Hyaluronic Acid In Patients Research Articles

Evaluation of the efficacy, safety and satisfaction rates of platelet-rich plasma, non-cross-linked hyaluronic acid and the combination of platelet-rich plasma and non-cross-linked hyaluronic acid in patients with burn scars treated with fractional CO2 laser: A randomized controlled clinical trial.

Skin scarring can result from burns, injuries, stretch marks and acne, leading to cosmetic and functional difficulties. Treatments for burn scars encompass a range of options, such as lasers, corticosteroid injections, surgery and regenerative techniques such as platelet-rich plasma (PRP). Hyaluronic acid-based products offer skin hydration and shield against aging effects. A study is being conducted to evaluate how effective PRP injection, hyaluronic acid and their combination improve burn scars and their effects on quality of life and potential disabilities. In our study, PRP and non-cross-linked hyaluronic acid treatments were compared in 10 individuals with burn scars between 2022 and 2023. Patients received CO2 fractional laser treatment followed by injections in scar areas. Evaluations included the Vancouver scar scale (VSS), biometric assessments, ultrasounds and satisfaction ratings. Two therapy sessions were conducted at 1-month interval, and assessments were done before treatment, 1 month after the first session, and 3 months after the first session. Biometric assessments showed significant improvements in various parameters (tewametry, corneometry, erythema index, melanin index, cutometry, thickness and density) in the intervention groups compared to the placebo group (p <0.05). PRP-non-cross-linked hyaluronic acid, PRP and non-cross-linked hyaluronic acid treatments exhibited the best clinical responses with significant differences between groups (p <0.05). Dermal thickness did not show significant improvement during treatment sessions, and changes among subjects were not significantly different. The colorimetry parameter improved in all groups except the placebo group, with no significant difference between intervention groups. The VSS significantly decreased in all treatment groups except the placebo group. PRP, non-cross-linked hyaluronic acid and especially the combination of these two treatment options are very effective in treating burn scars.

Predictors of Clinical Benefit with Intra-articular Hyaluronic Acid in Patients with Knee Osteoarthritis - A Narrative Review.

There is conflicting evidence regarding the efficacy of viscosupplementation with intra-articular hyaluronic acid injections in knee osteoarthritis. One possible explanation for the inconsistent findings on its efficacy is that only certain subpopulations of patients benefit from this therapy. The purpose of this narrative review is to succinctly summarize the existing data on the predictive factors of clinical response to intra-articular hyaluronic acid to identify the patient profile most likely to benefit from this therapy. For this narrative review, a PubMed search was conducted in January 2023, with no date limits, to identify publications reporting predictive factors of response to viscosupplementation using the following terms: hyaluronic acid OR viscosupplem* AND osteoarthritis AND knee AND predict*. Searches were limited to randomized controlled trials, systematic reviews and meta- analyses, or observational studies written in English. Other relevant references were identified by searching the references of retrieved articles. The disease severity was found to reliably predict response to intra-articular hyaluronic acid injections; patients with less severe disease consistently had a more robust therapeutic response than those with more severe disease. Other clinical variables such as level of baseline pain did not reliably predict response. Body mass index, and possibly age, may also be independent predictors of the response. A review of the existing literature suggests that patients with less severe clinical symptoms and radiological findings, who are younger, and with a lower or normal body mass index are the best candidates for intra-articular hyaluronic acid therapy.

Use of inhaled solution of hypertonic saline combined with high-molecular-weight hyaluronic acid in patients with lower respiratory tract diseases

