Efficacy Of Hyaluronic Acid Research Articles

Corrigendum: Efficacy of hyaluronic acid in the treatment of nasal inflammatory diseases: a systematic review and meta-analysis

Corrigendum: Efficacy of hyaluronic acid in the treatment of nasal inflammatory diseases: a systematic review and meta-analysis

Efficacy of Hyaluronic Acid in Mandibular Third Molar Surgery Performed Using Conventional Bur Technique and Piezosurgery: A Comparative Study

Efficacy of Hyaluronic Acid in Mandibular Third Molar Surgery Performed Using Conventional Bur Technique and Piezosurgery: A Comparative Study

Botulinum Toxin Type A and Hyaluronic Acid Dermal Fillers in Dentistry: A Systematic Review of Clinical Application and Indications.

Botulinum toxin type A (BoNT-A) and hyaluronic acid (HA) dermal fillers are increasingly utilized in dentistry for therapeutic and aesthetic purposes. However, a comprehensive synthesis of their clinical applications and indications in dentistry is lacking. This systematic review aimed to analyze the clinical application and indications of BoNT-A and HA dermal fillers in dentistry, providing insights into their efficacy, safety profiles, and limitations. A systematic search was conducted in PubMed/MEDLINE databases to identify relevant studies published between 2018 and 2024. Medical Subject Headings (MeSH) terms and keywords related to BoNT-A, HA dermal fillers, dentistry, clinical applications, and indications were used. Study selection criteria included randomized controlled trials (RCTs) and non-RCTs involving human participants of any age group. Data extraction and synthesis followed established guidelines, focusing on study characteristics, participant demographics, intervention details, outcome measures, and key findings related to BoNT-A and HA dermal fillers' clinical application in dentistry. Systematic searches across electronic databases and grey literature identified 857 records, with an additional 73 from hand searches. After screening titles and abstracts, 542 records were excluded, leaving 374 full-text publications for evaluation. Ultimately, 12 RCTs and 13 non-RCTs were included. The systematic review encompassed diverse geographic locations: Brazil, Italy, Spain, Syria, India, Egypt, Korea, and the Netherlands, involving samples sizes ranging from 14 to 143 participants. The review synthesized findings on HA's efficacy in various areas, including bone repair, gingivitis management, temporomandibular joint disorders, postoperative swelling reduction, periodontal defect treatment, chin and check projection and lips augmentation. BoNT-A exhibited promising efficacy in managing orofacial pain conditions, gummy smile treatment and neuromodulation of the lower third muscles. Safety profiles varied among studies, with some reporting minimal adverse effects while others noted dose-related concerns. BoNT-A and HA dermal fillers offer a wide array of clinical applications in dentistry, ranging from therapeutic interventions to aesthetic enhancements. Despite promising efficacy, careful consideration and monitoring of safety outcomes are essential when integrating these interventions into clinical practice. Further research addressing methodological limitations and safety concerns is warranted to optimize their utilization and improve patient care in dentistry.

Efficacy of Hyaluronic Acid Against Cyclophosphamide Toxic Effects on the Urinary Bladder of Adult Male Albino Rat (Histological and immunohistochemical study)

Efficacy of Hyaluronic Acid Against Cyclophosphamide Toxic Effects on the Urinary Bladder of Adult Male Albino Rat (Histological and immunohistochemical study)

Efficacy of Hyaluronic Acid in Relieving Post-implantation Pain: A Split-Mouth Randomized Controlled Trial.

