Section Review: Recent developments in the use of hyaluronan in wound healing:Pulmonary-Allergy, Dermatological, Gastrointestinal & Arthritis

Abstract

Hyaluronan (hyaluronic acid) is a high molecular weight glycosaminoglycan, distributed ubiquitously in the extracellular spaces in the body, and especially in the soft connective tissues. Early research into hyaluronan focused primarily upon its physicochemical properties, such as its viscosity and elasticity. Based upon these properties, hyaluronan has been applied clinically as a viscosurgical tool in ophthalmology and in otology. During the last decade, hyaluronan has been shown to be involved in a range of cell behaviours, such as cell movement, growth and differentiation. In addition, hyaluronan receptors have been isolated from a variety of cell surfaces. Hence, hyaluronan is no longer considered solely to be a constituent of the extracellular space, but, in addition, to have a role in modulating cellular functions. The roles of hyaluronan in such functions as wound healing and cell migration, locomotion and motility have been investigated. The epithelial surface of the body is one of the most important barrier systems to protect and maintain the internal environment. The epithelium possesses an active wound healing system to repair defects, and, in general, has a tremendous capacity to heal rapidly after injury. However, disturbance or delay to normal wound healing processes results in undesirable outcomes, such as persistent defects or recurrent erosions. In order to treat these epithelial disorders clinically, it is important to understand the mechanisms of epithelial wound healing. In this article, we review the recent developments in the use of hyaluronan in wound healing, and, particularly, the mechanisms of action of hyaluronan during corneal epithelial wound healing.