Resolution of the Council of ExpertsNovember 17, 2023Respiratory diseases (acute and chronic bronchitis, chronic obstructive pulmonary disease (COPD), bronchiectasis, cystic fibrosis (CF), bronchial asthma, etc.) are often accompanied by impaired mucus clearance. In this regard, mucoactive drugs are most commonly used for the treatment. Hypertonic saline plus high-molecular-weight hyaluronic acid is one of the affordable and effective agents that can help with thinning and removal of bronchial secretions. The effect of 3%, 6%, 7% hypertonic saline on the respiratory system is multifaceted: it stimulates the osmotic fluid flow, breaks bonds linking polymers in the sputum, reduces swelling in the mucous membranes, stimulates ciliary beat frequency, and reduces the neutrophilic inflammation severity. The molecular size of HA plays an important role in the effectiveness of inhalation therapy with hypertonic saline combined with hyaluronic acid (HA). External administration of high-molecular-weight hyaluronic acid inhibits neutrophil elastase and metalloproteinase, potentiates hydration of bronchial secretions and has anti-inflammatory properties. In addition to clinical studies, real-life clinical practice in patients with cystic fibrosis, bronchiectasis and acute bronchitis also demonstrated the effectiveness of hypertonic saline combined with high-molecular-weight hyaluronic acid. The rationale for the use of hypertonic saline was reflected in the international GOLD (Global Initiative for Chronic Obstructive Lung Disease) guidelines in 2023. Therefore, due to high interest in the hypertonic saline combined with high-molecular-weight hyaluronic acid, it is important to expand the evidence base: to initiate a Russian multicenter study evaluating the effectiveness and safety of this combination in patients with chronic bronchitis and COPD in the Russian Federation. It will allow us to recommend hypertonic saline combined with high-molecular-weight hyaluronic acid to be included in the Russian clinical guidelines on treatment of chronic bronchitis and COPD as a mucoactive drug.

Evaluation of Effectiveness of Combined Intra-Articular Injection of Ozone and High Molecular Weight Hyaluronic Acid in Patients With Knee Osteoarthritis

Osteoarthritis is one of the major causes of disability and a source of social cost in the elderly. Its prevalence is increasing due to ageing and increasing obese population. The knee is one of the most common joints to be affected by osteoarthritis and it can lead to serious effects on one’s mobility, quality of life and livelihood. One of non-surgical treatments is intra-articular injection. Injection of both ozone and hyaluronic acid into knee joint are common methods for treatment of knee osteoarthritis. The aim of this study was to evaluate reduction of pain and improvement of function in patients who received combination of intra-articular injection of high molecular weight hyaluronic acid and ozone. In this retrospective case series study data of patients with knee osteoarthritis who underwent intra-articular injection of high molecular weight hyaluronic acid with ozone were evaluated. Participants had fulfilled Western Ontario and McMaster Universities Arthritis Index (WOMAC) short form questionnaire before, three days, one month and six months after the intra-articular injection. Pain reduction and function improvement factors were assessed according to the WOMAC short form questionnaire. A total of 65 patients were evaluated in this study. There was significant decrease in the total score of WOMAC SF (stiffness and function) in all three follow-ups (P&lt;0.001). Also, patients who had more severe pain before the injection benefited more from the intra-articular injection. Our study showed that the effectiveness of intra-articular injection of high molecular weight hyaluronic acid with ozone does not depend on the age, sex and BMI of patients. Injection of high molecular weight hyaluronic acid and ozone into the joint cause to significant improvement in patient’s knee pain and function. It is recommended that the combination of high molecular weight hyaluronic acid and ozone be considered as an effective treatment in the process of these patients.

Эффективность микроигольчатого радиочастотного лифтинга и инъекционных наполнителей на основе гиалуроновой кислоты в комплексной терапии инволютивных изменений кожи лица

The purpose of the study is to scientifically substantiate and develop an algorithm for the complex use of microneedle radiofrequency lifting and injectable fillers based on hyaluronic acid in patients with involutive changes in facial skin. Material and methods. 83 patients with involutive changes in facial skin were observed on an outpatient basis. Depending on the method of correction of involutive changes, the patients were divided into three groups. The control method was the Scientific Assessment Scale of Skin Quality (SASSQ). Results. It was revealed that the combined use of microneedle radiofrequency lifting and injectable fillers based on hyaluronic acid significantly reduces the severity of clinical manifestations in patients with involutive changes in the facial skin: 11 [9; 12], 10 [9; 11], 8 [8; 9] in the first, second, third groups, respectively, according to SASSQ. Conclusion. Thus, the combined use of microneedling radiofrequency lifting and injectable fillers based on hyaluronic acid can be recommended for patients with involutive skin changes in practical healthcare.

