DOCSLIB.ORG

Applications of Hyaluronic Acid in Ophthalmology and Contact Lenses

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Applications of Hyaluronic Acid in Ophthalmology and Contact Lenses molecules Review Applications of Hyaluronic Acid in Ophthalmology and Contact Lenses Wan-Hsin Chang 1, Pei-Yi Liu 1, Min-Hsuan Lin 1, Chien-Ju Lu 1, Hsuan-Yi Chou 1, Chih-Yu Nian 1, Yuan-Ting Jiang 1,* and Yuan-Hao Howard Hsu 2,* 1 Research and Development Center, Yung Sheng Optical Company, Daya District, Taichung 42881, Taiwan; [email protected] (W.-H.C.); [email protected] (P.-Y.L.); [email protected] (M.-H.L.); [email protected] (C.-J.L.); [email protected] (H.-Y.C.); [email protected] (C.-Y.N.) 2 Department of Chemistry, Tunghai University, Xitun District, Taichung 40704, Taiwan * Correspondence: [email protected] (Y.-T.J.); [email protected] (Y.-H.H.H.); Tel.: +886-4-25658384 (ext. 3706) (Y.-T.J.); +886-4-23590121 (ext. 32238) (Y.-H.H.H.) Abstract: Hyaluronic acid (HA) is a glycosaminoglycan that was first isolated and identified from the vitreous body of a bull’s eye. HA is ubiquitous in the soft connective tissues of animals and therefore has high tissue compatibility for use in medication. Because of HA’s biological safety and water retention properties, it has many ophthalmology-related applications, such as in intravitreal injection, dry eye treatment, and contact lenses. Due to its broad range of applications, the identification and quantification of HA is a critical topic. This review article discusses current methods for analyzing HA. Contact lenses have become a widely used medical device, with HA commonly used as an additive to their production material, surface coating, and multipurpose solution. HA molecules on contact lenses retain moisture and increase the wearer’s comfort. HA absorbed by contact lenses Citation: Chang, W.-H.; Liu, P.-Y.; can also gradually release to the anterior segment of the eyes to treat dry eye. This review discusses Lin, M.-H.; Lu, C.-J.; Chou, H.-Y.; applications of HA in ophthalmology. Nian, C.-Y.; Jiang, Y.-T.; Hsu, Y.-H.H. Applications of Hyaluronic Acid in Keywords: hyaluronic acid; contact lenses; ophthalmology Ophthalmology and Contact Lenses. Molecules 2021, 26, 2485. https:// doi.org/10.3390/molecules26092485 Academic Editor: Silvia Arpicco and 1. Introduction Barbara Stella Hyaluronic acid (HA) is a natural high-molecular-weight biopolymer. It belongs to the group of long linear nonsulfated glycosaminoglycans (GAGs) with repeating disaccharide Received: 26 March 2021 units of glucuronic acid and acetylglucosamine [1–3] (Figure1). HA contains multiple Accepted: 19 April 2021 hydrophilic functional groups, including carboxyl, hydroxyl, and acetamido groups [4,5]. Published: 24 April 2021 The abundant hydroxyl groups form a hydrogen bond with water, leading to a high capacity to retain water in a spiral chain [6]. HA’s biocompatibility is because of its high Publisher’s Note: MDPI stays neutral structural homology with endogenous HA in humans [7]. When dissolved in aqueous with regard to jurisdictional claims in solution, HA swells and the chains of HA entangle and become random coils, leading to published maps and institutional affil- its unique viscoelasticity [6,8,9]. Because of its advantageous characteristics, such as high iations. water retention, high biocompatibility, and viscoelasticity [10], HA has a wide range of applications for medicine, aesthetic medicine, and cosmetics. Various biological functions of HA are related to its level of polymerization. High- molecular-weight HA (≥106 Da) inhibits inflammation through its interaction with the Copyright: © 2021 by the authors. cluster of differentiation 44 (CD44) cell surface receptor and the HA-mediated motility Licensee MDPI, Basel, Switzerland. receptor [4,11]. High-molecular-weight HA can also form a film on the skin’s surface This article is an open access article that retains water and prevents water loss [1,12]. Conversely, low-molecular-weight HA distributed under the terms and (<106 Da) promotes the macrophage inflammatory process by macrophage activation conditions of the Creative Commons to remove infectious materials from the wound site [4,13]. Low-molecular-weight HA Attribution (CC BY) license (https:// has a high capacity to