Hyaluronic Acid

 

Hyaluronic acid is a key component of cartilage and healthy hyaluronic acid is vital for a healthy joint.

Hyaluronic Acid is a type of glycosmaminoglycan (GAGs). GAGs are complex sugars linked together in long chains and possess a highly negative charge. This negative charge has significant biomechanical consequences.The negative charge attracts water and the water-GAG combination creates special mechanical properties allowing hyaluronic acid to act both as a lubricant and a shock absorbing material.

As the joint ages the quality and quantity of hyaluronic acid diminishes and this contributes to the joints poor function, pain, and degeneration.

Potential Joint Benefits of Hyaluronic Acid*

1. Boosts Cartilage Cell Health 

Hyaluronic Acid has been shown to boost cartilage cell production and inhibit cartilage cell death (apoptosis)

Italian researchers examined the effect of hyaluronic acid on human cartilage cells. The researchers found that hyaluronic acid induced cartilage cell proliferation. (Brun P et al. In vitro response of osteoarthritic chondrocytes and fibroblast-like synoviocytes to a 500-730 kDa hyaluronan amide derivative. J Biomed Mater Res B Appl Biomater. 2012 Nov;100(8):2073-81.)

2. Promotes Proteoglycan & Glycosaminoglycan Synthesis

As the joint ages, intrinsic proteoglycan and GAG concentrations decline within the cartilage. Proteoglycans and GAGs are crucial for the joints normal mechanical and shock absorbing properties. Research suggests hyaluronic acid stimulates proteoglycan synthesis.

Japanese researchers explored the effect of hyaluronic acid on proteoglycan synthesis on a bovine (cow) model of cartilage damage. The researchers found that hyaluronic acid promoted proteoglycan synthesis and acted as an antioxidant.(Miki Y et al. Hyaluronan reversed proteoglycan synthesis inhibited by mechanical stress: possible involvement of antioxidant effect. Inflamm Res. 2010 Jun;59(6):471-7.)

3. Demonstrates Anti-inflammatory Attributes

Hyaluronic acid  suppresses the activity of IL-1β, a master cytokine, that initiates and magnifies unhealthy inflammation.

Spanish investigated the effect of hyaluronic acid on human cartilage cells. The researchers found that hyaluronic acid significantly reduced the synthesis to nitric oxide and prostaglandin E2, both important mediators of joint inflammation. (Maneiro E et al. The biological action of hyaluronan on human osteoartritic articular chondrocytes: the importance of molecular weight.Clin Exp Rheumatol. 2004 May-Jun;22(3):307-12.)

4. Promotes the Mechanical Properties of the Joint

Hyaluronic acid helps lubricate the joint preventing wear through decreased friction. Additionally, HA provides cushioning to counteract the stress and strain of gravity and weight bearing.

British researchers examined the effect of hyaluronic acid on friction within a human cartilage damage model. The researchers concluded that hyaluronic acid reduced friction by approximately 50%.(The effect of hyaluronicacid and phospholipid based lubricants on friction withina human cartilage damage model.Biomaterials. 2006 Sep;27(26):4581-90.)

5. Supports Subchondral Bone Health

Subchondral bone is the area of bone just beneath cartilage. Subchondral bone influences cartilage’s shock absorption attributes and contributes to cartilage nutrition. HA helps promote an optimal sub chondral bone density that reduces the impact stress on the overlying cartilage.

Investigators in Denmark assessed the effect of hyaluronic acid on a guinea pig model of cartilage injury. The researchers found that hyaluronic acid decreased subchondral bone density and thickness; resulting in subchondral bone that was more compliant and thereby reduced the cartilage stress during impact loading. (Ding M1et al. Effects of hyaluronan on three-dimensional microarchitecture of subchondral bone tissues in guinea pig primary osteoarthrosis.Bone. 2005 Mar;36(3):489-501.)

