A Comprehensive Monograph on Hyaluronic Acid (DB08818): From Foundational Biomaterial to Advanced Therapeutic Platform

Executive Summary

Hyaluronic Acid (HA), identified by DrugBank ID DB08818, is a ubiquitous and multifunctional glycosaminoglycan that is integral to the structure and function of vertebrate tissues. Chemically, it is a simple, linear polysaccharide, yet its biological role is remarkably complex and fundamentally dictated by its molecular weight. This report provides an exhaustive analysis of HA, covering its history, chemical properties, multifaceted pharmacology, extensive clinical applications, safety profile, and global regulatory status.

The core of HA's function lies in its dual nature. As a high-molecular-weight (HMW) polymer, it serves as a passive structural molecule, leveraging its unique viscoelastic and hygroscopic properties to lubricate joints, hydrate tissues, and provide shock absorption. In this capacity, it is a cornerstone of therapies for osteoarthritis and a primary component of ophthalmic surgical aids. Conversely, as a low-molecular-weight (LMW) fragment, HA acts as an active signaling molecule. By interacting with cell surface receptors such as CD44, it can initiate pro-inflammatory and angiogenic cascades essential for tissue repair and wound healing. This size-dependent dichotomy is a central theme in its pharmacology and explains its diverse, and at times seemingly contradictory, biological effects.

Clinically, HA's utility is most established in three key areas: orthopedics, for the viscosupplementation of osteoarthritic joints; aesthetic medicine, as the gold-standard biodegradable dermal filler for soft tissue augmentation; and ophthalmology, as an indispensable viscoelastic tool in ocular surgery. Its safety profile is excellent, with most adverse events being mild, transient, and related to the injection procedure rather than the material itself.