier Thin Keratinocytes, Mc, proliferation, 3 maturation Proteoglycans synthesis Dermal Epidermal junction Dermis/epidermis cohesion Dermis level ECM component (collagens, elastin..) 1 MMPs activities Immune functions Hypodermis level Subcutaneous fat Adipose derived stem cells/growth factor Progerin 2 Flat AGING

Structural aging due to senescence marker: progerin 1 Progerinas a new marker of aging Originally associated with the Hutchinson-Gilford Syndrome (= Progeria) Progerin is an altered form of the Lamin A protein (nuclear intermediate filament protein) Accumulation of progerin in nucleus Progerin and acceleration of aging Accumulation of progerin induces various defects in nuclear structure and functions Alterations cell cycle progression caused by progerin known to accelerate human aging Lamin A/C From Cao et al. 2011 This process of aging gallops to about seven times the normal rate

Progerin in healthy cells 1 The same molecular mechanisms responsible for premature aging in progeria act at low level in healthy cells Progerin is expressed in healthy cells (fibroblasts and terminally differentiated keratinocytes mainly) and accumulated with age(3% per year) Cell nuclei from old individuals acquire defects similar to those of progeria patient cells 9 years old 96 years old Progeria From Scaffidi et al. 2008 Progerinhas been linked to physiological ageing as presence of progerinis concomitant with alterations of the dermal compartment such as disorganized connective tissue

TT-2 - a biomimetic structural peptide 1 Focus on biomimetic peptide derived from structural proteins and enzymes implicated in the maintenance of dermal structure and connective tissue organization TT-2(INCI:F 3 -AcetylTripeptide-2):3aminoacidpeptidederivedbiomimeticofElafin,anenzymeinhibitor Protocol Mature human dermis fibroblasts were incubated for 96 hours with TT-2 peptide The progerin was quantified using an ELISA methodology. Results are given in pg of progerin per µg of proteins 22% inhibition progerin production TT-2 peptide TT-2 peptide decreases significantly the production of progerin, attesting its efficacy on the senescence process

Effect of TT-2 peptideon dermal structure and connective tissue organization 1 MMP-1, MMP-3 & MMP-9 inhibition control TT-2 Progeline peptide control Progeline TT-2 peptide Dermis contraction MMPs +27% collagen contraction Progerin T0 After24h

Effect of TT-2 peptideon dermal structure and connective tissue organization 1 dermis epidermis Control + Elastase + Elastase + Progeline TT-2 peptide 100% inhibition elastase Elastin fibers Elastase, collagenase Dermis contraction MMPs Progerin dermis Control + collagenase + collagenase + Progeline TT-2 peptide 43% inhibition collagenase Collagen fibers

Effect of TT-2 peptideon dermal structure and connective tissue organization 1 By modula ng senescence process ( progerin), TT-2 peptide induces several biological Dermis contraction Elastase, collagenase MMPs responses at the dermis & epidermis levels Progerin 15

1 Clinical Studies Firmness, Laxity

Clinical evaluation of anti-sagging effect on jawlines 1 Protocol 10 healthy volunteers: 54-64 years old with aged skin Formulation: 2% TT-2 peptide emulsion cream or placebo Application: split-face and split-neck 2X/day for 56 days Measurement of the volume of the jawlinesof the face by in vivo fringe projection profilometry 2% TT-2 peptide 80% of volunteers had an improvement TT-2 peptide decreases significantly the volume of the jaw lines after 28 and 56 days

Clinical evaluation of firmness & elasticity Cutometry Protocol 1 13 healthy volunteers (54-66 years old) with saggy skin (loss of firmness, slackening skin) Formulation: 2% TT-2 peptide emulsion cream or placebo Application: split-face and split-neck 2X/day for28 days Measurements are performed on both cheeks (diameter probe = 2mm) by cutometry Improvement up to: 93% of cutaneous elasticity 82% of cutaneous firmness 42% of cutaneous viscoelasticity 2% TT-2 peptide TT-2 peptideincreases significantly firmness, elasticity and viscoelasticity after 28 days