Background Many patients suffer from some degree of pain following the surgical procedures of dental implantation. The fear of pain may be one reason for postponing such prosthodontic treatments. Many procedures have been suggested to control post-implantation pain.This trial evaluated the effectiveness of using hyaluronic acid (HA) during dental implantation on patients' perceived pain during the postsurgicalsoft-tissue healing period. Methodology A split-mouth randomized controlled trial (RCT) was conducted. The trial sample consisted of 22 dental implants in 11 patients (five males and six females). Patients were selected from thoseattending the Department of Oral Medicine at the Faculty of Dentistry, University of Damascus between February 2021 and May 2022. The implants were performed in similar bone quality and density for each patient as the implants were inserted in the same jaw on both sides to ensure the same physiological conditions. The study sample was divided into two groups. The first group (the experimental group) consisted of 11 implants in which the implant site was drilled, following which HA was placed inside the implant site and on the surrounding bone before the flap was returned and sutured. The second group (the control group) comprised 11 implants following the conventional procedure without applying any material to the implant socket. The main outcome measure was pain perception which was assessed using the visual analog scale (VAS). Patients were asked to record their perceived pain on the first, third, and tenth days. Two-sample t-tests were used to detect significant differences. Results There were statistically significant differences in the mean pain intensity between the experimental and control groups on the first, third, and tenth days (p < 0.05). The mean values of perceived pain in the control group were 5.68, 1.72, and 0.56 on the first, third, and tenth days, respectively. In comparison, the mean values of perceived pain in the experimental group were 4.52, 1.14, and 0.18 on the first, third, and tenth days, respectively. The maximum perceived pain in the control group was 7.5 on the first day following implantation, whereas the maximum value recorded in the experimental group was 6.5. At the third assessment time (i.e., 10 days following the surgical intervention), the mean values were in the very mild category of pain intensity. Conclusions This study showed that applying HA in the implant cavity and on the surrounding bone effectively reduced pain after dental implant surgery in comparison with the control group. Patients had lower mean pain scores at one, three, and ten days following surgery compared to the conventional method. HA is suggested to be an adjunctive method to control postsurgical pain after dental implantation.

Safety and Efficacy of High Molecular Weight Intra-Articular Hyaluronic Acid in the Management of Knee Osteoarthritis: A Prospective Study

Intra-articular Hyaluronic acid (IAHA) injection provides intra-articular (IA) anti-inflammatory effect and improves synovial fluid flow dynamics and viscoelasticity. The aim of this prospective observational, clinical study was to evaluate the safety and efficacy of Hyaluronic Acid (HA) (40mg/2ml) 3 times with one week interval for the treatment of osteoarthritis (OA). Methods and materials: A total of 105 adults with OA were enrolled in the study. Each patient received 3 injection cycles of HA with one week interval. WOMAC OA Index was used to assess the effectiveness of injection and SF-36 to observe the change in quality of life. Physical examination was performed before injection and at the 3rd and 6th months following injection. Results: WOMAC score showed significant reduction from baseline (61.6) to 3rd treatment procedure visit (32.1), 3 months (16.2) and 6 months follow up visit (4.8) respectively (p&lt;0.001). Significant improvement was observed in quality of life from baseline values to 3 month and 6 month follow up visit (p&lt;.0001) Discussion: Studies have shown that HA is safe and well tolerated to achieve clinically significant improvement in patients with mild to moderate knee OA. It is presented that repeated IAHA injections are an effective treatment for knee OA, and reduce pain and contribute to recovery. It was concluded that HA with higher molecular weight improved pain more and suggested that the use of HA products may be effective in knee OA. A significant increase was observed in SF-36 parameters reporting quality of life with IAHA, and HMW-IAHA added to usual care is effective for knee OA in working individuals. Conclusion: Three weekly IA injections of HA provided pain relief and functional improvements with high treatment satisfaction in patients with painful knee OA lasted for a minimum 6 months.

Efficacy of Hyaluronic Acid in Endoscopic Dacryocystorhinostomy: A Systematic Review and Meta-Analysis.

The aim of this meta-analysis is to compare the surgical results of endoscopic dacryocystorhinostomy (Endo-DCR) for chronic dacryocystitis (CD) with and without intraoperative hyaluronic acid (HA) application. An electronic literature search was performed using the PubMed, Embase, Cochrane Library, CNKI, and Wan Fang databases in April 1, 2022. Review Manager software version 5.4 was used for data synthesis and a forest plot was generated for each outcome measure. Seven randomized control trials (RCTs), which involved 739 eyes, were included in this meta-analysis. Overall, compared with the control group, intraoperative HA application significantly enhance the success rate (odds ratio [OR] = 3.27, 95% confidence interval [CI]: 2.15-4.98, P < .00001), promote re-epithelization (OR = 2.93, 95% CI: 1.83-4.68, P < .00001), reduce granulation (OR = 0.41, 95% CI: 0.21-0.80, P = .008), and scar (OR = 0.39, 95% CI: 0.22-0.68, P = .001) formation after Endo-DCR. Intraoperative HA application seems to be a useful adjuvant that could enhance success rate by promoting re-epithelization and inhabiting granulation and scar formation around the ostium.

