Intra-articular use of hyaluronic acid in the treatment of osteoarthritis

Migliore, Alberto; Granata, M.

doi:10.2147/cia.s778

Cited by 69 publications

(63 citation statements)

References 21 publications

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“…The most frequently reported events are local side effects (8,9,25), such as site reactions of mild to moderate pain and swelling at the injection site, similar to the events observed with any IA injection. They are generally not clinically relevant, and resolve spontaneously or with conservative treatment (8,9,25). Furthermore, they do not preclude a clinical response to HA injection.…”

Section: Tolerability Of Intra-articular Hyaluronic Acidmentioning

confidence: 78%

Safety and Tolerability of Intra-Articular Hyaluronic Acid Injection (Sinovial®) in Experimental and Clinical Practice

Chevalier

Migliore

2013

Eur J Inflamm

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Osteoarthritis (OA) requires long-term treatment, therefore, tolerability is a key factor in treatment choice. Hyaluronic acid (HA), a glycosaminoglycan with viscoelastic properties, a major component of synovial fluid and the extracellular matrix of the joint cartilage, plays key roles in synovial fluid viscosity and maintaining normal cartilage. Viscosupplementation is an intra-articular (IA) injection of exogenous HA in an effort to delay joint mobility loss. Commercially available viscosupplementation includes HA of different average molecular weight (MW), concentration and origins, with varying tolerability. This review describes the tolerability and safety profile of Sinovial" in knee and hip OA. A literature search of PubMed using the search queries [Sinovial" OR hyaluronic acid OR hyaluronan] and [intra-articular OR osteoarthritis] was performed using terms as medical subject headings and free text searches. Studies were selected manually for inclusion in this review. Sinovial" is a low-medium MW HA of non-avian origin, produced by biofermentation to ensure the product is pure and free of allergenic animal proteins. We analyzed data regarding the tolerability of Sinovlal" in OA patients. This formulation has a favorable tolerability profile; no systemic reactions have been reported and most adverse events (AEs) are mild, transient and easily managed local injection site reactions. Reactionspain and burning at the injection site -are typical of IA injections. AEs with Sinovial" used in the hip are similar to knee OA.Osteoarthritis (OA) is the most common form ofjoint disease, affecting almost one in 10 men and one in five women over 60 years of age (l), with approximately one in four OA patients over 55 years of age being severely disabled (2). This public health problem will soon become even greater, because of an aging population and the obesity pandemic. OA is characterized by local pain and progressive loss of joint function, stability and mobility and is predicted to become the fourth leading cause of disability by the year 2020 (3).OA is a disease of the whole joint that targets the cartilage but also involves the synovial membrane, the subchondral bone, muscles, ligaments and the meniscus. Eventually, loss of shock absorption by cartilage and synovial fluid, hypertrophy of bone and thickening of the joint capsule leads ultimately to biomechanical joint failure OA is a lifelong progressive condition requiring long-term treatment, and thus tolerability becomes an important consideration in the choice oftreatment. The aims of treatment are pain relief and the improvement of joint function, which help delay debilitating and costly immobility (3). Initial and conservative

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Section: Tolerability Of Intra-articular Hyaluronic Acidmentioning

confidence: 78%

Safety and Tolerability of Intra-Articular Hyaluronic Acid Injection (Sinovial®) in Experimental and Clinical Practice

Chevalier

Migliore

2013

Eur J Inflamm

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“…14 The viscosity is the most distinctive property of HA in the hydrated state largely depends on the length of the chains or molecular mass. For example, the viscosity of a 1% HA solution (a molar mass of 3 -4 × 10 6 Da) is about 500,000 times that of water. The viscosity may vary with the shear rate and is positively related to molar mass and concentration.…”

Section: Dovepressmentioning

confidence: 99%

“…The HA-immobilized proteoglycan aggregates have enormous viscosupplementation (intra-articular administration for the treatment of osteoarthritis). [4][5][6] Recent research has recognized the role of HA beyond its "bio-lubricant" and "bio-polymer filler" functions. HA plays an important role in embryonic development, tissue organization, wound healing, angiogenesis, cell migration, pericellular matrix formation and tumor invasion.…”

