Hyaluronan and wound healing: a new perspective

doi:10.1016/0007-1226(91)90093-Y

British Journal of Plastic Surgery

Volume 44, Issue 8, 1991, Pages 579-584

https://doi.org/10.1016/0007-1226(91)90093-Y Get rights and content

Abstract

Hyaluronan has long been associated with the remodelling extracellular matrix. Such remodelling occurs in development, growth and wound healing. This role has been thought to be related to the physical structure and chemical composition of the pure glycosaminoglycan chain. We question this proposition and present evidence which suggests that proteins associated with hyaluronan may be more critical determinants of tissue remodelling.

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Effectiveness of Sodium Hyaluronate and ADCON-T/N for the Prevention of Adhesions in Hand Flexor Tendon Surgery: A Systematic Review and Meta-Analysis
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Citation Excerpt :
Hyaluronic acid is a glycosaminoglycan derived from fibroblasts. It is absorbable and provides a temporary barrier to formation of adhesions.37 It also has viscoelastic properties and provides lubrication to surrounding tissues.38
A common complication after digital flexor tendon repair in the hand is postoperative adhesions that can cause loss of motion and compromise hand function. The aim of this review of relevant published literature was to assess the effectiveness of locally administered sodium hyaluronate or ADCON-T/N for the prevention of adhesions after hand flexor tendon repair.
A literature search was conducted in June 2020 in multiple databases for randomized controlled trials . Our primary outcome was measurement of active finger motion. Follow-up was defined as short-term (< 12 weeks), mid-term (12 weeks to 6 months) and long-term (> 6 months). Mean differences (MD) and standardized mean differences (SMD) of total active motion (TAM) of the interphalangeal joints (IPJs) and active motion of the IPJs separately were calculated where results were meta-analyzed.
Six randomized controlled trials were included. For ADCON-T/N, no benefits were detected for TAM of the IPJs (MD 1.71 [-21.54, 24.96]) or active motion of the IPJs separately (proximal: MD 4.77 [-4.47, 14]; distal: MD 1.17 [-10.33, 12.66]) in the short-/mid-term. The mid-term benefit in TAM of sodium hyaluronate over standard care (placebo/no treatment) did not reach statistical significance (SMD 0.31 [0, 0.63]); however, a subgroup comparison of repeated administration of sodium hyaluronate versus standard care was both statistically and clinically significant (SMD 0.55 [0.11, 0.98]).
Repeated administration of sodium hyaluronate at the tendon repair site may be effective in improving postoperative active finger motion after primary hand flexor tendon repair in the mid-term.
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The molecular profile of urethral stricture disease
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A novel in situ silver/hyaluronan bio-nanocomposite fabrics for wound and chronic ulcer dressing: In vitro and in vivo evaluations
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In-situ formed hyaluronan/silver (HA/Ag) nanoparticles (NPs) were used to prepare composite fibers/fabrics for the first time. Different concentrations of silver nitrate (1, 2 mg/100 ml) were added at ambient temperature to sodium hyaluronate solution (40 mg/ml), then the pH was increased to 8 by adding sodium hydroxide. The in-situ formed HA/Ag-NPs were used to prepare fibers/nonwoven fabrics by wet-dry-spinning technique (WDST). UV/vis spectroscopy, SEM, TEM, DLS, XPS, XRD and TGA were employed to characterize the structure and composition of the nanocomposite, surface morphology of fiber/fabrics, particle size of Ag-NPs, chemical interactions of Ag⁰ and HA functional groups, crystallinity and thermal stability of the wound dressing, respectively. The resultant HA/Ag-NPs1 and HA/Ag-NPs2 composite showed uniformly dispersed throughout HA fiber/fabrics (SEM), an excellent distribution of Ag-NPs with 25 ± 2, nm size (TEM, DLS) and acceptable mechanical properties. The XRD analysis showed that the in-situ preparation of Ag-NPs increased the crystallinity of the resultant fabrics as well as the thermal stability. The antibacterial performance of medical HA/Ag-NPs fabrics was evaluated against gram negative bacteria E. coli K12, exhibiting significant bactericidal activity. The fibers did not show any cytotoxicity against human keratinocyte cell line (HaCaT). In-vivo animal tests indicated that the prepared wound dressing has strong healing efficacy (non-diabetics/diabetics rat model) compared to the plain HA fabrics and greatly accelerated the healing process. Based on our results, the new HA/Ag-NPs-2 mg nonwoven wound dressing fabrics can be used in treating wounds and chronic ulcers as well as cell carrier in different biological research and tissue engineering.
Hyaluronic acid on collagen membranes: An experimental study in rats
2017, Archives of Oral Biology
Citation Excerpt :
