Smart addition is multiplication: a review concerning combined use of hyaluronic acid and polynucleotides for intra-articular administration in osteoarthritis

Abstract

The article presents an overview of modern methods to the treatment of osteoarthritis (OA). It is focused on intra-articular injections of hyaluronic acid and polynucleotides (PNs) of natural origin. Hyaluronic acid is a natural component of connective tissue that has the ability to restore the viscoelastic properties of synovial fluid. Besides, it also has anti-apoptotic, anti-inflammatory, anti-angiogenic and antifibrotic characteristics. PNs are natural macromolecules derived from DNA. They have trophic activity and promote cell growth and collagen production, as has been shown in preclinical and clinical studies concerning cartilage regeneration. When injected into the joint cavity, PNs are subjected to enzymatic cleavage with the release of nucleosides, nucleotides and nitrogenous bases, thereby, providing long-term moisturizing and viscoelastic properties of synovial fluid. The efficacy of a combination of hyaluronic acid preparations with PNs for intra-articular administration for the treatment of knee OA has been studied. It has been established that the combined therapy with PNs and hyaluronic acid leads to the development of a more persistent therapeutic effect for 2 years after the treatment course versus with hyaluronic acid monotherapy. KEYWORDS: osteoarthritis, synovial fluid, viscoelastic properties, synovial fluid substitute, intra-articular injections, hyaluronic acid, polynucleotides FOR CITATION: Svintsitskaya I.S., Volkov K.Yu. Smart addition is multiplication: a review concerning combined use of hyaluronic acid and polynucleotides for intra-articular administration in osteoarthritis. Russian Medical Inquiry. 2022;6(4):182–186 (in Russ.). DOI: 10.32364/2587-6821-2022-6-4-182-186