Hyaluronic acid (HA) is a naturally occurring biodegradable polymer with a variety of applications in medicine, including scaffolding for tissue engineering, dermatological fillers and viscosupplementation for osteoarthritis treatment. HA is available in most connective tissues in body fluids such as synovial fluid and the vitreous humor of the eye. HA is responsible for several structural properties of tissues as a component of extracellular matrix and is involved in cellular signaling. Degradation of HA is a stepwise process that can occur via enzymatic or non-enzymatic reactions. A reduction in HA mass or molecular weight via degradation or slowing of synthesis affects physical and chemical properties such as tissue volume, viscosity and elasticity. This review addresses the distribution, turnover and tissue-specific properties of HA. This information is used as the context for considering recent products and strategies for modifying the viscoelastic properties of HA in tissue engineering, as a dermal filler and in osteoarthritis treatment.
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