Clinical and prognostic implications of hyaluronic acid in patients with COVID-19 reinfection and first infection.

Previous research has shown that human identical sequences of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) promote coronavirus disease 2019 (COVID-19) progression by upregulating hyaluronic acid (HA). However, the association of HA with mortality and long COVID in SARS-CoV-2 reinfection and first infection is unclear. Patients with COVID-19 at Beijing Ditan Hospital from September 2023 to November 2023 were consecutively enrolled. SARS-CoV-2 reinfections were matched 1:2 with first infections using a nearest neighbor propensity score matching algorithm. We compared the hospital outcomes between patients with COVID-19 reinfection and first infection. The association between HA levels and mortality and long COVID in the matched cohort was analyzed. The reinfection rate among COVID-19 hospitalized patients was 25.4% (62 cases). After propensity score matching, we found that reinfection was associated with a better clinical course and prognosis, including lower levels of C-reactive protein and erythrocyte sedimentation rate, fewer cases of bilateral lung infiltration and respiratory failure, and shorter viral clearance time and duration of symptoms (p < 0.05). HA levels were significantly higher in patients with primary infection [128.0 (90.5, 185.0) vs. 94.5 (62.0, 167.3), p = 0.008], those with prolonged viral clearance time [90.5 (61.5, 130.8) vs. 130.0 (95.0, 188.0), p < 0.001], and deceased patients [105.5 (76.8, 164.5) vs. 188.0 (118.0, 208.0), p = 0.002]. Further analysis showed that HA was an independent predictor of death (AUC: 0.789), and the risk of death increased by 4.435 times (OR = 5.435, 95% CI = 1.205-24.510, p = 0.028) in patients with high HA levels. We found that patients with HA levels above 116 ng/mL had an increased risk of death. However, the incidence of long COVID was similar in the different HA level groups (p > 0.05). Serum HA may serve as a novel biomarker for predicting COVID-19 mortality in patients with SARS-CoV-2 reinfection and first infection. However, HA levels may not be associated with long COVID.

A Randomized Clinical Trial on the Clinical and Immunological Efficacy of a Mouth Rinse Containing Hydrogen Peroxide and Hyaluronic Acid in Patients with Gingivitis.

OBJECTIVE: The present study aimed to investigate the impact of HA/H2O2 (Hyaluronic Acid/Hydrogen Peroxide) mouthwash on pro-inflammatory cytokines, specifically IL-1β and IL-6, in individuals diagnosed with gingivitis. Furthermore, a comparison was made between the effects of HA/H2O2 and those of CHX (Chlorhexidine) and placebo.MATERIALS AND METHODS: This clinical trial was randomized, double-blinded, and parallel. Fifty-four students with biofilm-induced gingivitis (18 to 23 years old) were randomly assigned to three mouthwash groups: HA/H2O2, CHX, and placebo. Unidentified bottles were delivered to participants. For 14 days, 10 millilitres of HA/H2O2 mouthwash formulation, CHX (0.12%), and placebo were used twice a day. All subjects were assessed twice, once at baseline and once after 14 days. Before and after each participant's mouthwash usage, bleeding on probing was measured as a clinical parameter for inflammation, Salivary IL-1β and IL-6 were also assessed by ELISA. Changes in salivary interleukins and bleeding between baseline and after treatment were determined and compared by the t test with an alpha of 0.05.RESULTS: There was a statistically significant decrease in salivary interleukin-1β and IL-6 in all three groups. However, intergroup comparisons at second visits showed no significant difference between HA/H2O2 and CHX groups (P&gt;0.05) for the interleukins tested. Furthermore, all treatments considerably reduced bleeding on probing, although mouthwash with hyaluronic acid (HA) and hydrogen peroxide (H2O2) had a greater impact than the other two treatments.CONCLUSION: Mouthwash containing HA/H2O2 demonstrated an anti-inflammatory effect, suggesting they are immunomodulatory agents. These findings may be beneficial and encouraging for the use of HA/H2O2 in the treatment of gingivitis; thus, HA/H2O2 rinse has the potential to serve as an appropriate replacement for chlorhexidine (CHX).

