Chapter 23 - Medicinal Uses of Modified Hyaluronate

Abstract

Since hyaluronate is a naturally occurring and ubiquitous material, there has been significant commercial focus on the development of products either from hyaluronate or from chemically modified derivatives of hyaluronate. A variety of hyaluronate and hyaluronate plus chemically crosslinked hyaluronate preparations have been approved as viscosupplements for patients with osteoarthritis of the knee. The biocompatibility and physiochemical properties of hyaluronate and its presence in virtually every tissue and fluid in the body make it an excellent material to develop medical devices from. The lubricity of hyaluronate at relatively low solution concentrations have been exploited to significantly lower the risk of complications in phacoemulsion and intra-ocular lens insertion and offers a new treatment for pain associated with early stage osteoarthritis. Recently, several products derived from chemically modified hyaluronate have appeared on the market. Several hyaluronate-based adhesion reduction barriers now afford both general and gynecological surgeons products that can reduce the incidence of post-surgical adhesions while being able to bioresorb with time. Conjugation of drugs to hyaluronate holds great promise for the generation of a new class of polymer based therapeutics. Drug delivery systems made from chemically modified hyaluronate have the ability to function as drug delivery platforms for the local delivery of therapeutics. Drugs conjugated to hyaluronate could also serve to target the drug to cells or tissues in the body that are rich in hyaluronate binding receptors. One of the most promising uses of chemically modified hyaluronate is in the area of tissue engineering.