Hyaluronic acid for the treatment of vocal fold scars

Chhetri, Dinesh K.; Mendelsohn, Abie H.

doi:10.1097/moo.0b013e32833f85d1

Cited by 42 publications

(25 citation statements)

References 34 publications

(42 reference statements)

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“…Hepatocyte Growth Factor injected via microtubules has shown to decrease procollagen production in mouse models 38. Autologous fibroblasts have been injected into vocal folds and have shown to improve mucosal wave and patients Voice Handicap Index 39. Laryngeal steroid injections have been used in the past, but data on the efficacy this approach is mixed 40.…”

Section: Discussionmentioning

confidence: 99%

Radiation fibrosis of the vocal fold: From man to mouse

et al. 2012

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Objectives To characterize fundamental late tissue effects in the human vocal fold following radiation therapy. To develop a murine model of radiation fibrosis to ultimately develop both treatment and prevention paradigms. Design Translational study using archived human and fresh murine irradiated vocal fold tissue. Methods 1) Irradiated vocal fold tissue from patients undergoing laryngectomy for loss of function from radiation fibrosis were identified from pathology archives. Histomorphometry, immunohistochemistry, and whole-genome microarray as well as real-time transcriptional analyses was performed. 2) Focused radiation to the head and neck was delivered to mice in a survival fashion. One month following radiation, vocal fold tissue was analyzed with histomorphometry, immunohistochemistry, and real-time PCR transcriptional analysis for selected markers of fibrosis. Results Human irradiated vocal folds demonstrated increased collagen transcription with increased deposition and disorganization of collagen in both the thyroarytenoid muscle and the superficial lamina propria. Fibronectin were increased in the superficial lamina propria. Laminin decreased in the thyroarytenoid muscle. Whole genome microarray analysis demonstrated increased transcription of markers for fibrosis, oxidative stress, inflammation, glycosaminoglycan production and apoptosis. Irradiated murine vocal folds demonstrated increases in collagen and fibronectin transcription and deposition in the lamina propria. Transforming growth factor (TGF)-β increased in the lamina propria. Conclusion Human irradiated vocal folds demonstrate molecular changes leading to fibrosis that underlie loss of vocal fold pliability that occurs in patients following laryngeal irradiation. Irradiated murine tissue demonstrates similar findings, and this mouse model may have utility in creating prevention and treatment strategies for vocal fold radiation fibrosis.

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Section: Discussionmentioning

confidence: 99%

Radiation fibrosis of the vocal fold: From man to mouse

et al. 2012

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“…Although the cell biological mechanisms underlying the action of HA in both animal models and human OA are poorly understood, the capacity of HA to inhibit aberrant tissue remodeling in the joint appears to be related to its efficacy in postsurgical repair in other tissues and organs. For example, ocular, thoracic and plastic surgery all involve the use of HA to optimize tissue restoration and minimize scarring [18,19], and HA is also used to prevent postoperative peritoneal and intrauterine adhesions [20,21]. …”

Section: Introductionmentioning

confidence: 99%

Intraarticular injection of hyaluronan prevents cartilage erosion, periarticular fibrosis and mechanical allodynia and normalizes stance time in murine knee osteoarthritis

Plaas

Riesco

et al. 2011

Arthritis Res Ther

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IntroductionIntraarticular hyaluronan (HA) is used clinically for symptomatic relief in patients with knee osteoarthritis (OA); however, the mechanism of action is unclear. In this study, we examined the effects of a single injection of HA on joint tissue pathology, mechanical allodynia and gait changes (measured by stride times) in a murine model of OA.MethodsOA was induced in the right knee joint (stifle) of 12-week-old male C57BL/6 mice by transforming growth factor β1 (TGFβ1) injection and treadmill running for 14 days. Gait parameters were quantified by using TreadScan, mechanical allodynia was evaluated with von Frey filaments, and joint pathology was evaluated by scoring of macroscopic images for both cartilage erosion and periarticular fibrosis. HA or saline control was injected 1 day after TGFβ1 injection but before the start of treadmill running.ResultsOA development in this model was accompanied by significant (P < 0.01) enhancement of the stance and propulsion times of affected legs. HA injection (but not saline injection) blocked all gait changes and also protected joints from femoral cartilage erosion as well as tibial and femoral tissue fibrosis. Both HA injection and saline injection attenuated acute allodynia, but the HA effect was more pronounced and prolonged than the saline injection.ConclusionsWe conclude that videographic gait analysis is an objective, sensitive and reproducible means of monitoring joint pathology in experimental murine OA, since stance time appears to correlate directly with OA severity. A single injection of HA prevents acute and prolonged gait changes and ameliorates the cartilage erosion and periarticular fibrosis normally seen in this model. We speculate that the capacity of HA to prevent cartilage erosion results from its normalization of joint biomechanics and its inhibitory effects on periarticular cells, which are involved in tissue hyperplasia and fibrosis. This effect of exogenous HA appears to mimic the protective effects of ablation of Adamts5 (a disintegrin and metalloproteinase with thrombospondin motifs 5) on experimental murine OA, and we speculate that a common mechanism is involved.

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“…It is used to optimise tissue restoration and minimise scarring in ophthalmic, thoracic and plastic surgery, 31,32 and is also used to prevent postoperative peritoneal and intrauterine adhesions. 33,34 HA has indirect and direct analgesic activity within the joints.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study of Intra-Articular Hyaluronic Acid and Intra-Articular Triamcinolone Hexacetonide in Primary Osteoarthritis of Knee

Kizhedath¹,

Abboobacker²,

Valoth³

et al. 2017

jemds

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BACKGROUND Intra-articular (IA) corticosteroid injection has an established therapeutic role, but the effect is short lasting. IA Hyaluronic acid (HA) is considered as a therapeutic alternative in patients who have failed non-pharmacologic and analgesic treatment. Aim of the study is to compare the efficacy and safety of IA HA with Triamcinolone hexacetonide (THA) in treatment of primary osteoarthritis (OA) knee. MATERIALS AND METHODSA descriptive cross-sectional study was done among 30 patients. One group (n=15) received IA THA 20 mg/2 mL on day 0 and other group (n=15) received IA HA 20 mg/2 mL on day 0, 7 &14 under aseptic precautions. The efficacy assessment using KGMC Score for pain, disability and functional impairment was done in 0-100 mm scale. Side effects if any were noted. RESULTSThe present study revealed IA THA has superior short-term efficacy compared to IA HA. But HA has got long term superior efficacy. CONCLUSIONOA being a chronic disease process, we need a drug which has a long lasting effect. Additive effect of HA & THA can be considered for better efficacy.

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Hyaluronic acid for the treatment of vocal fold scars

Cited by 42 publications

References 34 publications

Radiation fibrosis of the vocal fold: From man to mouse

Radiation fibrosis of the vocal fold: From man to mouse

Intraarticular injection of hyaluronan prevents cartilage erosion, periarticular fibrosis and mechanical allodynia and normalizes stance time in murine knee osteoarthritis

Comparative Study of Intra-Articular Hyaluronic Acid and Intra-Articular Triamcinolone Hexacetonide in Primary Osteoarthritis of Knee

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