Precautions

Hyaluronic acid is likely safe when taken by mouth, applied to the skin, or given by injection and appropriately. Rarely, hyaluronic acid may cause allergic reactions.As with any consideration of any form of supplementation consult your healthcare provide prior to use if you are pregnant, nursing, taking any medications or have any medical conditions. Discontinue use and consult your doctor is any adverse reactions occur.

*These statements have not been evaluated by the Food and Drug Administration. These statements are not intended to diagnose, treat, cure or prevent any disease.

 

References

Moreland LW. Intra-articular hyaluronan (hyaluronic acid) and hylans for thetreatment of osteoarthritis: mechanisms of action. Arthritis Res Therapy. 2003;5(2):54.

Diaz-Gallego L, Prieto JG, Coronel P, Gamazo LE, Gimeno M, Alvarez AI. Apoptosis and nitric oxide in an experimental model of osteoarthritis in rabbit after hyaluronic acid treatment. J Orthop Res. 2005;23(6):1370–6.

Brun P, Panfilo S, Daga Gordini D, Cortivo R, Abatangelo G. The effect of hyaluronan on CD44-mediated survival of normal and hydroxyl radicaldamaged chondrocytes. Osteoarthritis Cartilage. 2003;11(3):208–16.

Ando A, Hagiwara Y, Chimoto E, Hatori K, Onoda Y, Itoi E. Intra-articular injection of hyaluronan diminishes loss of chondrocytes in a rat immobilized-knee model. Tohoku J Exp Med. 2008;215(4):321–31.

Greenberg DD, Stoker A, Kane S, Cockrell M, Cook JL. Biochemical effects of two different hyaluronic acid products in a co-culture model of osteoarthritis. Osteoarthritis Cartilage. 2006;14(8):814–22.

Maneiro E, de Andres MC, Fernandez-Sueiro JL, Galdo F, Blanco FJ. The biological action of hyaluronan on human osteoartritic articular chondrocytes: the importance of molecular weight. Clin Exp Rheumatol. 2004;22(3):307–12.

Mladenovic Z, Saurel AS, Berenbaum F, Jacques C. Potential role of hyaluronic acid on bone in osteoarthritis: matrix metalloproteinases, aggrecanases, and RANKL expression are partially prevented by hyaluronic acid in interleukin 1-stimulated osteoblasts. J Rheumatol. 2014;41(5):945–54.

Sasaki A, Sasaki K, Konttinen YT, Santavirta S, Takahara M, Takei H, et al. Hyaluronate inhibits the interleukin-1beta-induced expression of matrix metalloproteinase (MMP)-1 and MMP-3 in human synovial cells. Tohoku J Exp Med. 2004;204(2):99–107.

Smith MM, Cake MA, Ghosh P, Schiavinato A, Read RA, Little CB. Significant synovial pathology in a meniscectomy model of osteoarthritis: modification by intra-articular hyaluronan therapy. Rheumatology (Oxford). 2008;47(8):1172–8.

Plaas A, Li J, Riesco J, Das R, Sandy JD, Harrison A. Intraarticular injection of hyaluronan prevents cartilage erosion, periarticular fibrosis and mechanical allodynia and normalizes stance time in murine knee osteoarthritis. Arthritis Res Ther. 2011;13(2):R46.

Bell CJ, Ingham E, Fisher J. Influence of hyaluronic acid on the timedependent friction response of articular cartilage under different conditions. Proc Inst Mech Eng H. 2006;220(1):23–31.

Ghosh P, Read R, Numata Y, Smith S, Armstrong S, Wilson D. The effects of intraarticular administration of hyaluronan in a model of early osteoarthritis in sheep. II. Cartilage composition and proteoglycan metabolism. Semin Arthritis Rheum. 1993;22(6 Suppl 1):31–42.

Hiraoka N, Takahashi KA, Arai Y, Sakao K, Mazda O, Kishida T, et al. Intraarticular injection of hyaluronan restores the aberrant expression of matrix metalloproteinase-13 in osteoarthritic subchondral bone. J Orthop Res. 2011;29(3):354–60.

 Lucas J. Bader MD

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