Hyaluronan: its potential application in intervertebral disc regeneration

Abstract

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.

Screening of hyaluronic acid–poly(ethylene glycol) composite hydrogels to support intervertebral disc cell biosynthesis using artificial neural network analysis

“…Hyaluronic acid (HA) has been a popular choice as an injectable biomaterial for delivery to the NP region of the intervertebral disc, as HA is a key component of the native extracellular matrix. HA biomaterials have several advantages in that they are biocompatible with a long history of clinical use, non-immunogenic, and their side chains can be readily manipulated to present various functional groups [8, 22–25]. Studies have demonstrated proof-of-concept for HA-based biomaterials, alone or in combination with a second constituent such as collagen, gelatin or poly(ethylene glycol), as cell carriers to the disc [14, 19, 26–31].…”

Advanced Strategies for the Regeneration of Lumbar Disc Annulus Fibrosus

“…Several studies have shown that the injection of genipin resulted in the integration of AF tissue in degenerated IVD temporarily and improved interfacial shear properties between the AF lamellae [ 60 , 61 , 62 , 63 ]. The application of different natural polymers (collagen, alginate, chitosan, silk, and hyaluronan) and synthetic biomaterials (lactic-glycolic composites, poly (1, 8-octanediol malate) and polycaprolactone) for the AF repair have been reported in several studies [ 64 , 65 , 66 , 67 , 68 , 69 ]. To fabricate collagen-based implants, collagen fibers have been harvested from animal tail tendons and were cross-linked in situ using riboflavin or ammonia [ 70 , 71 , 72 , 73 , 74 ].…”

Polymer Based Therapies for the Treatment of Chronic Pain

“…Unique viscoelastic properties of HA enables it to maintain rheological homeostasis of the synovial fluid in the joints and plays a critical role in providing lubrication, elasticity, and shock absorption to joint tissues. Furthermore, by providing a coat on the surface of articular cartilage, HA protects the cartilage and blocks the loss of proteoglycan from the cartilage matrix into the synovial space [41]. In healthy joint of human knee, the normal concentration of HA in the synovial fluid is in the range of 2.5 -4.0 mg/mL.…”