Combined use of microneedle radiofrequency lifting and injectable fillers based on hyaluronic acid in treatment of involutive changes in facial skin

Combined procedures can be performed during one appointment to solve several problems for the patient. However, some treatments should be planned over several consecutive sessions to avoid complications and achieve optimal results. The purpose of our study was the scientific substantiation and development of an algorithm for the complex use of microneedle radiofrequency lifting and injection fillers based on hyaluronic acid in patients with involutive changes in the facial skin, taking into account the data of the pathomorphological research method. The patients were divided into three groups, depending on the treatment methods. In order to assess the effectiveness of therapy, a histological examination was carried out in five patients from each group, and a morphometric assessment was carried out. The histological picture and morphometric assessment of microslides from patients from different study groups indicate that microneedle RF lifting entails scar-type changes, which thins the thickness of the epidermis. However, the use of hyaluronic acid smoothes out these changes and leads to faster tissue restoration. At the same time, in the complex treatment group, better regenerative potential was noted than in the monotherapy groups, which is confirmed by the maximum value of basal epidermocytes per unit length.

Efficacy of intra-articular injections of hyaluronic acid in patients with glenohumeral joint osteoarthritis: A systematic review and meta-analysis.

Symptomatic primary glenohumeral (GH) joint osteoarthritis (OA) can be challenging to treat. Hyaluronic acid (HA) has emerged as a promising treatment for the nonsurgical management of GH-OA. In this systematic review with meta-analysis, we aimed to evaluate the current evidence regarding the efficacy of intra-articular HA on pain relief in patients suffering from GH-OA. A total of 15 studies (only randomized controlled trials providing data at the end of the intervention) were included. The relevant studies were selected based on the following PICO model: P: patients with diagnosis of shoulder OA; I: HA infiltrations as therapeutic intervention administered; C: no restriction for comparators assessed; O: pain, in terms of visual analog scale (VAS) or numeric rating scale. The risk of bias among the included studies was estimated using the PEDro scale. A total of 1023 subjects were analyzed. Comparing HA injections combined with physical therapy (PT) compared to PT alone resulted in superior scores, showing an overall effect size (ES) of 4.43 (p = 0.00006). Moreover, pooled analysis of VAS pain scores demonstrated a significant improvement in the ES of the HA in comparison with corticosteroid injections (p = 0.002). On average, we reported a PEDro score of 7.2. A total of 46.7% of studies showed probable signs of a randomization bias. The findings of this systematic review and meta-analysis showed that IA injections of HA might be effective on pain relief with significant improvements compared to baseline and compared to corticosteroid injections in patients affected by GH-OA.

Evaluation of the effect of injectionsof both platelet-rich plasma and hyaluronic acid in patients with early knee osteoarthritis via the concentration of interleukin-1β in serum

Background Early knee osteoarthritis, which causes the degeneration of articular cartilage and subchondral bone, is a disease that worsens with time and is a major contributor to physical disability. Several inflammatory cy- tokines released by chondrocytes work in concert to trigger the production of enzymes that break down cartilage. A pro-inflammatory cytokine called interleukin-1β (IL-1 β ) accelerates cartilage breakdown after trauma, re- duces matrix production, and results in chondrocyte death. Dendritic cells and macrophages are the main sources of IL-1β. On the other hand, os- teoblasts, periodontal ligament cells, and gingival fibroblasts have the abil- ity to release IL-1β. Treatment pure- platelet rich plasma (P-PRP) effec- tiveness of transforming growth factor, platelet-derived growth factor, type I insulin-like growth factor, and the vascular endothelial growth factor is thought to be related to their release. Because of their capacity to increase matrix formation, growth factors have been widely researched for OA and cartilage regeneration. Hyaluronic acid (HA) is a glycosaminoglycan poly- mer composed of N-acetyl glucosamine and D-glucuronic acid disaccharide molecules. Early embryonic development, inflammatory, wound repair, cell differentiation, and viscoelasticity are all affected by HA, and other biologi- cal processes. Materials and Methods Elabscience kits were used to assess the serum IL-1β level. The experimental investigation included 18 control groups, 10 HA injections, and 21 pure PRP injections. age ranged from 30 to 80. The study was excluded all individuals with advanced osteoarthritis in the knee, COVID-19, diabetes, and autoimmune diseases. the time frame running from November 2021 until June 2022. Other variables in our research were age, gender, family history, use of antihypertensive medications or medica- tions for other disorders, and body mass index (BMI). Results The findings of this study demonstrate elevated IL-1β levels in patients with early KOA before treatments injection compared with the healthy control. After treatments injection, the level of IL-1β was decreased compared with before injection. Conclusions IL-1β could be one of the prognostic signs of early KOA

