Can hyaluronic acid be only used for keeping skin moisturizing?

Hyaluronic acid (HA) is one of the main components of the extracellular matrix, it is an anionic small molecule. HA is hydrolyzed by HAase in vivo, liver is the site of metabolism. Molecular formula of HA is (C14H21NO11)n, the molecular weight of HA ranges from 5kDa to 20,000kDa, the structural formula of HA as shown in figure 1.

The proliferation and differentiation of epidermal cells can be promoted by HA, besides, HA has the oxygen free-radical scavenging property, these contribute to the restoration of skin damage. Moreover, HA is known as the ideal natural moisturizing factor because of its water-retaining property. You must be familiar with the name of  hyaluronic acid, especially if you are a girl. HA is called as the “key to the fountain of youth”.

May be the water-retaining function of HA is too powerful, people only know its this property. Actually, HA can be helpful to cell proliferation and migration, and may also be involved in the progression of some malignant tumors.

According to the reports, HA can stimulate the proliferation of tumor cells, promote the transfer of tumor cells, bind with HA receptor (mainly CD44), so the attack of immune cells to tumor is reduced. Here I want to introduce the binding of HA and CD44. The structure and content of CD44 is different in different cells, the content of CD44 is high in tumor cells. In some malignant tumors, the soluble CD44 can be used to bind the HA, the binding proteins have antitumor activity.

HA levels correlate well with the differentiate of tumor cells. Compared to the HA levels in malignant tumor and normal cells, the HA levels in malignant tumors is higher. When HA level is high, the tumors are at developing stage. When HA level is low, the tumors are controlled and at stable phase.

In addition to its role in the progression of tumor, there is evidence the inflammatory signal of degradation products of HA can be transduced by toll-like receptor 2 (TLR2) or TLR4 in macrophages and dendritic cells. It can be seen HA plays a role in innate immunity.

Moreover, HA has been widely used in kinds of eye surgery, such as crystal implantation, corneal transplantation, glaucoma surgery and so on. It also has been used to create artificial tears to treat dry eye. The researchers want to treat osteoarthritis of the knee via injecting HA into the joint, it is effective but has potentially severe adverse effects.

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