Anti-Inflammatory Effects of Intra-Articular Hyaluronic Acid: A Systematic Review

Roy D Altman, Asheesh Bedi, Ajay Manjoo, Faizan Niazi, Peter Shaw, Philip Mease

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objective: 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. Methods: 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. Results: 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. Conclusions: 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.

Original languageEnglish (US)
JournalCartilage
DOIs
StateAccepted/In press - Feb 1 2018
Externally publishedYes

Fingerprint

Hyaluronic acid
Hyaluronic Acid
Anti-Inflammatory Agents
Joints
Oligosaccharides
Knee Osteoarthritis
Molecular Weight
Molecular weight
Cell Surface Receptors
Macromolecules
Osteoarthritis
Toll-Like Receptor 2
Intra-Articular Injections
Toll-Like Receptor 4
Synovial Fluid
Intercellular Adhesion Molecule-1
Knee Joint
Chemokines
Adrenal Cortex Hormones
Membrane Proteins

Keywords

  • anti-inflammatory
  • hyaluronic acid
  • knee
  • osteoarthritis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Biomedical Engineering
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Altman, R. D., Bedi, A., Manjoo, A., Niazi, F., Shaw, P., & Mease, P. (Accepted/In press). Anti-Inflammatory Effects of Intra-Articular Hyaluronic Acid: A Systematic Review. Cartilage. https://doi.org/10.1177/1947603517749919

Anti-Inflammatory Effects of Intra-Articular Hyaluronic Acid : A Systematic Review. / Altman, Roy D; Bedi, Asheesh; Manjoo, Ajay; Niazi, Faizan; Shaw, Peter; Mease, Philip.

In: Cartilage, 01.02.2018.

Research output: Contribution to journalArticle

Altman, Roy D ; Bedi, Asheesh ; Manjoo, Ajay ; Niazi, Faizan ; Shaw, Peter ; Mease, Philip. / Anti-Inflammatory Effects of Intra-Articular Hyaluronic Acid : A Systematic Review. In: Cartilage. 2018.
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