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Acide hyaluronique anti-inflammatoire

Hyaluronic Acid, an Anti-Inflammatory Agent?

Hyaluronic acid boasts numerous benefits and is highly prevalent in the dermo-cosmetic sphere. It is primarily known for its ability to hydrate the skin, but it is sometimes suggested that this active ingredient could also soothe and alleviate irritations. Does hyaluronic acid possess anti-inflammatory properties? We address this question here.

Summary
Published May 7, 2024, updated on May 14, 2024, by Pauline, Head of Scientific Communication — 6 min read

Does hyaluronic acid have anti-inflammatory effects?

Hyaluronic acid is one of the active components of the extracellular matrix and belongs to the family of glycosaminoglycans. Predominantly produced by mesenchymal cells, or stem cells, it can also be synthesized by activated fibroblasts in the dermis. By occupying the spaces between cells, hyaluronic acid contributes to tissue hydration and cohesion. It also plays a role in controlling inflammation. Depending on its molecular weight, location, and certain cellular factors, the binding of hyaluronic acid to proteins can have opposing effects: pro- or anti-inflammatory.

Hyaluronic acid can notably interact with specific cytokines and thus modulate the function of immune cells. Interleukin-8 (IL-8), released by fibroblasts, macrophages, and endothelial and epithelial cells in the presence of inflammation, is an example. Studies in vitro conducted with human keratinocytes have shown that cells treated with hyaluronic acid produced less interleukin-8. The use of this active ingredient could therefore be advantageous in inhibiting an undesirable immune response.

Furthermore, hyaluronic acid has a strong affinity for the CD44 receptor, allowing it to prevent the release of pro-inflammatory cytokines and the synthesis of matrix metalloproteinases (MMP) and prostaglandin E2 (PGE2). These inflammatory molecules, which cause skin redness and itching, are also involved in the onset of musculoskeletal disorders such as osteoarthritis. Hyaluronic acid can also interact with the RHAMM receptor, playing a significant role in inflammation and tissue repair. Located on the surface of cells, RHAMM interacts with CD44 and modulates cell motility, healing, and signal transduction. At the intracellular level, RHAMM binds to actin filaments and the mitotic spindle, thus affecting crucial cellular processes in tumorigenesis, encompassing all stages leading to tumor formation.

Finally, the smallest fragments of hyaluronic acid can bind to Toll-like receptors TLR2 and TLR4, also orchestrating the inflammatory response. Indeed, these molecules are involved in the recruitment and activation of protein complexes leading to the activation of the nuclear factor kappa B (NF-κB) and the induction of inflammatory cytokines. As a reminder, NF-κB is a key transcription factor regulating a set of genes involved in inflammation such as the tumor necrosis factor-α (TNF-α), interleukins 1, 6 and 12, and cyclooxygenase-2 (COX-2).

Due to its involvement in numerous inflammation processes, hyaluronic acid has been the subject of various studies evaluating its effectiveness in treating certain inflammatory skin conditions such as the rosacea and the psoriasis. The results of these studies are presented in the following table.

StudyDermatosis StudiedNumber of PatientsProtocolResults
SCHLESINGER & al. (2013)Rosacea14Daily application of a cream containing 0.2% hyaluronic acid saltsAfter 4 weeks, there was a 47% reduction in papules, a 51.7% reduction in erythema, a 65% reduction in burning sensations, and a 78.8% reduction in skin dryness. After 8 weeks, overall rosacea improvement was observed in 11 patients (78.6%).
BAE et al. (2018)Psoriasis10Application of 26 x 26 mm hyaluronic acid microneedle patches for a week80% of patients were "satisfied" or "very satisfied"
LEE & al. (2021)Eczema23Application of a cream containing hyaluronic acid, proteoglycans, and collagen twice a dayAfter 4 weeks, there was a 45% increase in hydration of the stratum corneum and a 16.8% decrease in erythema

Hyaluronic acid can also be used to alleviate joint pain, particularly those caused by osteoarthritis. The primary cause of mobility loss, this disease affects 65% of individuals over the age of 65 and is characterized by the destruction of cartilage and inflammation of the membrane lining the inside of the joint. To restore the lubrication and the viscoelastic properties of the synovial fluid, some hospitals offer viscosupplementation, which involves injecting hyaluronic acid directly into the joints. Generally yielding good results (pain reduction, improved mobility, decreased need for pain and inflammation medication...), these injections can only provide temporary relief (between 3 and 12 months) and are less effective than corticosteroid injections.

Sources

  • SCHLESINGER T. E. & others. Efficacy and tolerability of 0.2% cream of low molecular weight hyaluronic acid sodium salt in rosacea. Journal of Drugs in Dermatology (2013).

  • MEASE P. & al. Anti-Inflammatory Effects of Intra-Articular Hyaluronic Acid: A Systematic Review. Cartilage (2018).

  • BAE J. M. & others. A microneedle patch based on hyaluronic acid for the treatment of psoriatic plaques: a preliminary open trial. British Journal of Dermatology (2018).

  • REIS S. & al. Hyaluronic Acid: A Crucial Component in the Treatment of Inflammation. Biomolecules (2021).

  • LEE J. H. & al. Proteoglycan Combined with Hyaluronic Acid and Hydrolyzed Collagen Restores the Skin Barrier in Mild Atopic Dermatitis and Dry, Eczema-Prone Skin: A Pilot Study. International Journal of Molecular Sciences (2021).

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