Many physicians may be unfamiliar with the importance of hyaluronic acid (HA) and
its physiological and biochemical functions at cellular level. Despite the vast number of published
studies using HA in medical treatments, it is still difficult for the reader to clearly distinguish the
different types of HA employed in different medical applications. In addition, published studies do
not mention the exact type of HA used or its biochemical properties. Usually, a study mentions
only its molecular weight and concentration, which are insufficient to know its exact designed
properties or to make a comparison with other types of HA. This article is intended to summarise
the information about native and modified HAs with a focus on explaining their different physiological
and biochemical functions in the human body, their different commercially available types,
and how they affect the associated medical applications. The goal is to provide a basis to researchers
and physicians for distinguishing different types of HA and their properties in order to enhance
physicians’ clinical practice in terms of application of different types of HA to treatments and to
help the international research community to change the reporting of HA characteristics in published
papers. This is necessary to enhance future acquisition of data, with the ability to create an
HA data bank for further research and as a reference for different HA types and their medical applications.
These developments should enhance the scientific and clinical knowledge about HA.
Furthermore, the overall approach in this paper can be applied to other similar substances.
Keywords: Hyaluronic acid, hyaluronan, hyaluronan cross-linking, hyaluronan hydrogel, hyaluronan molecular
weight, hyaluronan synthesis, hyaluronan degradation, hyaluronidase, extracellular matrix, glycosaminoglycan,
hyaluronan modification, hyaluronan medical applications, hyaluronan production,
hyaluronan cellular functions, hyaluronan physiochemical functions.
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