Randomized control trial of mesenchymal stem cells versus hyaluronic acid in patients with knee osteoarthritis - A Hong Kong pilot study.

ObjectiveThis pilot study evaluated the efficacy of autologous bone marrow-derived mesenchymal stem cells (BM-MSCs) versus hyaluronic acid (HA) in surgically naïve patients with knee osteoarthritis (OA).MethodsSingle-centre, single-blind randomized study of patients with knee OA. Twenty patients were randomized into groups of 10 each for intra-articular injection of cultured BM-MSCs (6 ​ml of BM-MSCs at 1 ​× ​106 ​cells/mL) or HA (6 ​ml). Clinical assessments of pain, quality of life, radiographic imaging, and magnetic resonance imaging (MRI) compositional change were performed at baseline and 12 months follow-up.ResultsCompared with HA, BM-MSCs injection resulted in significant improvement in qualify of life and reduction in pain as reflected by visual analogue scale (VAS) pain score, Western Ontario and McMaster Universities Arthritis Index (WOMAC) score, and 36-Item Short Form Survey (SF-36) score collectively. T2-relaxation time tended to decrease more in the BM-MSCs group with a 38 ​± ​24.0% reduction in 6 out of 10 BM-MSC participants; while there was only a 12 ​± ​7.9% reduction in 4 out of 10 HA participants at the end of follow-up. The remaining participants showed either no response or had relaxation time increased on MRI assessment.ConclusionsThis pilot study found that autologous BM-MSCs significantly reduced pain, improved functional assessment score, and improved quality of life parameters comparing with HA at one year follow-up. Further clinical trial with larger sample size and longer follow up duration is warranted.The Translational Potential of this ArticleThis pilot RCT demonstrated the feasibility and potential effectiveness of BM-MSCs advanced therapy for patients with knee OA compared to HA injection. Further multi-center clinical trial with a larger sample size and longer follow up duration in accordance with latest regulatory guidelines is warranted to ascertain the long term safety and effectiveness of MSCs therapy for cartilage regeneration in OA.RegistrationThe study was registered in the Centre for Clinical Research Biostatistics - Clinical Trials Registry (CUHK_CCT00469).

Evaluation of the efficacy and safety of the 7% hypertonic solution with hyaluronic acid in patients with COVID-19 in the outpatient phase

Introduction. Since 2020, the pandemic caused by the SARS-CoV-2 virus poses a serious threat to health systems in many countries around the world. Finding inexpensive and affordable, effective and safe medications that can promote rapid recovery and reduce the risk of a severe course of COVID-19 is an important challenge for the health care system of any country. It has long been known that 7% hypertonic sodium chloride solution has nonspecific antiviral, antibacterial and antifungal properties. A 2020 study shows the effectiveness of hypertonic NaCl solutions in blocking SARS-CoV-2 replication in Vero cells. These data suggest that hypertonic solutions can be used as a prophylactic and alternative comprehensive treatment for patients with COVID-19.Aim. We study the efficacy and safety of hypertonic solution with hyaluronic acid in patients undergoing outpatient treatment with mild to moderate COVID-19.Materials and methods. We conducted an open prospective study of the use of hyaluronic acid (HA) solution 7% (Ingasalin® forte 7%) in outpatients with confirmed SARS-CoV-2 infection who had 1 or more risk factors for a severe course of the disease. Patients were divided into 2 groups of 30 patients each. The main group received, in addition to standard therapy (according to the interim guidelines in effect at the time of treatment, version 14 dated 12/27/21), inhalation of 7% HG with HA in the morning and evening for 10 days; patients in the control group received standard therapy according to the interim guidelines.Results and discussion. Patients of the study group who received hyaluronic acid solution 7% had statistically significant decrease of dyspnea and normalization of saturation values already on the 5th day of therapy compared to patients of the control group. One patient in the study group was hospitalized, and 4 patients in the control group were hospitalized. There were no side effects associated with the administration of hyaluronic acid solution 7%. Also, there was no development of cough or its intensification against the background of inhalation in patients of the main group.Conclusion. It is reasonable to use hyaluronic acid solution 7% in outpatients with mild to moderate COVID-19 and with one or more risk factors of severe disease course as part of complex therapy.

