Hyaluronic acid increases tendon derived cell viability and collagen type I expression in vitro: Comparative study of four different Hyaluronic acid preparations by molecular weight

Abstract

BackgroundHyaluronic Acid (HA) has been already approved by Food and Drug Administration (FDA) for osteoarthritis (OA), while its use in the treatment of tendinopathy is still debated. The aim of this study was to evaluate in human rotator cuff tendon derived cells the effects of four different HA on cell viability, proliferation, apoptosis and the expression of collagen type I and collagen type III.MethodsAn in vitro model was developed on human tendon derived cells from rotator cuff tears to study the effects of four different HA preparations (Ps) (sodium hyaluronate MW: 500-730 KDa - Hyalgan®, 1000 kDa Artrosulfur HA®, 1600 KDa Hyalubrix® and 2200 KDa Synolis-VA®) at various concentrations. Tendon derived cells morphology were evaluated after 0, 7 and 14 d of culture. Viability, proliferation, apoptosis were evaluated after 0, 24 and 48 h of culture. The expression and deposition of collagen type I and collagen type III were evaluated after 1, 7 and 14 d of culture.ResultsAll HAPs tested increased viability and proliferation, in dose dependent manner. HAPs already reduce apoptosis at 24 h compared to control cells (without HAPs). Furthermore, HAPs stimulated the synthesis of collagen type I in a dose dependent fashion over 14 d, without increase in collagen type III; moreover, in the presence of Synolis-VA® the expression and deposition of collagen type I was significantly higher as compare with the other HAPs.ConclusionsHAPs enhanced viability, proliferation and expression of collagen type I in tendon derived cells.

High-molecular-weight hyaluronic acid attenuated matrix metalloproteinase-1 and -3 expression via CD44 in tendinopathy

“…The therapeutic effects of different molecular weights of HA on tendinopathy remain unknown. Osti et al 40. reported that in human rotator cuff tendon-derived cells, various HA preparations dose-dependently stimulated the synthesis of collagen type I over 14 days, and that the preparation with the highest molecular weight upregulated the expression of collagen type I significantly more than did the other preparations.…”

I.S.Mu.L.T. Hyaluronic acid injections in musculoskeletal disorders guidelines

“…Tendons HA should enhance tenocyte viability and proliferation and reduce collagen III production, while it is not well established if HA may determine increase in collagen I production [62][63][64] .…”

Hyaluronic acid increases tendon derived cell viability and proliferation in vitro: comparative study of two different hyaluronic acid preparations by molecular weight

“…Clinical studies on patients suffering of rotator cuff disease ranging from tendinopathy derived from rotator cuff tears detected a positive influence on the reduction of pain and an improved function with no consistent side-effects recorded. Our previous data showed that different hyaluronic acid preparations induced increase of cell metabolism, decrease of apoptosis of tendon derived cells collagen type I protein secretion in dose-dependent manner but not related to the molecular weight 20 . These results confirmed a physiological role of HA in the homeostasis of tendons and they have implications among regenerative medicine.…”