Costa Fábio Ramos, Pires Luyddy, Martins Rubens Andrade, Costa Bruno Ramos, Santos Gabriel Silva, Lana José Fábio
Department of Orthopedics, FC Sports Traumatology, Salvador 40296-210, BA, Brazil.
Department of Orthopedics, Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba 13334-170, SP, Brazil.
Gels. 2024 Aug 2;10(8):510. doi: 10.3390/gels10080510.
Hyaluronic acid (HA), a naturally occurring polysaccharide, holds immense potential in regenerative medicine due to its diverse biological functions and clinical applications, particularly in gel formulations. This paper presents a comprehensive exploration of HA, encompassing its origins, molecular characteristics, and therapeutic roles in gel-based interventions. Initially identified in bovine vitreous humor, HA has since been found in various tissues and fluids across vertebrate organisms and bacterial sources, exhibiting consistent physicochemical properties. The synthesis of HA by diverse cell types underscores its integral role in the extracellular matrix and its relevance to tissue homeostasis and repair. Clinical applications of HA, particularly in addressing musculoskeletal ailments such as osteoarthritis, are examined, highlighting its efficacy and safety in promoting tissue regeneration and pain relief. Building upon this foundation, a novel classification system for HA-based interventions is proposed, aiming to standardize treatment protocols and optimize patient outcomes. The ViSCNOVAS classification system refers to viscosity, storage, chain, number, origin, volume, amount, and size. This classification is specifically designed for HA-based orthobiologic products used in regenerative medicine, including orthopedics, sports medicine, aesthetics, cosmetic dermatology, and wound healing. It aims to provide clinicians with a structured framework for personalized treatment strategies. Future directions in HA research are also discussed, emphasizing the need for further validation and refinement of the proposed classification system to advance the field of regenerative medicine. Overall, this manuscript elucidates the biological functions of hyaluronic acid and its potential in clinical practice while advocating for standardization to enhance patient care in various regenerative applications.
透明质酸（HA）是一种天然存在的多糖，由于其多样的生物学功能和临床应用，尤其是在凝胶制剂中的应用，在再生医学中具有巨大潜力。本文对HA进行了全面探索，涵盖其来源、分子特征以及在基于凝胶的干预措施中的治疗作用。HA最初在牛玻璃体液中被鉴定出来，此后在脊椎动物和细菌来源的各种组织和体液中均有发现，呈现出一致的物理化学性质。多种细胞类型合成HA突出了其在细胞外基质中的重要作用及其与组织稳态和修复的相关性。本文研究了HA的临床应用，特别是在治疗骨关节炎等肌肉骨骼疾病方面，强调了其在促进组织再生和缓解疼痛方面的有效性和安全性。在此基础上，提出了一种基于HA的干预措施的新分类系统，旨在规范治疗方案并优化患者治疗效果。ViSCNOVAS分类系统涉及粘度、储存、链、数量、来源、体积、量和大小。该分类专门针对再生医学中使用的基于HA的矫形生物制品，包括骨科、运动医学、美容、皮肤美容学和伤口愈合。它旨在为临床医生提供一个用于个性化治疗策略的结构化框架。还讨论了HA研究的未来方向，强调需要对所提出的分类系统进行进一步验证和完善，以推动再生医学领域的发展。总体而言，本文阐明了透明质酸的生物学功能及其在临床实践中的潜力，同时倡导标准化以改善各种再生应用中的患者护理。