Evaluation of a single-shot of a high-density viscoelastic solution of hyaluronic acid in patients with symptomatic primary knee osteoarthritis: the no-dolor study

BackgroundPronolis®HD mono 2.5% is a novel, one-shot, high-density sterile viscoelastic solution, recently available in Spain, which contains a high amount of intermediate molecular weight hyaluronic acid (HA), highly concentrated (120 mg in 4.8 mL solution: 2.5%). The objective of the study was to analyze the efficacy and safety of this treatment in symptomatic primary knee osteoarthritis (OA).MethodsThis observational, prospective, multicenter, single-cohort study involved 166 patients with knee OA treated with a single-shot of Pronolis®HD mono 2.5% and followed up as many as 24 weeks.ResultsCompared with baseline, the score of the Western Ontario and McMaster Universities Arthritis Osteoarthritis Index (WOMAC) pain subscale reduced at the 12-week visit (primary endpoint, median: 9 interquartile range [IQR]: 7–11 versus median: 4; IQR: 2–6; p < 0.001). The percentage of patients achieving > 50% improvement in the pain subscale increased progressively from 37.9% (at 2 weeks) to 66.0% (at 24 weeks). Similarly, WOMAC scores for pain on walking, stiffness subscale, and functional capacity subscale showed significant reductions at the 12-week visit which were maintained up to the 24-week visit. The EuroQol visual analog scale score increased after 12 weeks (median: 60 versus 70). The need for rescue medication (analgesics/nonsteroidal anti-inflammatory drugs) also decreased in all post-injection visits. Three patients (1.6%) reported local adverse events (joint swelling) of mild intensity.ConclusionsIn conclusion, a single intra-articular injection of the high-density viscoelastic gel of HA was associated with pain reduction and relief of other symptoms in patients with knee OA.Trial registrationClinicalTrial# NCT04196764

Intra-articular Injection of Autologous Adipose-Derived Stem Cells or Stromal Vascular Fractions: Are They Effective for Patients With Knee Osteoarthritis? A Systematic Review With Meta-analysis of Randomized Controlled Trials

Background: Intra-articular injection of adipose-derived stem cells, which are divided into adipose-derived mesenchymal stem cells (ASCs) and adipose-derived stromal vascular fractions (ADSVFs), has been reported to be a viable treatment modality for knee osteoarthritis (OA); however, its efficacy remains limited. Purpose: This study aimed to provide comprehensive information about the efficacy and safety of intra-articular injections of autologous ASCs and ADSVFs without adjuvant treatment in patients with knee OA. Study Design: Meta-analysis; Level of evidence, 1. Methods: A systematic search of the MEDLINE, Embase, Web of Science, and Cochrane Library databases was performed to identify randomized controlled trials (RCTs) that evaluated the efficacy and safety of intra-articular injections of autologous ASCs or ADSVFs without adjuvant treatments compared with placebo or hyaluronic acid in patients with knee OA. Clinically, the 100-mm visual analog scale for pain relief and the Western Ontario and McMaster Universities Osteoarthritis Index for functional improvement were implemented. Radiologically, cartilage status was assessed using magnetic resonance imaging (MRI). Procedure-related knee pain, swelling, and adverse events (AEs) were evaluated for safety. Additionally, we performed subgroup analyses comparing ASCs versus ADSVFs. Methodological quality was assessed using the modified Coleman Methodology Score (mCMS). Results: A total of 5 RCTs were included in this study. Based on the meta-analysis, ASCs or ADSVFs showed significantly better pain relief at 6 months (Z = 7.62; P < .0001) and 12 months (Z = 7.21; P < .0001) and functional improvement at 6 months (Z = 4.13; P < .0001) and 12 months (Z = 3.79; P = .0002), without a difference in procedure-related knee pain or swelling compared with controls. Although a meta-analysis with regard to cartilage improvements was not performed owing to heterogeneous MRI assessment, 3 studies reported significantly improved cartilage status after the injection. No serious AEs associated with ASCs or ADSVFs were reported. Subgroup analyses showed similar efficacy between ASC and ADSVF treatments. The median mCMS was 70 (range, 55-75). Conclusion: For patients with knee OA, intra-articular injection of autologous ASCs or ADSVFs without adjuvant treatment showed remarkable clinical efficacy and safety at short-term follow-up. Some degree of efficacy has been shown for cartilage regeneration in knee OA, although the evidence remains limited. Further RCTs that directly compare ASCs and ADSVFs are needed.

