Hyaluronan: its potential application in intervertebral disc regeneration

Bojiang Shen, Aiqun Wei, Divya Bhargav, Thomas Kishen, Ashish D Diwan

Orthopaedic Research Institute, Department of Orthopaedic Surgery, St. George Hospital, The University of New South Wales, Sydney, Australia

Abstract: Hyaluronan (HA) is a ubiquitous component of extracellular matrix in human tissues with diverse functions in skeletal biology. The biophysical properties of HA, such as high viscosity, elasticity and highly negative charge, make it useful in various therapeutic procedures. Although intra-articular administration of HA has been extensively used in the management of osteoarthritis (OA), there is a paucity of data on the clinical application of HA in intervertebral disc repair. This review discusses the biology and signaling mechanisms of HA, the pathophysiology of disc degeneration and summarises current evidence relating to the role of HA in cell phenotype maintenance, differentiation of chondrocytes, intervertebral disc cells and bone marrow stromal cells, and its application in tissue engineering. Based on recent advances in the clinical outcomes of OA treatment, HA has demonstrated potential as a bio-polymer filler, therapeutic agent and cell carrier in the management of intervertebral disc degeneration.

Keywords: hyaluronan, cartilage, intervertebral disc, stromal cells, tissue engineering, back pain