Costa Fabio Ramos, Costa Marques Mariana Ramos, Costa Vinicius Calumby, Santos Gabriel Silva, Martins Rubens Andrade, Santos Marcia da Silva, Santana Maria Helena Andrade, Nallakumarasamy Arulkumar, Jeyaraman Madhan, Lana João Vitor Bizinotto, Lana José Fábio Santos Duarte
Department of Orthopaedics, FC Sports Traumatology Clinic, Salvador 40296-210, Brazil.
Department of Orthopaedics, Brazilian Institute of Regenerative Medicine, Indaiatuba 13334-170, Brazil.
Biomedicines. 2023 Mar 30;11(4):1061. doi: 10.3390/biomedicines11041061.
Musculoskeletal diseases continue to rise on a global scale, causing significant socioeconomic impact and decreased quality of life. The most common disorders affecting musculoskeletal structures are osteoarthritis and tendinopathies, complicated orthopedic conditions responsible for major pain and debilitation. Intra-articular hyaluronic acid (HA) has been a safe, effective, and minimally invasive therapeutic tool for treating these diseases. Several studies from bedside to clinical practice reveal the multiple benefits of HA such as lubrication, anti-inflammation, and stimulation of cellular activity associated with proliferation, differentiation, migration, and secretion of additional molecules. Collectively, these effects have demonstrated positive outcomes that assist in the regeneration of chondral and tendinous tissues which are otherwise destroyed by the predominant catabolic and inflammatory conditions seen in tissue injury. The literature describes the physicochemical, mechanical, and biological properties of HA, their commercial product types, and clinical applications individually, while their interfaces are seldom reported. Our review addresses the frontiers of basic sciences, products, and clinical approaches. It provides physicians with a better understanding of the boundaries between the processes that lead to diseases, the molecular mechanisms that contribute to tissue repair, and the benefits of the HA types for a conscientious choice. In addition, it points out the current needs for the treatments.
肌肉骨骼疾病在全球范围内持续增加，造成了重大的社会经济影响并降低了生活质量。影响肌肉骨骼结构的最常见疾病是骨关节炎和肌腱病，这些复杂的骨科疾病会导致严重疼痛和功能障碍。关节内透明质酸（HA）一直是治疗这些疾病的一种安全、有效且微创的治疗工具。从床边研究到临床实践的多项研究揭示了HA的多种益处，如润滑、抗炎以及刺激与细胞增殖、分化、迁移和其他分子分泌相关的细胞活性。总体而言，这些作用已显示出积极的效果，有助于软骨和肌腱组织的再生，否则这些组织会被组织损伤中常见的主要分解代谢和炎症状态所破坏。文献分别描述了HA的物理化学、机械和生物学特性、其商业产品类型以及临床应用，而它们之间的相互作用却很少被报道。我们的综述涉及基础科学、产品和临床方法的前沿领域。它能让医生更好地理解导致疾病的过程、促成组织修复的分子机制以及不同类型HA的益处之间的界限，从而做出明智的选择。此外，它还指出了当前治疗的需求。
