Hyaluronic Acid
injections, products, gels,
side effects, benefits, reesearch finds. updated on FEB 17, 2008
WHAT IS HYALURONIC ACID?
Hyaluronic Acid is a polysaccharide composed of alternating molecules
of N-acetyl glucosamine and D-glucuronic acid. It can be found within
collagen throughout the body.
As the most important space filling substance in the human body
Hyaluronic Acid holds water tto keep collagen hydrated and youthful.
Hyaluronic Acid forms a viscous fluid with exceptional lubricating
properties necessary for the vital functions of many parts of the human
body including the skin, heart valves, aqueous/ vitreous humor of the
eye and synovial fluid (joint lubricant). The skin contains over 50% of the
bodies Hyaluronic Acid. Considering that skin is over 70% water and
renews itself more readily than most other bodily tissues. Definitely,
hyaluronic Acid may have benefits on skin's structure and daily
maintenance.
Hyaluronic Acid is made by human fibroblast cells. Commercial sources
may be from Cocks combs, Chicken cartilage or Microbial fermentation.
Vegetarian source may be made via Microbial fermentation.
Our bodies are in a continual state of rebuilding. New skin cells for
example replace old ones about every 20 to 30 days. Normally,
Hyaluronic Acid in skin tissue is broken down by hyaluronidase. And, the
rate of Hyaluronic Acid degradation can be increased by excess intake
of riboflavin (B-2), ultraviolet radiation exposure or viruses. Any long-
term overexposure to any of these may result in premature connective
tissue destruction.
ARE THERE ORAL HYALURONIC ACID SUPPLEMENTS?
In the past, because of its large molecular weight, the absorption for
Hyaluronic Acid in the digestive tract was almost impossible. However, an
enzyme-cleaving technique has been developed to break down
Hyaluronic Acid into lower molecular weight polymers. This allows easy
absorption of Hyaluronic Acid when taken orally. Studies have shown
that this lighter Hyaluronic Acid might improve wound healing, facial
moisture, and skin smoothness. But its greatest benefit has been seen in
joint function.
Assuming that 10-150 mgs of Hyaluronic Acid is a normally metabolized
or excreted daily with the higher rate of loss in persons over 50, it may
make sense for older adults to begin supplementing with 1- 50mg
capsule 3 times daily just to maintain equilibrium.
WHAT ARE THE BENEFITS OF HYALURONIC ACID?
Osteoarthritis
Hyaluronan preparations have shown to decrease pain and improve
mobility of patients suffered from knee osteoarthritis. It is believed that
the improvement in the condition may be related to alternations in the
synovial fluid viscoelasticity, cartilage metabolism, and inflammation.
[Moskowitz RW, Hyaluronic acid supplementation, Curr. Rheumatol Rep. 2000 Dec; 2 (6): 466-71].
Turkish researchers injected high molecular weight hyaluronic acid
(Hylan G-F 20) and low molecular weight hyaluronic acid (Orthovisc) to
92 patients suffered from knee osteoarthritis separately at one-week
intervals for three weeks. Both hyaluronic acid preparations resulted in
a pronounced reduction in pain and improved function, without
complications. [Karatosum V et al, Comparison of two hyaluronan drugs in patients with
advanced osteoarthritis of the knee. A prospective, randomized, double-blind study with long term
follow-up., Clin Exp Rheumatol. 2005 Mar-Apr;23(2):213-8.]
Roth A et al, Friedrich Schiller University Jena, Germany, treated rats
with high molecular weight hyaluronic acid (1.7X10(6) a; 0.5 mg/dose).
They found that a short-term hyaluronic acid treatment could inhibit
acute inflammation and cartilage damage while a long-term hyaluronic
acid treatment promote joint swelling, inflammation and cartilage
damage. [Intra-articular injections of high-molecular-weight hyaluronic acid have biphasic
effects on joint inflammation and destruction in rat antigen-induced arthritis. Arthritis Res Ther.
