Skip to main content
. 2018 Oct 23;10:73–81. doi: 10.2147/ORR.S174649

Table 1.

Biological effects of HA

Effects on extracellular matrix Effects on immune cells Effects on inflammatory mediators
• Enhanced HA synthesis • Inhibits proliferation and activation • Reduced levels of
• Enhanced synthesis of PG and chondroitin sulfate • Reduced motility of lymphocytes and macrophages  ○ Prostaglandins
 ○ Leukotrienes
• Suppressed PG release from extracellular matrix • Inhibits phagocytosis • Increased production of cAMP
• Suppresses aggregation of neutrophils • Reduced expression/activity of
• Prevents PG breakdown from cartilage • Inhibits adhesion and neutrophil-associated cartilage destruction  ○ IL-1, IL-6
• Reduced markers of cartilage breakdown (chondroitin 4- and 6-sulfates)  ○ Stromelysin
 ○ TNF-α
 ○ TIMP-1 (inhibits MMP)
 ○ Plasminogen activator
• Reduced arachidonic acid release
• Antioxidant effects
• Reduced production of NO

Note: Data from Moreland,1 Abate and Salini,6 and Kusayama et al.9

Abbreviations: HA, hyaluronic acid; PG, proteoglycans; cAMP, cyclic adenosine monophosphate; IL-1, interleukin-1; IL-6, interleukin-6; TNF-α, tumor necrosis factor α; TIMP-1, tissue inhibitor of metalloproteinases-1; MMP, metalloproteinase; NO, nitric oxide.