Diagnostic value of Hyaluronic acid in patients with chronic obstructive pulmonary diseases

Diagnostic value of Hyaluronic acid in patients with chronic obstructive pulmonary diseases

Comparison of 24-month voice outcomes after injection laryngoplasty with calcium hydroxylapatite or hyaluronic acid in patients with unilateral vocal fold paralysis

PurposeThe objective was to evaluate the long-term voice outcomes in pa-tients with unilateral vocal fold paralysis treated with injection laryngoplasty using either cal-cium hydroxylapatite (CaHA) or hyaluronic acid (HA). MethodsA single-centre retrospective study was performed. There were 75 patients with dysphonia due to unilateral vocal fold paralysis: injected with CaHA or injected with HA. We analysed Voice Handicap Index-30 (VHI), videostroboscopic images, auditory-perceptual (GRBAS), and acoustic measures (MDVP) in 6, 12, and 24 months after augmentation. ResultsThe mean change in VHI 24 months after augmentation was 29.14 in the CaHA group, and 22.88 in the HA group. There was an improvement of glottal gap 6, 12, and 24 months after augmentation in both groups. The GRBAS parameters were similar in both groups throughout the whole period. The MDVP pa-rameters decreased 6 and 12 months after augmentation and were similar in both groups. There were 4 patients augmented with CaHA (12.5%) who needed reintervention within 2 years of surgery and another 4 (9.3%) augmented with HA. ConclusionThis study demonstrates that there are no long-term differences in voice outcomes or number of reaugmentations for injection laryn-goplasty with CaHA compared to HA.

Alterations in plasma hyaluronic acid in patients with clinically stable COPD versus (non)smoking controls

Hyaluronic acid (HA) is a key component of the extracellular matrix. HA and its metabolism are suggested to be altered in the lungs of patients with chronic obstructive pulmonary disease (COPD). The present study explored systemic HA, and its metabolic regulators, in patients with clinically stable COPD and smoking and non-smoking controls. Furthermore, associations of HA with acute exacerbations (AECOPD), airway-related hospitalizations, systemic inflammation and cardiovascular risk were studied. In total, 192 patients with moderate to very severe COPD [aged 62.3 y (± SD 7.0)], 84 smoking controls [aged 61.8 y (± 5.7)], and 107 non-smoking controls [aged 60.1 y (± 7.0)] were included. Plasma HA was reduced in patients with COPD compared to non-smoking controls (p = 0.033), but was comparable after adjusting for age and sex. Expression of HAS-3 did not differ between groups, but was substantially less detectable in more patients with COPD than (non)smoking controls (p < 0.001). Expression of HYAL-2 was enhanced in patients with COPD versus smoking (p = 0.019) and non-smoking (p < 0.001) controls, also in the age- and sex- adjusted model (p < 0.001). Plasma HA was not associated with AECOPD, airway-related hospitalizations in the previous year, or systemic inflammation in COPD. Arterial pulse wave velocity explained some of the variance (< 10%) in plasma HA (p = 0.006). Overall, these results indicate that expression of HYAL-2, but not plasma HA nor HAS-3, is enhanced in patients with COPD compared to (non)smoking controls. Furthermore, HA was not associated with clinical outcomes, yet, cardiovascular risk might play a role in its systemic regulation in stable COPD.

