Medicinal properties in whole foods

Townsend Letter for Doctors and Patients, April, 2004 by Gina L. Nick

The Disease-Fighting Effects of Hyaluronan

Hyaluronan (also known as hyaluronic acid) is a naturally occurring, ubiquitous, safe and non-toxic chemical (1) that is demonstrating surprising results for addressing inflammation and pain. Its principle characteristics include viscoelasticity, high water solubility, extended domain presence in solution and maintenance of cellular and extracellular homeostasis.

Orthopedic surgeons, veterinarians, ophthalmologists, dermatologists, general surgeons and even dentists use hyaluronan. It hastens and improves the healing of skin, mucus membranes and bone, and is showing remarkable results when used as a dietary supplement, particularly for patients with arthritic conditions, individuals who are in extreme pain and are waiting to endure back surgery to reduce their suffering, and even to improve the health of skin. Further, this ingredient has an extraordinary safety profile. Within the body it performs and facilitates innumerable basic and essential functions.

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The Chemistry Behind this Powerful Substance

Hyaluronan is a naturally occurring glycosaminoglycan along with chondroitin sulphate, dermatin sulfate, heparin sulfate and heparan sulfate, (2) but the only one that is not covalently bound to plasma proteins. (Figure 1--Chemical Structure) The chemical name for sodium hyaluronate is poly(sodium--D-glucuronate-[1-3]--N-acetyl-D-glucosamine-[1-4].

Many tissues, most notably synovial tissue, keratinocytes and chondrocytes manufacture this substance, and it is naturally present in bacteria and all higher organisms. Hyaluronan's most remarkable characteristic is its "viscoelastic" properties, making it an excellent lubricant and shock absorber for the joints. (4) Depending upon its environment, and primarily upon the pressure exerted upon it, it serves in joint spaces both as a lubricant and a shock absorber. Its lubricating properties far exceed those of the finest motor oil. This substance has been used intramuscularly, intravenously, intraarticularly, intraperitoneally, intravesically, topically on both skin and mucus membranes, and even intraocularly. Now, it is being shown to be highly effective when ingested as well.

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Research on Hyaluronan

Hyaluronan is used extensively in horses and has been approved by the FDA for human use as an intra-articular injection for osteoarthritis of the knee and as an adjunct in ophthalmologic surgery. It has also seen a quantity of studies in cosmetic dermatology, cosmetic surgery, dentistry and arthritis, often with glucosamine and chondroitin.

Researchers in the Czech Republic have performed a number of studies on sodium hyaluronate in horses, rats and humans. The most extensive animal experience to date with hyaluronan has been with racehorses. For example,

* In a study of 53 sport horses of various breeds, given oral sodium hyaluronate syrup 100mg/500kg body weight for 30 days, good to very good results were observed in multiple orthopedic diagnoses. (4)

* Daily 100 mg doses of an oral hyaluronan gel produced higher serum levels at day 7 in 4 horses than a single IV infusion of hyaluronan in 4 comparable horses. (5)

* The effect of 100 mg of hyaluronan as an oral gel on lameness and other orthopedic conditions in 13 actively training Thoroughbreds was notably beneficial when compared with 12 others horses serving as controls. (6)

* A blinded study of 13 horses found a significant benefit of 20 mg hyaluronan, 5000 mg of glucosamine sulfate and 450 mg of chondroitin sulfate in accelerating recovery from arthroscopic surgery. (6)

* Four Thoroughbreds with synovitis of the MCP joints were cured or considerably improved after 21 days of 100 mg of hyaluronan as an oral gel. Improvement was noted during the first week. (6)

A review of various available veterinary preparations of hyaluronan rated their effectiveness. The nutraceutical preparation was found to be noticeably effective. A commercial preparation of hyaluronan oral gel was deemed to be as effective as an IV formulation. Finally, intra-articular injections were rated high for severe disease, when accompanied by maintenance on nutraceutical preparations. (7)

In humans, a number of hyaluronan products have been used intra-articularly for osteoarthritis of the knee. Overall they seem to be as effective in relieving pain as NSAIDs, (8), (9) perhaps more effective for earlier disease than advanced degeneration. (10) In fact, the American College of Rheumatology recommends these injections and suggests they may have disease-modifying benefits, making them superior to NSAIDs. (11)

Hyaluronan as a Dietary Supplement for Joint Pain and Inflammation in Humans

The most promising research in the area of nutraceutical supplementation for arthritic pain and joint support comes from studies on oral hyaluronan supplements.

* In a human study, an oral mixture of sodium hyaluronate (10mg) and chondroitin sulfate (100mg) for three months accelerated healing from knee surgery in all 27 test subjects in comparison with the 27 control subjects. (5)