Intra-articular hyaluronan (hyaluronic acid) and hylans for the treatment of osteoarthritis: mechanisms of action |
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Authors: | Email author" target="_blank">Larry?W?MorelandEmail author |
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Institution: | (1) University of Alabama at Birmingham, Birmingham, AL, USA |
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Abstract: | Although the predominant mechanism of intra-articular hyaluronan (hyaluronic acid) (HA) and hylans for the treatment of pain
associated with knee osteoarthritis (OA) is unknown, in vivo, in vitro, and clinical studies demonstrate various physiological effects of exogenous HA. HA can reduce nerve impulses and nerve sensitivity
associated with the pain of OA. In experimental OA, this glycosaminoglycan has protective effects on cartilage, which may
be mediated by its molecular and cellular effects observed in vitro. Exogenous HA enhances chondrocyte HA and proteoglycan synthesis, reduces the production and activity of proinflammatory
mediators and matrix metalloproteinases, and alters the behavior of immune cells. Many of the physiological effects of exogenous
HA may be a function of its molecular weight. Several physiological effects probably contribute to the mechanisms by which
HA and hylans exert their clinical effects in knee OA. |
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