Outcome of hyaluronic acid gel injection in glans penis for treatment of lifelong premature ejaculation: A pilot study

ABSTRACT Objective To assess safety and efficacy of hyaluronic acid (HA) gel injection in glans penis for treatment of premature ejaculation (PE) using our new five puncture technique. Patients and methods This is a prospective, non-randomized clinical trial on HA gel injection in glans penis for all patients with lifelong PE; all patients were circumcised having heterosexual normal marital life and sexually active. Patients with history of ejaculatory medication use within the previous 3 months, psychiatric disorders, erectile dysfunction, lower urinary tract symptoms (LUTS) due to prostatitis and acquired PE were excluded from the study. A local anesthetic was applied to the skin of glans penis for 30 minutes before the injection of 2 ml HA in glans penis via 30-gauge needle using our new Five-puncture technique. Intra-vaginal ejaculatory latency time (IELT) was measured at 1, 3, 6 and 12 months after injection. Results Thirty patients completed our study follow up schedule. Mean age of the patients was 41.72 ± 8.50, while mean age of female partner was 37.23 ± 8.54 years. IELT was highly significantly increased (P-value < 0.001) after HA gel injection from baseline, which was in maximum 37.83 ± 11.01 sec at baseline to 323.03 ± 42.06, 281.07 ± 41.05, 241.03 ± 43.09 and 235.6 ± 41.87 sec after 1, 3, 6 and 12 months, respectively, after injection. Three patients complained from discomfort at the site of injection, two from bullae formation at the site of injection and one from ecchymosis, and all resolved spontaneously after 1 week to 10 days after injection. Conclusion HA gel injection in glans penis using our new five-puncture technique is a safe and effective method that ensures a modest long-term significant increase in IELT and improves ejaculatory control.

Efficacy of hyaluronic acid, absorbable collagen sponge, and their combination in minimizing bisphosphonate-related osteonecrosis of the jaws (BRONJ) after dental extraction: a preliminary animal histomorphometric study

IntroductionThere is no study on the effectiveness of hyaluronic acid (HA) placement either with or without absorbable collagen sponge (ACS) in reducing or preventing bisphosphonate-related osteonecrosis of the jaws (BRONJ). This preliminary animal study examined the efficacy of this clinically important treatment.MethodsFor simulating BRONJ, zoledronic acid was administered to 40 rats for 5 weeks. Two weeks later, a right first molar was extracted from each rat. The rats were randomized into four groups of socket treatments: control (empty extraction socket) or with sockets filled with ACS, HA, or HA+ACS (n=4×10). After 2 weeks, 5 rats in each group were sacrificed and subjected to histopathologic and histomorphometric evaluation. Eight weeks post-surgically, the rest of rats were euthanized and histologically examined. The Kruskal-Wallis test was used to compare the four treatments at each time point (α=0.05).ResultsSix rats were lost overall. In the second week, vascularization was higher in ACS group (P<0.05); osteoclast activity was not different between groups (P>0.05); empty lacunae were the most and fewest in control and HA+ACS groups, respectively (P<0.05); eosinophil infiltration was maximum in HA group (P<0.05); lymphocyte counts were maximum and minimum in the HA+ACS and ACS groups, respectively (P<0.05); the highest and lowest neutrophil counts were seen in ACS and control groups, respectively (P<0.05); and the extent of live bone did not differ between groups (P>0.05). In the eighth week, vascularization was not different in groups (P>0.05); the highest and lowest osteoclast activities were seen in the control and HA+ACS groups, respectively (P<0.05); empty lacunae were the most and fewest in control and HA+ACS, respectively (P<0.05); maximum and minimum numbers of eosinophils were in control and HA+ACS groups, respectively (P<0.05); HA and control groups exhibited the highest and lowest lymphocyte counts, respectively (P<0.05); the lowest and highest neutrophil counts were observed in HA+ACs and control groups, respectively (P<0.05); and the highest and lowest extents of the live bone were observed in HA+ACS and control groups, respectively (P<0.05).ConclusionsWithin the limitations of this preliminary animal study, HA and especially HA+ACS seem a proper method for preventing or treating BRONJ.

