The Relationship of Hyaluronic Acid-CD44 on Cancer Progression and Hyaluronic Acid-Based Self-Assembled Nanoparticle Roles

Abstract

The incidence and mortality rate of cancer are increasing fast worldwide. According to the cancer statistics of the year 2018, it was reported that 18.1 million new cancer cases occurred in the world, and 9.6 million people died of cancer [1]. This number is increasingly higher every year [2]. Cancer cells are cells that multiply uncontrollably. Cancer cells that divide and multiply rapidly may spread to the entire body by invading normal tissues and organs. It is believed that anomalies in multicellular systems such as mutation, chromosomal translocation and deletion accumulate and lead to the disruption of mechanisms that control cell multiplication [2]. Metastatic spreading of cancer cells is a 90% cause of mortality [3]. In order to eliminate invasion and metastasis in the process of cancer formation, it is needed to understand the behaviors of cancer cells and the nature of their microenvironment. One of the most significant characteristics of cancer cells is that they have the ability to change the extracellular matrix (ECM) to be able to metastasize [3-5]. HA is the main component of the extracellular matrix [6].Hyaluronic acid (HA) is a mucopolysaccharide with a hydrophilic structure that is found in the interstitial region seen in animal tissues [7]. HA is a long glycosaminoglycan that consists of repeated chains of (β1-4)-glucuronic acid (GlcUA) and (β1-3)-N-acetyl glucosamine (GlcNAc) disaccharide (GAG) and has a high molecular weight (1-10 million Da) [8]. HA is one of the main structures of the extracellular matrix and a significant component of connective tissue. Recent studies have shown that, in addition to