Hyaluronic acid (HA), a natural linear glycosaminoglycan, is biocompatible, biodegradable (Fraser, Laurent, & Laurent, 1997), and has been suggested to display anti-inflammatory and bacteriostatic action (Campo et al., 2012; Pirnazar et al., 1999). Furthermore, HA has important tissue healing properties, including the induction of angiogenesis, and the promotion of cell migration, adhesion, and proliferation (Burd et al., 1991; Jiang, Liang, & Noble, 2007; Toole, 2001). Due to its desirable effects, HA-based gels have been used in various medical specialties (Robert, 2015), and recent studies (Fawzy El-Sayed, Dahaba, Aboul-Ela, & Darhous, 2012) have analyzed its application in dentistry.
The aim of this study was to evaluate the effect of hyaluronic acid (HA) in the structure and degradation patterns of BioGide^® and OsseoGuard™ collagen membranes. HA mediates inflammation and acts in cell migration, adhesion, and differentiation, benefitting tissue remodeling and vascularization. These are desirable effects in guided regeneration procedures, but it is still unknown whether HA alters the barrier properties of absorbable membranes.
Bone defects were created in the calvaria of rats, which were treated with HA gel 1% (HA group) or simply filled with blood clot (control group), and covered with BioGide^® or OsseoGuard™. The animals were euthanized after 1, 30, and 60 days, and their calvarias were processed for histological analysis.
BioGide^®, in both HA and control groups, showed vascularization, intense cell colonization, bone formation, and tissue integration at 30 and 60 days. In contrast, Osseoguard™ presented minimal cellular colonization, and inflammatory reaction associated to foreign body reaction in both time points and groups. The HA group of BioGide^® showed higher cell colonization (574.9 ± 137.6) than the control group (269.1 ± 70.83) at 60 days (p < 0.05). Despite this finding, the structure and degradation pattern were similar for BioGide^® and Osseoguard™ in the HA and control groups.
The results suggest that HA did not interfere with tissue integration and structural degradation of BioGide^® and Osseoguard™ membranes.
Cell Surface Access Is Modulated by Tethered Bottlebrush Proteoglycans
2016, Biophysical Journal
The hyaluronan-rich pericellular matrix (PCM) plays physical and chemical roles in biological processes ranging from brain plasticity, to adhesion-dependent phenomena such as cell migration, to the onset of cancer. This study investigates how the spatial distribution of the large negatively charged bottlebrush proteoglycan, aggrecan, impacts PCM morphology and cell surface access. The highly localized pericellular milieu limits transport of nanoparticles in a size-dependent fashion and sequesters positively charged molecules on the highly sulfated side chains of aggrecan. Both rat chondrocyte and human mesenchymal stem cell PCMs possess many unused binding sites for aggrecan, showing a 2.5x increase in PCM thickness from ∼7 to ∼18 μm when provided exogenous aggrecan. Yet, full extension of the PCM occurs well below aggrecan saturation. Hence, cells equipped with hyaluronan-rich PCM can in principle manipulate surface accessibility or sequestration of molecules by tuning the bottlebrush proteoglycan content to alter PCM porosity and the number of electrostatic binding sites.
Glycosaminoglycans in Tendon Physiology, Pathophysiology, and Therapy
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Although glycosaminoglycans constitute a minor portion of native tissues, they play a crucial role in various physiological processes, while their abnormal expression is associated with numerous pathophysiologies. Glycosaminoglycans have become increasingly prevalent in biomaterial design for tendon repair, given their low immunogenicity and their inherent capacity to stimulate the regenerative processes, while maintaining resident cell phenotype and function. Further, their incorporation into three-dimensional scaffold conformations significantly improves their mechanical properties, while reducing the formation of peritendinous adhesions. Herein, we discuss the role of glycosaminoglycans in tendon physiology and pathophysiology and the advancements achieved to date using glycosaminoglycan-functionalized scaffolds for tendon repair and regeneration. It is evidenced that glycosaminoglycan functionalization has led to many improvements in tendon tissue engineering and it is anticipated to play a pivotal role in future reparative therapies.

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: Presented in part at the Summer Meeting of the British Association of Plastic Surgeons in Bristol, July 1989.

View full text

Hyaluronan and wound healing: a new perspective

Abstract

Matrix

British Journal of Plastic Surgery

Journal of Pediatric Surgery

Journal of Paediatric Surgery

Otolaryngology Clinics of North America

Journal of Pediatric Surgery

Journal of Investigative Dermatology

Journal of Pediatric Surgery

Carbohydrate Research

Journal of Biological Chemistry

Journal of Investigative Dermatology

British Journal of Plastic Surgery

Collagen Related Research

Developmental Biology

Developmental Biology

Journal of Biological Chemistry

Journal of Theoretical Biology

Healing of hyaluronic acid-enriched wounds: histological observations

Journal of Surgical Research

Comparison of fetal, newborn, and adult healing by histologic, enzyme-histochemical and hydroxyproline determination

Journal of Pediatric Surgery

Physiological function of connective tissue polysaccharides

Physiological Review