The Role of Hyaluronic Acid for Soft Tissue Indications: A Systematic Review and Meta-Analysis.

Soft tissue injuries are often treated with injectables such as corticosteroids and platelet-rich plasma (PRP) to reduce inflammation and promote healing. There is increasing evidence examining the use of hyaluronic acid (HA) for the management of soft tissue injuries. To evaluate the treatment effect and role of HA for available soft tissue indications. A search of PubMed, MEDLINE, EMBASE, and CENTRAL from the inception date of each database through February 24, 2021, was conducted for all randomized controlled trials (RCTs) involving the use of HA for soft tissue indications. Two reviewers independently screened articles for eligibility and extracted data from included studies for analysis. We assessed risk of bias for all included studies and pooled outcomes using a fixed-effects model. Outcomes (ie, function and pain relief) were categorized to short-term (<6 weeks, 6-12 weeks) and mid-term (>12 weeks) data. We present effect estimates as mean differences (MDs) and standardized mean differences (SMDs) and present the estimate of effect of HA for available indications in relation to available comparators. Meta-analysis of RCTs. Level 1. Of the 6930 articles screened, 19 RCTs (n = 1629 patients) were eligible and included in this review. HA was evaluated across a variety of soft tissue indications including rotator cuff disease, elbow pain, ankle sprains, Achilles tendinopathy, patellar tendinopathy, and trigger finger. Of the 19 RCTs, 11 were placebo-controlled and 9 used active comparators (PRP, cortisone, prolotherapy, or extracorporeal shockwave therapy). The pooled treatment effect of HA across most soft indications against placebo and active comparators demonstrated benefit in short-term pain <6 weeks (MD visual analogue scale [VAS] 2.48, 95% CI 2.31-2.65) and 6 to 12 weeks (MD VAS 2.03, 95% CI 1.86-2.20). Mid-term pain relief also favored HA over comparators across indications >12 weeks from administration (MD VAS 3.57, 95% CI 3.35-3.78). High heterogeneity was present with rotator cuff (10 trials, I2 = 94%), and elbow tendinopathy (2 trials, I2 = 99%). We identified uncertain benefit for trigger finger (2 trials, I2 = 67%). Heterogeneity for ankle sprains, patellar tendinopathy and Achilles tendinopathy could not be assessed as they only had 1 trial each. This systematic review and meta-analysis support HA's efficacy in the treatment of a variety of soft tissue indications. Understanding the relative effects of HA to other injectable modalities requires additional, large trials.

Intra-Articular Platelet-Rich Plasma Injections in Knee Osteoarthritis: A Review of Their Current Molecular Mechanisms of Action and Their Degree of Efficacy.

Knee osteoarthritis (OA) is estimated to affect more than 10% of the population, with a lifetime risk of 45%. Contemporary guidelines advise control of body weight, therapeutic physical exercise, drug treatment (oral non-steroidal anti-inflammatory drugs, paracetamol, opioids), and mechanical aids (walking aids, braces, orthoses). Nevertheless, these treatments typically have only short-term benefits. Intra-articular corticosteroids are typically advised, but only for short-term pain alleviation, given that their benefits last only a few weeks. The efficacy of hyaluronic acid is controversial. When the aforesaid options fail, total knee arthroplasty is generally recommended as an efficacious treatment. However, it is costly and can involve medical and postoperative complications. Therefore, determining alternate safe and effective treatments for knee OA is paramount. Platelet-rich plasma (PRP) has lately been investigated for the treatment of knee OA. This article reviews recent knowledge concerning PRP’s molecular mechanisms of action. The effectiveness of intra-articular PRP injections in the knee joint remains controversial, although most recent publications show pain alleviation in the short term. Orthopedic surgeons treating people with knee OA are becoming increasingly interested in PRP, despite indecisive clinical data and basic science information. Further studies comparing PRP with placebo are required.

Mechanisms of Action and Efficacy of Hyaluronic Acid, Corticosteroids and Platelet-Rich Plasma in the Treatment of Temporomandibular Joint Osteoarthritis-A Systematic Review.

