Hyaluronan as an immune regulator in human diseases

Physiol Rev. 2011 Jan;91(1):221-64. doi: 10.1152/physrev.00052.2009.


Accumulation and turnover of extracellular matrix components are the hallmarks of tissue injury. Fragmented hyaluronan stimulates the expression of inflammatory genes by a variety of immune cells at the injury site. Hyaluronan binds to a number of cell surface proteins on various cell types. Hyaluronan fragments signal through both Toll-like receptor (TLR) 4 and TLR2 as well as CD44 to stimulate inflammatory genes in inflammatory cells. Hyaluronan is also present on the cell surface of epithelial cells and provides protection against tissue damage from the environment by interacting with TLR2 and TLR4. Hyaluronan and hyaluronan-binding proteins regulate inflammation, tissue injury, and repair through regulating inflammatory cell recruitment, release of inflammatory cytokines, and cell migration. This review focuses on the role of hyaluronan as an immune regulator in human diseases.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Arthritis / metabolism
  • Brain Injuries / metabolism
  • Diabetes Mellitus / metabolism
  • Heart Diseases / metabolism
  • Humans
  • Hyaluronan Receptors / metabolism
  • Hyaluronic Acid / biosynthesis
  • Hyaluronic Acid / immunology*
  • Hyaluronoglucosaminidase / metabolism
  • Immune System / metabolism*
  • Kidney Diseases / metabolism
  • Liver Diseases / metabolism
  • Lung Diseases / metabolism
  • Signal Transduction
  • Stem Cells / metabolism
  • Toll-Like Receptors / metabolism
  • Wounds and Injuries / metabolism


  • Hyaluronan Receptors
  • Toll-Like Receptors
  • Hyaluronic Acid
  • Hyaluronoglucosaminidase