Diagnostic value of Hyaluronic acid in patients with chronic obstructive pulmonary diseases

Diagnostic value of Hyaluronic acid in patients with chronic obstructive pulmonary diseases

Safety of a single intra-articular injection of LBSA0103 hyaluronic acid in patients with osteoarthritis of the knee: a multicenter, single-arm, prospective, cohort study

Objective LBSA0103 is a recently developed high-molecular-weight, cross-linked, non-animal hyaluronic acid (HA). The safety of LBSA0103 has been investigated only in a limited number of patients, therefore this prospective study was designed. This study sought to assess the safety including injection-site reactions and adverse drug reactions after a single intra-articular injection of LBSA0103 in patients with osteoarthritis (OA) of the knee joint. Methods This study was a multicenter, single-arm, prospective cohort study. After screening, eligible patients with OA of the knee joint (Kellgren–Lawrence grades I–III) were enrolled, received a single intra-articular HA (LBSA0103) injection, and were followed up for two weeks. Any adverse events including injection-site reactions and adverse drug reactions were evaluated by the investigators. Results A total of 1949 subjects (2976 knee joints) was enrolled, all of whom received a single intra-articular injection of LBSA0103. Injection-site reactions occurred in 5.59% of enrolled subjects (109/1949), and the most frequently reported injection-site reaction was pain (4.87%), followed by swelling (1.03%). Most of the injection-site reactions were transient and resolved within 14 days without additional treatment. The incidence of adverse drug reactions other than injection-site reactions was 0.67% (13/1949). Most adverse events were of mild severity. No serious adverse events related to the study drug were reported. Conclusions A single intra-articular injection of LBSA0103 in patients with OA of the knee joint was safe, and no significant safety concerns were observed. As such, LBSA0103 could be safely applied as an intra-articular injection for the management of knee OA. Trial Registration The study was registered at ClinicalTrials.gov (identifier: NCT04369261).

Intra-articular injections of platelet-rich plasma vs. hyaluronic acid in patients with knee osteoarthritis: Preliminary follow-up results at 6-months.

The aim of the present study was to compare the clinical and economic benefits of intra-articular injections of platelet-rich plasma (PRP) and hyaluronic acid (HA) in Chinese patients with knee osteoarthritis (OA). A total of 86 patients (42 treated with PRP and 44 with HA) were treated with three weekly intra-articular injections. The inclusion criteria included patients between 18 and 75 years of age, with chronic knee pain or swelling lasting >3 months and X-ray findings of degenerative joint alterations according to the Kellgren-Lawrence score grade I-III. Clinical examinations were performed before treatment, at 1- and 6-month post-injection intervals. International Knee Documentation Committee subjective, Western Ontario and McMaster Universities and visual analogue scale scores were determined at each examination. Adverse reactions, average cost, treatment time and patient satisfaction were also recorded. Compared with patients injected with HA, PRP was found to be associated with increased and more severe post-injection pain and swelling, where the duration of adverse reactions was greater in the PRP group (P=0.02). During the follow-up evaluations, both groups showed statistically significant improvements in all clinical scores from pre-injection to 1- and 6-month assessments (P<0.05). However, no significant inter-group (PRP vs. HA) differences were observed in the clinical scores between the two follow-up time points. There were also no significant differences in clinical score between the groups with regards to the Kellgren-Lawrence grade I, II or III. The average cost of PRP injections was 22.8X that of HA administration and the average treatment time was 5X that of HA, but there was no significant difference in patient satisfaction. These preliminary results indicate that although PRP injections can significantly improve clinical outcome in patients with knee OA, PRP is not any more effective compared with HA. Furthermore, PRP injections are associated with higher costs and treatment times. Therefore, additional clinical studies are required before PRP injections can be considered as a first-line treatment option for knee OA.