Temporomandibular joint osteoarthritis (TMJ OA) is a low-inflammatory disorder with multifactorial etiology. The aim of this review was to present the current state of knowledge regarding the mechanisms of action and the efficacy of hyaluronic acid (HA), corticosteroids (CS) and platelet-rich plasma (PRP) in the treatment of TMJ OA.: The PubMed database was analyzed with the keywords: “(temporomandibular joint) AND ((osteoarthritis) OR (dysfunction) OR (disorders) OR (pain)) AND ((treatment) OR (arthrocentesis) OR (arthroscopy) OR (injection)) AND ((hyaluronic acid) OR (corticosteroid) OR (platelet rich plasma))”. After screening of 363 results, 16 studies were included in this review. Arthrocentesis alone effectively reduces pain and improves jaw function in patients diagnosed with TMJ OA. Additional injections of HA, either low-molecular-weight (LMW) HA or high-molecular-weight (HMW) HA, or CS at the end of the arthrocentesis do not improve the final clinical outcomes. CS present several negative effects on the articular cartilage. Results related to additional PRP injections are not consistent and are rather questionable. Further studies should be multicenter, based on a larger group of patients and should answer the question of whether other methods of TMJ OA treatment are more beneficial for the patients than simple arthrocentesis.

Hyaluronic acid injection in the glans penis for the treatment of refractory premature ejaculation: A prospective, controlled study

We aimed to demonstrate the safety and efficacy of hyaluronic acid (HA) injection in the glans penis for the treatment of persistent premature ejaculation (PE). Eighty patients with persistent PE were divided equally into two groups. In group A, patients underwent HA injection by four-inlet injection technique, while in group B, patients were subjected to saline injection in glans penis by the same method as a control group. Patients were followed up for six months. At the end of follow-up, the IELT significantly improved in the HA injection group, as compared to the baseline values and control group. The maximal glandular circumference significantly increased at the 1st, 3rd and 6th month of follow-up. The rate of patient satisfaction with sexual intercourse was 64.9%, 70.3% and 78.4% at the 1st, 3rd and 6th month of follow-up, respectively. Besides, the partner satisfaction with sexual intercourse was 54.1%, 48.6% and 59.5% at the 1st, 3rd and 6th month of follow-up, respectively. In conclusion, HA injection may represent a promising treatment modality for persistent PE.

Гиалуроновая кислота при внутрисуставном введении: зависимость эффекта от молекулярной массы

The article discusses the patient management with knee osteoarthritis according to the ESCEO 2019 algorithm. The focus is on the second stage in the persistence of osteoarthritis signs. The article pays attention to the means based on hyaluronic acid for intra-articular injection. It also provides the study analysis that proved the anti-inflammatory mechanism of action of hyaluronic acid-based drugs during intraarticular administration, as well as the study results in which histology data indicated that hyaluronic acid prevents cartilage degradation and can promote its regeneration. These researches show that repeated injections of hyaluronic acid are not only effective, but also safe. In the literature, there is evidence that during treatment, the time to endoprosthesis increases, as well as the need for taking NSAIDs and opioids decreases. The article discusses the molecular weight of hyaluronic acid, providing research data confirming the greatest efficacy of hyaluronic acid with medium and high molecular weight. KEYWORDS: osteoarthritis, knee joints, hyaluronic acid, intraarticular injection. FOR CITATION: Filatova Yu.S., Gawert V.R. Intra-articular hyaluronic acid: dependence of the effect on molecular weight. Russian Medical Inquiry. 2021;5(3):156–161. DOI: 10.32364/2587-6821-2021-5-3-156-161.