Clinical evaluation of firmness & elasticity 1 Major building effect over time! D0 TT-2 peptide

Summary TT-2 peptide effect 1 Firmness, Elasticity Laxity Dermis contraction Elastase, collagenases Progerine Reverse effect of TT-2 peptide

Our strategy to reverse skin aging 1 2 SC Epidermis DEJ Dermis Hypodermis Flaky Thick Wavy Low Stratum corneum Compact Epidermis Thickness = proper skin barrier Thin Keratinocytes, Mc, proliferation, maturation Proteoglycans synthesis Dermal Epidermal junction Dermis/epidermis cohesion Dermis level ECM component (collagens, elastin..) MMPs activities Immune functions Hypodermis level Subcutaneous fat Adipose derived stem cells/growth factor Flat

Structural aging due to lipo-atrophy 2 Young skin Full fat compartments Mature skin Deflated fat compartments Nasolabial wrinkles

Hormesis concept 2 Hormesis : homeostatic and adaptative beneficial response of cells to microstress exposure in order to correct a physiological imbalance The word hormesis comes from the greek root hormeticos, which means stimulation and the first mention of the term hormesis in the open scientific literature was published in 1943 - + + + + Concept launched by Givenchy with Vax in(2010): This vaccine-like serum is formulated with a unique complex capable of generating micro-stimuli, which encourage the skin's cells to produce their own age-defying protein HSP70

Lipohormesis New concept 2 Lipohormesis = hormesis applied to adipose tissue Various stresses in the adipose tissue are able to stimulate its expansion through the activation of Hypoxia Inducible Factor(HIF-1α), a transcription factor Mature skin + HIF-1α Activation of adipocyte anabolism Adipogenesis activation (adipocyte differenciation) Lipogenesis activation (triglyceride synthesis) Lipolysis Inhibition (free fatty acid release) Young skin Adipose tissue growth Reverse aging Wrinkle reduction Plumper skin

L-O : A lipofilling-like alternative 2 L-O(INCI: Ornithine (and) Phospholipids (and) Glycolipids): L-ornithine encapsulated in a Ionosome Ionosome : new generation of delivery system. Polysaccharide(stearoyl inulin)-coated encapsulation = protective coating Ionosome benefits: - Resistant delivery system - High penetration capacity to target adipocytes - Higher efficacy L-ornithine Lipophilic side Hydrophilic side C18 C18 C18 C18 L-O

Effect of L-O on the activation of HIF-1α and adipocyte anabolism 2 Protocol Humanpreadipocyteswereisolatedfrombiopsies and cultivatedfor differentiation. 0.02% L-Owasaddedon adipocytes culture Genic expression was evaluated through cdna methodology Results L-O HIF-1α genes involved in adipogenesis genes involved in lipogenesis genesinvolvedin lipolysis Adipocyte differenciation Triglyceride synthesis Free fatty acid release L-O reproduces lipohormesis phenomenon and mimics lipofilling result by increasing fatty tissue volume with a global action

Lipid storage enhancement lipolysis 2 Protocol Human adipocyte obtained from a piece of surgical resection were incubated with 0.05% and 0.2% L-O Free fatty acids (NEFA) were quantified in the media using a spectrophotometric method and the adipocyte size was evaluated through the measurement of their average diameter after staining with red oil(specific for lipids) L-O Increase human adipose size L-O Increase in lipid content L-O inhibits lipolysis and decreases the release of fatty acids from adipocytes by increasing lipid storage

2 Clinical Studies Nasogenianfold

Reduction of nasogenian fold 2 Protocol 20 healthy volunteers (40-60 years old) with nasogenianfolds. Formulation: 2% L-O emulsion cream or placebo Application: split-face and split-neck 2X/day for 56 days Measurement of depthand roughnessby profilometryand evaluation of smoothnessby a dermatologist Reduction up to: 27.5% of roughness 37.6% of wrinkle depth 2% L-O 2% L-O 85% of volunteers had an improvement L-O strongly reduces the appearance of nasogenian fold after only one month

Reduction of nasogenian fold 2 D0 D60 L-O strongly reduces the appearance of nasogenian fold

