Hyaluronic acid in the management of osteoarthritis: injection therapies innovations

Santilli, Valter; Paoloni, Marco; Mangone, Massimiliano; Alviti, Federica

doi:10.11138/ccmbm/2016.13.2.131

Cited by 23 publications

(16 citation statements)

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“…In general, patients below 65 years of age and those with less severe OA are likely to be benefited from HA viscosupplementation (252). Also, some clinical studies indicated that therapy with an IA HA formulation with a higher-MW (e.g., hylan G-F 20) was more effective in relieving OA-associated pain than therapies with lower-MWs (e.g., sodium hyaluronate) (142, 253–255).…”

Section: Pharmacotherapeutics Of Hamentioning

confidence: 99%

Hyaluronic Acid: Molecular Mechanisms and Therapeutic Trajectory

Gupta

Lall²,

Srivastava³

et al. 2019

Front. Vet. Sci.

519

345

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Hyaluronic acid (also known as hyaluronan or hyaluronate) is naturally found in many tissues and fluids, but more abundantly in articular cartilage and synovial fluid (SF). Hyaluronic acid (HA) content varies widely in different joints and species. HA is a non-sulfated, naturally occurring non-protein glycosaminoglycan (GAG), with distinct physico-chemical properties, produced by synoviocytes, fibroblasts, and chondrocytes. HA has an important role in the biomechanics of normal SF, where it is partially responsible for lubrication and viscoelasticity of the SF. The concentration of HA and its molecular weight (MW) decline as osteoarthritis (OA) progresses with aging. For that reason, HA has been used for more than four decades in the treatment of OA in dogs, horses and humans. HA produces anti-arthritic effects via multiple mechanisms involving receptors, enzymes and other metabolic pathways. HA is also used in the treatment of ophthalmic, dermal, burns, wound repair, and other health conditions. The MW of HA appears to play a critical role in the formulation of the products used in the treatment of diseases. This review provides a mechanism-based rationale for the use of HA in some disease conditions with special reference to OA.

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Section: Pharmacotherapeutics Of Hamentioning

confidence: 99%

Hyaluronic Acid: Molecular Mechanisms and Therapeutic Trajectory

Gupta

Lall²,

Srivastava³

et al. 2019

Front. Vet. Sci.

519

345

View full text Add to dashboard Cite

show abstract

“…There is no evidence in the available publications that a particular type of HA is superior to others. However, some clinical studies show that preparations with a higher MW were more effective than those with a lower MW in relieving pain associated with OA [27,28]. Intra-articular application of HA increases the quality of synovial fluid by increasing its viscoelastic properties.…”

Section: Review and Disscusionmentioning

confidence: 99%

Hyaluronic Acid in Orthopedics

et al. 2020

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Hyaluronic acid (HA) as a compound was discovered in 1934 by Karl Meyer and John Palmer as one of the glycosaminoglycans (GAG) in the vitreous body of the bovine eye. HA occurs naturally in many organs, tissues and body fluids, and especially is presented in large quantities in articular cartilage and synovial fluid. It is a non-protein, non-sulfate glycosaminoglycan which has an important role in the physiological biomechanics of synovial fluid, there is responsible for lubrication and drug-elasticity. In the musculoskeletal system, hyaluronic acid is produced by synoviocytes, fibroblasts and chondrocytes. The concentration of hyaluronic acid decreases not only with age, but also in connection with the progression of certain diseases, for example osteoarthritis (OA). For this reason, it has been used for almost 50 years to try to alleviate and treat symptoms of OA in humans and animals. Numerous studies confirmed the beneficial effect of hyaluronic acid supplementation in OA. Patients which has intraarticular viscosupplementation of HA experience less pain and have a reduced need to take nonsteroidal anti-inflammatory drugs. Intra articular HA administration shows a low risk of local and systemic side effects while maintaining proper administration under aseptic conditions. Nevertheless, local inflammatory reactions occur, but it are most often self-limiting or do not require invasive treatment. The issue of recommending hyaluronic acid in osteoarthritis is still ambiguous and controversial.

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“…HA-CD44 interaction is essential for the normal homeostasis of the cartilage [16,17], since it can modulate cartilage metabolism and promote matrix remodeling of the cartilage [18,19]. There is an ongoing database on the effects of HA in OA, in a review on the subject, Rutjes et al [20] concluded that there is a small and clinically irrelevant benefit while Santilli et al [21] and Maheu et al [22] concluded that intra-articular injection of HA results in longlasting improvements in function, including the potential to avoid a joint prosthetic implant and pain reduction. Additionally, repeated intra-articular injections of HA have been shown to relief pain and improve joint function with the effects persisting for up to 26 weeks [23].…”

Section: Introductionmentioning

confidence: 99%