Section: Dovepressmentioning

confidence: 99%

“…Clinical trial data have supported the intra-articular HA therapy as not only a symptom-modifying therapy but also a treatment which may significantly decrease the rate of deterioration of joint structure. 6 HA has shown cartilage-protective and anti-inflammatory effects during progression of osteoarthritic degeneration by inhibiting the degenerative changes and enhancing the synthesis of proteoglycans and extracellular matrix proteins of chondrocytes. HA decreases nociceptive activity in inflamed joints 69,70 and protects the cartilage by reducing reactive oxygen radicals, inflammatory mediators and matrix-degrading enzymes.…”

Section: Clinical Application Of Ha In the Treatment Of Osteoarthritismentioning

confidence: 99%

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Hyaluronan: its potential application in intervertebral disc regeneration

Shen

Wei²,

Bhargav³

et al. 2010

ORR

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Hyaluronan (HA) is a ubiquitous component of extracellular matrix in human tissues with diverse functions in skeletal biology. The biophysical properties of HA, such as high viscosity, elasticity and highly negative charge, make it useful in various therapeutic procedures. Although intra-articular administration of HA has been extensively used in the management of osteoarthritis (OA), there is a paucity of data on the clinical application of HA in intervertebral disc repair. This review discusses the biology and signaling mechanisms of HA, the pathophysiology of disc degeneration and summarises current evidence relating to the role of HA in cell phenotype maintenance, differentiation of chondrocytes, intervertebral disc cells and bone marrow stromal cells, and its application in tissue engineering. Based on recent advances in the clinical outcomes of OA treatment, HA has demonstrated potential as a bio-polymer filler, therapeutic agent and cell carrier in the management of intervertebral disc degeneration.

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“…[12][13][14][15][16] This gel formulation represents the final stage of a biologic and biomechanical test series including gelatin hydrogels and other albumin-based gel formulations. [17][18][19][20] The in vitro study investigated to which extent the HSA-HA hydrogel supports the phenotype of chondrocytes from human articular cartilage or human intervertebral disk tissue harvested from prolapses and discectomies.…”

mentioning

confidence: 99%

A Polyethylene Glycol‐Crosslinked Serum Albumin/Hyaluronan Hydrogel for the Cultivation of Chondrogenic Cell Types

et al. 2010

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Hydrogels are gaining increasing interest as a structural basis for regenerative cell implants. Here we present in vitro data on growth and differentiation of human mesenchymal stromal precursor cells (MSCs), adult human knee chondrocytes, and adult human intervertebral disk cells in a gel based on PEG‐crosslinked serum albumin, supplemented with 4% hyaluronan (HSA–HA). Each gel culture was compared to its parallel proliferating monolayer (PML) culture and non‐proliferating high density monolayer culture (HDML). MSCs were chondrogenically induced in both standard micromass (MM) cultures and HSA–HA. Cell viability in HSA–HA was above 90%. Chondrogenic differentiation was defined by changes in the expression of the mRNA for collagen types I, II, and X, for aggrecan, for alkaline phosphatase (ALP), and for hyaluronan synthases‐2 and ‐3 (has‐2, has‐3). For disk cells and chondrocytes, the changes for collagen type II and aggrecan were in the range of up to 100‐fold, depending on the human individual. After induction, MSCs differentiated equally well in MM and HSA–HA, showing increases spanning several orders of magnitude compared to uninduced monolayer (ML) cells. For has‐2 and has‐3, the changes were less obvious, but interestingly, the ratio of has‐2/has‐3 expression in HSA–HA cultures decreased approximately 40‐fold for disk cells, remained unchanged for chondrocytes, but increased sevenfold for MSCs, when compared to the corresponding ML cultures. Taken together, HSA–HA revealed its potential as an anchoring hydrogel for chondrogenic cell types.

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Intra-articular use of hyaluronic acid in the treatment of osteoarthritis

Cited by 69 publications

References 21 publications

Safety and Tolerability of Intra-Articular Hyaluronic Acid Injection (Sinovial®) in Experimental and Clinical Practice

Safety and Tolerability of Intra-Articular Hyaluronic Acid Injection (Sinovial®) in Experimental and Clinical Practice

Hyaluronan: its potential application in intervertebral disc regeneration

A Polyethylene Glycol‐Crosslinked Serum Albumin/Hyaluronan Hydrogel for the Cultivation of Chondrogenic Cell Types

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