Efficacy of Hyaluronic Acid in Patients with Osteoarthritis of The Knee

Osteoarthritis (OA) of the knee is the most common chronic degenerative joint disease characterized by pain,stiffness, swelling and progressive functional limitation in elderly. Non-surgical management modalitieslike physical therapy, lifestyle modification and oral non-steroidal anti-inflammatory drugs, are oftenineffective or do not alleviate symptoms adequately. Intra-articular corticosteroid (CS) and hyaluronic acid(HA) injections have been used for long to alleviate the symptoms of knee OA. viscosupplementation hasbeen used as a therapeutic modality for the management of knee OA. The principle of viscosupplementationis based on the physiological properties of the hyaluronic acid (HA) in the synovial joint which helps tissuelubricate, cushion and reduce pain in the joint.Study diagnosed forty patient of knee Osteoarthritis for both gender with age (45-70 years) and observedchange and effectiveness to pre-and post of HA injection, All patients diagnosed by Orthopedists andRheumatologists whose used X-rays were graded as stage I, II and III according to Kellgren and Lawrencescale.All the measurements were used at the time of enrollment in the study before any injection and then measuredagain at the end of three months by using Western Ontario and McMaster University Osteoarthritis Index(WOMAC) .All the patients before therapy were having minimum score of 72.4 &amp; 9.045 for Mean and Standard Deviationrespectively while after the therapy there score reduced to 36.2 &amp; 4.783.The results show improvement significant during four month under study and the effect peaks at around8–12 weeks following administration, This supports the potential use of intra-articular HA as an effectivelong therapeutic option for patients with OA of the knee.

Efficacy of hyaluronic acid on intervertebral disc inflammation: An in vitro study using notochordal cell lines and human disc cells.

Hyaluronic acid (HA) is widely recognized as a therapeutic target and currently used in medicine. However, HA metabolism during intervertebral disc degeneration (IVDD) has not been completely elucidated. This study aimed to evaluate the efficacy of HA on intervertebral disc (IVD) inflammation and identify the main molecules modulating HA degradation in IVDs. To assess HA function in IVD cells in vitro, we treated human disc cells and U-CH1-N cells, a notochordal nucleus pulposus cell line, with HA or hyaluronidase. Real-time reverse transcription polymerase chain reaction (RT-PCR) and Western blot analysis showed that tumor necrosis factor alpha (TNF-α)-mediated induction of the expression of TNF-α and cyclooxygenase-2 (COX2) was clearly neutralized by HA treatment, andthe expression of TNF-α and COX2 was significantly induced by hyaluronidase treatment in both cell types. Additionally, Western blot analysis showed that hyaluronidase-induced phosphorylation of p38 and Erk1/2, and that TNF-α-mediated phosphorylation of p38 and Erk1/2 was clearly reduced by HA addition. In degenerating human IVD samples, immunohistochemistry for hyaluronidase showed that the expression of hyaluronidases including HYAL1, HYAL2, and cell migration-inducing protein (CEMIP) tended to increase in accordance with IVDD. In particular, HYAL1 showed statistically significant differences. In vitro study also confirmed asimilar phenomenon that TNF-α treatment increased both messenger RNA and protein expression in both cell types. Our results demonstrated that HA could potentially suppress IVDD by regulating p38 and Erk1/2 pathways, and that the expression of HYAL1 was correlated with IVDD progression. These findings indicated that HYAL1 would be a potential molecular target for suppressing IVDD by controlling HA metabolism.

An assessment of the effectiveness of hyaluronic acid and polyacrylamide hydrogel in horses with osteoarthritis: Systematic review and network meta-analysis

For several years, hyaluronic acid (HyA) and, more recently, polyacrylamide hydrogel (PHyd) have been used to reduce lameness and pain caused by osteoarthritis. However, there is still a lack of scientific evidence of the efficacy of these substances to allow veterinary experts to make decisions about their use in horses. The objective of this study was to evaluate, through a systematic review and network meta-analysis (NMA), the efficacy of HyA, associated or not with other drugs, and PHyd in relieving lameness in horses with osteoarthritis. The searches for primary studies were conducted on four search platforms. The efficacy of HyA and PHyd was estimated through the relative risk difference method. Heterogeneity was observed in the efficacy of HyA, indicating long-term ineffectiveness of this drug when associated or not with anti-inflammatory drugs. In contrast, the results indicate that PHyd is an effective alternative therapy, with a long period of action in reducing lameness in horses with osteoarthritis. This study provides evidence that the application of PHyd and HyA is effective in reducing lameness caused by osteoarthritis in horses at different time periods, where PHyd has a longer time of action.

