Pathophysiological and Therapeutic Roles of Fascial Hyaluronan in Obesity-Related Myofascial Disease

Abstract

Myofascial disease is an important complication associated with obesity and one of the leading causes of physical disability globally. In the face of limited treatment options, the burden of myofascial disorders is predicted to increase along with the escalating prevalence of obesity. Several pathological processes in obesity contribute to modifications in fascial extracellular matrix mechanical and biological properties and functions. Changes in adipose tissue metabolism, chronic inflammatory phenotype, oxidative stress, and other mechanisms in obesity may alter the physiochemical and biomechanical properties of fascial hyaluronan. Understanding the pathophysiological importance of hyaluronan and other components of the fascial connective tissue matrix in obesity may shed light on the etiology of associated myofascial disorders and inform treatment strategies. Given its unique and favorable pharmacological properties, hyaluronan has found a broad range of clinical applications, notably in orthopedic conditions such as osteoarthritis and tendinopathies, which share important pathophysiological mechanisms implicated in myofascial diseases. However, while existing clinical studies uniformly affirm the therapeutic value of hyaluronan in myofascial disorders, more extensive studies in broader pharmacological and clinical contexts are needed to firmly validate its therapeutic adaptation.

Do the fasciae of the soleus have a role in plantar fasciitis?

“…The aponeurotic fascia envelops various muscles and has a high potential for gliding, whereas the epimysium adheres more tightly to the underlying muscles. Alterations in the physiological levels or physicochemical properties of HA have been associated with several myofascial diseases (Ugwoke et al, 2022).…”

Response to Mechanical Properties and Physiological Challenges of Fascia: Diagnosis and Rehabilitative Therapeutic Intervention for Myofascial System Disorders

“…Injuries to various fascial tissues can significantly reduce performance in sports [ 1 ] and may contribute to the development and persistence of symptoms of musculoskeletal disorders, including low back pain [ 2 ]. Although damage to the fascial tissue has been shown to be influenced primarily by exercise, aging, sex hormones, obesity, and inflammation [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ], there is limited information about the elastic fiber composition of fascial tissue, extracellular matrix properties, vascularity, extent of innervation, and their role in disease and treatment [ 15 ]. Although these properties are fundamental for optimal sports performance, the fascia is not considered in the physical examination and rehabilitation of sports injuries, omitting anatomical tissues that could play an important role in sports injury rehabilitation.…”

MicroRNA-29a Mitigates Laminectomy-Induced Spinal Epidural Fibrosis and Gait Dysregulation by Repressing TGF-β1 and IL-6

“…For example, the partition between the affected epidural and wound with polyethylene film and sterile Vaseline oil has been observed to reduce the occurrence of epidural fibrosis [5]. In experimental animal models, administration of decellularized adipose matrix [6,7], taurine [8], long non-coding ribonucleic acid (lncRNA) [9], hyaluronic acid hydrogel [10], etc. has been found to reduce the extent of epidural fibrotic matrix formation in scar after lumbar laminectomy.…”