Summary L-O effect 2 Nasogenian fold HIF-1α Adipogenesis Lipogenesis Lipolysis Adipose tissue Reverse effect of L-O

Our strategy to reverse skin aging 1 2 3 SC Epidermis DEJ Dermis Hypodermis Flaky Thick Wavy Low Stratum corneum Compact Epidermis Thickness = proper skin barrier Thin Keratinocytes, Mc, proliferation, maturation Proteoglycans synthesis Dermal Epidermal junction Dermis/epidermis cohesion Dermis level ECM component (collagens, elastin..) MMPs activities Immune functions Hypodermis level Subcutaneous fat Adipose derived stem cells/growth factor Flat

Structural aging due to epidermis regeneration 3 Epidermis Adipocytes Keratinocyte growth factors (KGF) Dermis Adipose-derived stem cells (ADSC) (about 10% adipose tissue) Hypodermis Adipose tissue Adipose-derived stem cells (ADSC) are one of the highest sources for keratinocyte growth factors (KGF) production. As a cell reservoir, stem cells produce growth factors to stimulate cell proliferation through cell communication pathway => regulation of regeneration process. Young skin Aged skin 10-12 keratinocyte layers 100 µm 50 µm 4-5 keratinocyte layers

Swertiamarin(SWT), a pure molecule with regenerative stem cell properties 3 Pure swertiamarin extracted from Indian gentian leaves (Swertia chirata) Swertiachirata: a traditional Ayurvedicherb native to Himalayaswith many therapeutic properties, including wound healing. Swertiamarin belongs to iridoid class, widely found in medicinal plants

Effect of SWT on skin regeneration properties 3 KGF production Wound healing Epidermis regeneration D0 keratinocytes injury 0% regenerated surface keratinocytes Epidermis D72h 24% Placebo Dermis Placebo 2% SWT D72h Untreated Epidermis 52% Dermis 0.4% SWT D9 -SWT 2% 2 TIMES FASTER EPIDERMIS THICKNESS X3

Clinical efficacy of SWT on Vertical Wrinkles 3 Horizontal wrinkles Vertical wrinkles Makeface look more sadand stern Forehead Crow s feet Lion s wrinkle Nasogenian fold Upperand lowerlipline Corner of the mouth (marionette wrinkles)

Clinical efficacy of SWT on vertical wrinkles 3 Protocol 17 women volunteers(45-65 years old) Application of a cream with 2% SWT on split face vs placebo Analysis of numerical pictures with VisiaCR filters Analysis of wrinkles volume by profilometry on skin prints D0 D14 SWT reduces the appearance of vertical wrinkles and improves skin texture for a younger and more peaceful facial expression

Clinical efficacy of SWT on lip contour 3 Protocol 10 women(45-65 years) regularsmokers Twice daily application -28 days - Split face of a cream with 2% SWT vs. a placebo Analysis of lip contour zone with fringe projection after D7 and D28-14% vertical wrinkles -11% skin roughness -15% vertical wrinkles -19% skin roughness Protocol 10 women(45-60 years) Twice daily application of a cream with 2% SWT during 28 days Scorageof lipstick migration 2 hours after the application of the lipstick at D0 and D28 2 times less lipstick migration SWT reduces the appearance of lip contour wrinkles for a more confident look

Summary SWT effect 3 Lipstickmigration Vertical wrinkles Keratinocytes prolifreation Epidermis thickness Growth factor from ADSC Reverse effect of SWT

1 TT-2 peptide By modulating senescence process ( progerin), TT-2 peptide targets DERMIS restructuration for a remodelling effect and wrinkles reduction 2 L-O By inducing lipohormesis ( HIF-1α), L-Otargets HYPODERMISrestructuration for a lipofillingeffect and nasogenian fold reduction 3 SWT By stimulatating ADSC ( KGF), SWT targets EPIDERMIS restructuration for a complete skin reneneragionand wrinkles reduction Reverse effect of TT-2 peptide, L-O & SWT Young Skin Mature Skin

Thank You! Jeanne Calment(1875 1997) Living to the age of 122 years = 44724 days