Concentration of Hyaluronic Acid in Synovial Fluid

Decker, Barry; McGuckin, Warren F.; McKenzie, Bernard F.; Slocumb, Charles H.

doi:10.1093/clinchem/5.5.465

Cited by 61 publications

(43 citation statements)

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“…Aggregation by hyaluronic acid was not inhibited by these sulfhydrylinhibiting reagents and was demonstrable only after the gamma globulin was first thermally denatured. In normal synovial fluid the average concentration of hyaluronic acid is 2.3 to 4.1 mg/ml, but in synovial fluid from patients with rheumatoid arthritis the concentration of hyaluronic acid may be less (0.7 to 1.2 mg/ml) (8,16,21). T h e amount of hyaluronic acid in a rheumatoid joint, however, is often increased (16) because the increase in volume of rheumatoid synovial fluid often overcompensates for the decrease in concentration of hyaluronic acid found in this disease.…”

Section: Discussionmentioning

confidence: 98%

“…that the reported beneficial effects of gold thiomalate, D-penicillamine, and L-histidine (4,5) in patients with rheumatoid arthritis are related to the ability of these compounds to inhibit the sulfhydryl-mediated thermal aggregation of human gamma globulin (6). Since rheumatoid arthritis is mainly a disease of diarthroidal synovial joints and since synovial fluid has the largest concentration of hyaluric acid in the human body (8)(9)(10)(11) as well as substantial amounts of gamma globulin (12,13), the present study was undertaken to determine the effect of hyaluronic acid on the thermal aggregation of human gamma globulin.…”

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confidence: 99%

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Sulfhydryl‐dependent thermal aggregation of human gamma globulin

Gerber

1975

Arthritis & Rheumatism

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Hyaluronic acid (4 mg/ml) augmented elevenfold the copper‐catalyzed (7 βxM) thermal (63°C, 2 hours) aggregation of human gamma globulin (2 mg/ ml) in 0.075 M phosphate buffer, pH 7.4. Almost no augmentation of aggregation occurred with hyaluron‐idase‐treated hyaluronate. Hyaluronate‐augmented copper‐catalyzed thermal aggregation was inhibited by L‐histidine, gold thiomalate, N‐ethylmaleimide, p‐chlo‐romercuribenzoic acid, and ethylenediaminetetraacetic acid. Together with previous reports of a decreased blood histidine concentration in rheumatoid arthritis, these studies provide a possible explanation for the affinity of this disease for joints.

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Section: Discussionmentioning

confidence: 98%

mentioning

confidence: 99%

Sulfhydryl‐dependent thermal aggregation of human gamma globulin

Gerber

1975

Arthritis & Rheumatism

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“…HAs exhibit unique viscoelastic properties with highly non-Newtonian characteristics that allow the synovial fluid to provide the fluid dynamic properties of lubrication, as well as resistance to compression and shear forces. [9,10] Healthy synovial fluid is primarily composed of HA of high molecular weight, but during the development of OA the concentration of HA drops and the average polymer length (normal molecular weight of 3-4 million Daltons [11]) degrades, which markedly impacts the viscoelastic properties of the synovial fluid. HA therapy is intended to temporarily restore the rheology of the synovial fluid toward its healthy state.…”

Section: Open Accessmentioning

confidence: 99%

Rheological and molecular weight comparisons of approved hyaluronic acid products – preliminary standards for establishing class III medical device equivalence

Braithwaite

Daley

Toledo-Velasquez

2015

Journal of Biomaterials Science, Polymer Edition

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Hyaluronic acid of various molecular weights has been in use for the treatment of osteoarthritis knee pain for decades. Worldwide, these products are regulated as either as drugs or devices and in some countries as both. In the US, this class of products is regulated as Class III medical devices, which places specific regulatory requirements on developers of these materials under a Pre-Market Approval process, typically requiring data from prospective randomized controlled clinical studies. In 1984 pharmaceutical manufacturers became able to file an Abbreviated New Drug Application for approval of a generic drug, thus establishing standards for demonstrating equivalence to an existing chemical entity. Recently, the first biosimilar, or 'generic biologic', was approved. Biosimilars are biological products that are approved by the FDA because they are 'highly similar' to a reference product, and have been shown to have no clinically meaningful differences from the reference product. For devices, Class II medical devices have a pathway for declaring equivalence to an existing product by filing a 510 k application for FDA clearance. However, until recently no equivalent regulatory pathway was available to Class III devices. In this paper, we consider the critical mechanical performance parameters for intra-articular hyaluronic products to demonstrate indistinguishable characteristics. Analogous to the aforementioned pathways that allow for a demonstration of equivalence, we examine these parameters for an existing, marketed device and compare molecular weight and rheological properties of multiple batches of a similar product. We propose that this establishes a scientific rationale for establishing Class III medical device equivalence.

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“…13 These parameters decrease in pathological SF. 1,14 Oates et al 15 showed that protein aggregation provides SF with the rheopectic behaviour. The common result of studies on the composition of normal and pathological SF showed that in pathological SF (compared to normal SF), both concentration and molecular weight of HA decreased and the proportionality of the HA concentration to the protein also changed.…”

Section: Introductionmentioning

confidence: 99%

Viscoelastic behaviour effect of hyaluronic acid on reciprocating flow inside mini-channel

2016

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One of the most successful surgeries during the 21st century is total joint replacement (TJR) with material combination of polymer‐on‐metal (PoM). Despite its success, wear particle generation at the interface of the polymer and metal causes eventually implant loosening. Investigating and understanding the wear particles distribution should help in designing implants with better performances. First step towards characterising wear particle distribution is deriving the lubricant behaviour and velocity distribution inside implant gap. Different hyaluronic acid (HA) solutions were subjected to a sinusoidal movement in straight rectangular channels. The velocity profiles along the channel width were measured with Micro Particle Image Velocimetry. HA solution behaviour was found to be dependent on the concentration. Results showed significant differences between the water (Newtonian) and HA behaviour in unsteady flow. The unsteady behaviour of the lubricant depended strongly on its non‐Newtonian viscoelastic behaviour which was due to the time dependent nature of HA solution. Copyright © 2016 John Wiley & Sons, Ltd.

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Concentration of Hyaluronic Acid in Synovial Fluid

Cited by 61 publications

References 0 publications

Sulfhydryl‐dependent thermal aggregation of human gamma globulin

Sulfhydryl‐dependent thermal aggregation of human gamma globulin

Rheological and molecular weight comparisons of approved hyaluronic acid products – preliminary standards for establishing class III medical device equivalence

Viscoelastic behaviour effect of hyaluronic acid on reciprocating flow inside mini-channel

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