Hyaluronic acid is a molecule with the potential to support cellular health, skin integrity, and healthy aging. It is produced by almost all cell types in the human body. Hyaluronic acid is an important component of cell membranes, and it’s part of the extracellular matrix. It has many different functions in the body and may support cellular development, differentiation, and proliferation. Hyaluronic acid has been shown to support matrix structure, hydration, and lubrication, and it can form a viscous gel that can act as a buffer for surrounding structures. Hyaluronic acid can also act as an external cytoskeleton. 

Research suggests hyaluronic acid may help promote a balanced inflammatory response. Research indicates it helps to modulate certain pro- and anti-inflammatory cytokines. It can bind to intercellular adhesion molecule-1, downregulate nuclear factor kappa B, and may help decrease interleukin-(IL)-6 levels in the body. Hyaluronic acid may also act as a signaling molecule to interact with IL-8 and the CD44 receptor, which is expressed in activated macrophages. These macrophages have been shown to be the most predominant immune cells in cases of osteoarthritis (OA). Hyaluronic acid administration has been shown to help reduce the inflammatory response induced by IL-1β. 

Synovitis is a key characteristic of OA in both its early and late stages. In cases of OA, synovial fluid has been correlated with lower amounts of hyaluronic acid when compared to healthy individuals. Hyaluronic acid is believed to help support the body’s response to OA through its ability to reduce friction and provide viscoelasticity to the synovial fluid. A recently published article by Lee and colleagues explored the potential for high-molecular-weight hyaluronic acid (HMW-HA) to support certain aspects of the inflammatory response in synovial fluid as a result of osteoarthritis-induced changes. In this laboratory study, significant decreases in IL-6 and prostaglandin E₂ (PGE2) levels were observed after HMW-HA administration in the synovial fluid from individuals with OA. Evidence suggests that PGE2 and IL-6 may be the primary catabolic agents involved in OA. 

Studies conducted in the clinical setting have also explored the relationship between hyaluronic acid and the inflammatory response. An 8-week randomized, double-blind, placebo-controlled clinical trial (n = 47) investigated the efficacy of low molecular weight hyaluronic acid combined with glucosamine, a precursor molecule to hyaluronic acid, and chondroitin on individuals experiencing mild knee pain in the presence of OA. Significant improvements in pain scores, stiffness, and physical function were observed in the treatment group as compared to the placebo. Due to the small sample size, relatively short duration, demographic homogeneity, and delivery method, no clinical conclusions can be made at this time. However, study results indicate that more research is warranted. 

Hyaluronic acid is an important molecule for optimal cellular structure. It may also help support healthy aging and skin health. Recent research also indicates it may help support a balanced inflammatory response. 

By Dr. C Ambrose, ND, MAT