Efficacy of Hyaluronic Acid in the Treatment of MIA-induced Ankle Osteoarthritis in Rats and its Effect on Antioxidant Response Element

Ankle osteoarthritis (OA) is a long-standing inflammatory degeneration disease; until now, its pathogenesis remains ambiguous. There is no complete remedy from OA and the present pharmacological therapy choices are restrained and combined with undesirable side effects. Clinically, Hyaluronic acid (HA) is widely consumed to cure OA. The present experiment aimed to assess the role of HA in the remedy of experimentally Monosodium iodoacetate (MIA) -induced ankle OA in the rat model. Thirty male Wistar rats were divided into 3 groups (each of 10 rats). Rats of group I were injected with 1 mg MIA in the right ankle joint for two successive days, while those of group II were treated with saline instead of MIA; and group III( osteoarthritic + HA) rats were injected with HA in the ankle joint at 2nd, 3rd, and 4th weeks following injection of MIA. Bodyweight, ankle measurement, total leukocytes count (TLC), antioxidant response element (ARE) level, and joint Magnetic Resonance Imaging (MRI) were investigated. HA reduced expressions of joint ARE level. HA also markedly reduced the TLC. The administration of HA decreases ankle measurement in MIA-induced OA rats. MRI of HA showed a gradual reduction in joint damage. These results suggest that HA has improvement effects on OA rats which are assessed through anti-inflammatory and antioxidant effects.

The Correction of Facial Morphea Lesions by Hyaluronic Acid: A Case Series and Literature Review.

IntroductionThe aim of the study is to assess the long-term safety and efficacy of hyaluronic acid (HA) administration in correction of facial morphea lesions and to review the literature on the subject. Morphea is a chronic inflammatory disease of the connective tissue which may lead to serious deformations. The lesions located on the face particularly affect patients’ quality of life and self-esteem; thus, there is a demand for safe and effective methods of treatment.Case PresentationThe paper presents three female patients aged 16, 17 and 70 with facial morphea lesions who had HA preparation Juvéderm® Voluma or Volux, Vycross® technology, Allergan, injected. One of the patients had additionally fractional ablative CO2 laser (FAL) therapy.DiscussionThe literature provides reports on successful use of HA, polymethylmethacrylate and poly-l-lactic acid for the correction of facial defects in localized scleroderma. HA is a natural component of the extracellular matrix and it therefore minimizes the probability of immunogenicity. The application technique also plays an important role. On the other hand, FAL therapy leads to the degradation of the abnormal collagen and the induction of normal collagen synthesis.ConclusionsHA injection and combination of HA application with FAL are minimally invasive, effective and safe therapeutic options for patients suffering from morphea.

Silver Sulphadiazine- xanthan gum- hyaluronic Acid Composite Hydrogel for Wound Healing: Formulation Development and &lt;I&gt;in vivo&lt;/I&gt; Evaluation

Background: Development and modifications of hybrid hydrogels have been done to improve biological properties or to decrease the disadvantages of biomaterials.Objectives: The efficacy of hyaluronic acid in combination with silver sulphadiazine in wound healing was investigated. The retaining properties of xanthan gum to aid re- epithelialization was also explored.Materials and Method: Four hybrid hydrogels comprising of different concentrations of xanthan gum, eugenol and antimicrobial agents – hyaluronic acid and silver sulphadiazine were formulated. The physicochemical properties of the gels were assessed, and the antimicrobial effectiveness of the different hydrogel were determined using the extent of wound closure as an index.Results: The hydrogel samples had approximately 90% moisture content with rate of evaporation between 26- 32% for a 5 h period at 37oC. The pH of all formulations was between 7.59 - 8.05 considering that the formulation would be applied to underlying tissues of the skin. The swelling index after a 12 h period in distilled water was 10% for HX 1, 27% for HX 2, 29% for HX 3 and 30% for HX 4. There was no new peak observed in the FTIR analysis to indicate formation of new bonds.Conclusion: Incorporation of silver sulphadiazine at 0.1% and hyaluronic acid at 1.5% in the formulation yielded the best results with regards to least presence of inflammatory cell infiltrates and excellent wound closure at 14 days compared to the control and other formulations. Further investigation may be required for clinical use as an effective wound dressing material.&#x0D; Keywords: Silver sulphadiazine, Xanthan gum, Hyaluronic acid, Hydrogels, Wound healing.