Altman Roy, Bedi Asheesh, Manjoo Ajay, Niazi Faizan, Shaw Peter, Mease Philip
1 Division of Rheumatology and Immunology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA.
2 Chief of Sports Medicine, University of Michigan Medical Center, Ann Arbor, MI, USA.
Cartilage. 2019 Jan;10(1):43-52. doi: 10.1177/1947603517749919. Epub 2018 Feb 11.
Osteoarthritis (OA) is one of the leading causes of disability in the adult population. Common nonoperative treatment options include nonsteroidal anti-inflammatory drugs (NSAIDs), intra-articular corticosteroids, and intra-articular injections of hyaluronic acid (HA). HA is found intrinsically within the knee joint providing viscoelastic properties to the synovial fluid. HA therapy provides anti-inflammatory relief through a number of different pathways, including the suppression of pro-inflammatory cytokines and chemokines.
We conducted a systematic review to summarize the published literature on the anti-inflammatory properties of hyaluronic acid in osteoarthritis. Included articles were categorized based on the primary anti-inflammatory responses described within them, by the immediate cell surface receptor protein assessed within the article, or based on the primary theme of the article. Key findings aimed to describe the macromolecules and inflammatory-mediated responses associated with the cell transmembrane receptors.
Forty-eight articles were included in this systematic review that focused on the general anti-inflammatory effects of HA in knee OA, mediated through receptor-binding relationships with cluster determinant 44 (CD44), toll-like receptor 2 (TLR-2) and 4 (TLR-4), intercellular adhesion molecule-1 (ICAM-1), and layilin (LAYN) cell surface receptors. Higher molecular weight HA (HMWHA) promotes anti-inflammatory responses, whereas short HA oligosaccharides produce inflammatory reactions.
Intra-articular HA is a viable therapeutic option in treating knee OA and suppressing inflammatory responses. HMWHA is effective in suppressing the key macromolecules that elicit the inflammatory response by short HA oligosaccharides.
骨关节炎（OA）是成年人群致残的主要原因之一。常见的非手术治疗方法包括非甾体抗炎药（NSAIDs）、关节内注射皮质类固醇以及关节内注射透明质酸（HA）。HA天然存在于膝关节内，为滑液提供粘弹性。HA疗法通过多种不同途径减轻炎症，包括抑制促炎细胞因子和趋化因子。
我们进行了一项系统综述，以总结已发表的关于透明质酸在骨关节炎中抗炎特性的文献。纳入的文章根据其中描述的主要抗炎反应、文章中评估的直接细胞表面受体蛋白或文章的主要主题进行分类。主要研究结果旨在描述与细胞跨膜受体相关的大分子和炎症介导的反应。
本系统综述纳入了48篇文章，这些文章聚焦于HA在膝关节OA中的一般抗炎作用，其通过与簇分化抗原44（CD44）、Toll样受体2（TLR-2）和4（TLR-4）、细胞间粘附分子-1（ICAM-1）以及层粘连蛋白（LAYN）细胞表面受体的受体结合关系介导。高分子量HA（HMWHA）促进抗炎反应，而短链HA寡糖则产生炎症反应。
关节内注射HA是治疗膝关节OA和抑制炎症反应的一种可行治疗选择。HMWHA可有效抑制由短链HA寡糖引发炎症反应的关键大分子。
