Moore A R, Willoughby D A
Department of Experimental Pathology, St. Bartholomew's Hospital Medical College, London, United Kingdom.
Int J Tissue React. 1995;17(4):153-6.
Hyaluronan (HA) in combination with diclofenac is currently undergoing clinical trials as a topical preparation in the management of osteoarthritic pain, basal-cell carcinoma and actinic keratosis. These are clearly diverse pathologies, but in all cases substance P plays a central role either directly or through secondary mediators such as prostaglandin E2 and nitric oxide. A common mechanism for HA in combination with diclofenac in these conditions may be through ameliorating the direct and indirect effects of substance P. Additionally, HA appears to depot and hold diclofenac in the epidermis, thereby prolonging its pharmacokinetic half-life. In rabbits, stenosis following balloon angioplasty is prevented by a subcutaneous dose of HA, probably through blockade of cell-surface HA receptors (ICAM-1, CD44 & RHAMM). The physicochemical properties of HA, and the binding of HA to HA receptors, suggests that HA will have value as a novel drug delivery system.
透明质酸（HA）与双氯芬酸联合使用目前正作为一种局部制剂进行临床试验，用于治疗骨关节炎疼痛、基底细胞癌和光化性角化病。这些显然是不同的病理情况，但在所有病例中，P物质要么直接发挥核心作用，要么通过前列腺素E2和一氧化氮等二级介质发挥核心作用。在这些情况下，HA与双氯芬酸联合使用的一个共同机制可能是通过改善P物质的直接和间接作用。此外，HA似乎能在表皮中储存并保留双氯芬酸，从而延长其药代动力学半衰期。在兔子身上，皮下注射HA可预防球囊血管成形术后的狭窄，这可能是通过阻断细胞表面的HA受体（ICAM-1、CD44和RHAMM）实现的。HA的物理化学性质以及HA与HA受体的结合表明，HA作为一种新型药物递送系统将具有价值。