2005;7(3):R677-86. Epub 2005 Mar 31]
Brain Injury
Tian WM et al, Tsinghua University, China, prepared a hyaluronic acid-
poly-D-lysine copolymer hydrogel with an open porous structure and
viscoelastic properties similar to neural tissue for brain tissue
engineering. They found this hydrogel compatible to rat brain tissue.
[Hyaluronic acid-poly-D-lysine-based three-dimensional hydrogel for traumatic brain injury. Tissue
Eng. 2005 Mar-Apr;11(3-4):513-25.]
TOPICAL DRUG DELIVERY SYSTEM (SKIN)
Regulatory approval in the USA, Canada and Europe was granted
recently for 3% diclofenac in 2.5% HA gel, Solaraze(R), for the topical
treatment of actinic keratoses, which is the third most common skin
complaint in the USA. The gel is well tolerated, safe and efficacious and
provides an attractive, cost-effective alternative to cryoablation,
curettage or dermabrasion, or treatment with 5-fluorouracil. [Brown M et al,
Hyaluronic acid: a unique topical vehicle for the localized delivery of drugs to the skin., J Eur
Acad Dermatol Venereol. 2005 May;19(3):308-18.]
INJECTABLE HYALURONIC ACID GEL - FACE
This injectable Restylane (hyaluronic acid) gel was approved on March
25, 2005. It is a transparent hyaluronic acid gel that is injected into facial
tissue to smooth wrinkles and folds, especially around the nose and
mouth (nasolabial folds). This hyaluronic acid gel works by temporarily
adding volume to facial tissue to restore a smoother appearance to the
face. The effect of this hyaluronic acid gel can last for about 6 months. In
a clinical study, most patients needed one injection of this hyaluronic
acid gel to achieve the optimal benefits of wrinkle smoothing; about one-
third of patients needed more than one injection of this hyaluronic acid
gel to get a satisfactory result.
Resource New Device Approval Restylane™ Injectable Gel - P040024, CDRH Consumer
Information, May 9, 2005
INTRAARTICULAR HYALURONIC ACID - KNEE
Petrella RJ. performed three-intraarticular injection series with Suplasyn
(10 mg/ml, 2-ml injection) to patients suffered from knee osteoarthritis
over 3 weeks. She observed very few adverse events or side effects
limited to local pain and swelling. She concluded that intraarticular
hyaluronic acid injections had benefits on patients with osteoarthritis by
improving resting and walking pain. [Hyaluronic acid for the treatment of knee
osteoarthritis: long-term outcomes from a naturalistic primary care experience. Am J Phys Med
Rehabil. 2005 Apr;84(4):278-83; quiz 284, 293.]
WHAT ARE THE SIDE EFFECTS OF HYALURONIC ACID?
Hyaluronic acid is found to be a useful, well-tolerated symptomatic
treatment for knee osteoarthritis. And, the onset of action is rapid.
Treatment-ralated non-serious adverse or side effects are about 2.5% of
administrations. [Multicenter study of hyaluronic acid obtained by biotechnology to
evaluate clinical efficacy and safety in knee osteoarthritis., Int J Clin Pharmacol Res. 2005;25(1):
1-7..]
Side effects of hyaluronic acid gel include bruising, redness, swelling,
pain, tenderness and itching Hyaluronic acid gel should not be used in
patients suffered from severe allergies. [New Device Approval Restylane™
Injectable Gel - P040024, CDRH Consumer Information, May 9, 2005]
After Solaraze(R) was approved for the topical treatment of actinic keratoses, hyaluronic acid was immediately gotten to be famous in cosmetic wrinkle removing preparation. Hyaluronic acid preparations do have their advantages. They have been shown to decrease pain and improve mobility of patients suffered from knee osteoarthritis. Hyaluronic acid also improves conditions such as synovial fluid viscoelasticity, wrinkle smoothing, cartilage metabolism, and inflammation.
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