penetrate skin that ensures a strong moisturizing ability [1,12]. creativecommons.org/licenses/by/ Reducing the molecular weight of high-molecular-weight HA through physical or chemical 4.0/). Molecules 2021, 26, 2485. https://doi.org/10.3390/molecules26092485 https://www.mdpi.com/journal/molecules Molecules 2021, 26, 2485 2 of 15 methods can increase HA’s potential applications. Physical pretreatment methods, such as ultrasonic degradation [14,15], ozone treatment [16], electron beam [17], gamma ray [13] or microwave irradiation, and thermal treatment [17], do not destroy the chemical structure Molecules 2021, 26, x FOR PEER REVIEW 2 of 15 of HA. However, chemical methods such as enzymatic [18] and acid degradation [15] break the structure of HA. FigureFigure 1. 1.Chemical Chemical structure structure of of hyaluronic hyaluronic acid. acid. HAVarious is synthesized biological infunctions humans of by HA HA are synthases, related to including its level of hyaluronan polymerization synthase. High 1,- hyaluronanmolecular-weight synthase HA 2, ( and≥106 hyaluronanDa) inhibitssynthase inflammation 3, mostly through present its interaction in the extracellular with the matrixcluster ofof vertebratedifferentiation tissue 44[ 4(CD44),5,19]. cell HA surface is present receptor in the and umbilical the HA cord-mediated (4100 motilityµg/g), synovialreceptor fluid[4,11] (1400–3600. High-molecularµg/g),-weight dermis HA (200 canµg/g), also form vitreous a film body on the (140–338 skin’s µsurfaceg/g), and that brainretains (35–115 waterµ andg/g) prevents[20–23]. water HA was loss originally [1,12]. Conversely, extracted fromlow-molecular animal tissue-weight [4,24 HA,25], ( but<106 theDa) process promotes is tediousthe macrophage and complicated inflammatory and the process quality by uncontrollable,macrophage activation with potentially to remove lowinfectious yield andmaterials a risk from of protein the wound and virussite [4,13] pollution. Low- [molecular6,26]. Microbial-weight fermentationHA has a high has ca- beenpacity widely to penetrate used to skin produce that HAensure buts the a strong safety andmoisturizing compatibility ability with [1,12] the. humanReducing body the ofmolecular such HA weig is ofht the of utmosthigh-molecular concern- [weight4,6,24– 26HA]. Numerousthrough physical toxicity or assays chemical of HA methods have demonstratedcan increase HA’s that in potential terms of cytotoxicity,applications L929. Physical mouse pretreatment fibroblast cells methods, have no toxicsuch effectas ultra- [7, 27sonic–29]. degradation The carcinogenicity [14,15], ozone of HA treatment was tested [16] by, theelectron mouse, beam and [17] no, tumorgamma growth ray [13] was or observedmicrowave after irrad deliverediation, and through thermal oral treatment administration [17], do of not 200 destroy mg/day the for chemical 4 weeks [structure7,30,31]. Concentrationsof HA. However, of 670 chemical mg/kg/day methods HA such in rats as andenzymatic 50 mg/kg/day [18] and HA acid in degradation rats and rabbits [15] deliveredbreak the through structure oral of administrationHA. and subcutaneous administration have exhibited no adverseHA effects is synthesized in reproductive in humans and developmental by HA synthases toxicity, includ assaysing [hyaluronan7,31–33]. These synthase results 1, havehyaluronan demonstrated synthase the 2, safety and ofhyaluronan HA. synthase 3, mostly present in the extracellular matrixHA of exhibits vertebrate good tissue versatility [4,5,19].in HA application. is present in Because the umbilical it retains cord water (4100 well,μg/g), it syno- can be employed to increase tear film stability to treat dry eye disease [34]; it can be added vial fluid (1400–3600 μg/g), dermis (200 μg/g), vitreous body (140–338 μg/g), and brain to contact lens during production [35] and contact lens care solutions [36] to increase (35–115 μg/g) [20–23]. HA was originally extracted from animal tissue [4,24,25], but the comfort; and it can be used in skin care products [37] or added to health food to reduce process is tedious and complicated and the quality uncontrollable, with potentially low dry skin [38,39]. Due to its high biocompatibility, HA can enhance tissue growth to heal yield and a risk of protein and virus pollution [6,26]. Microbial fermentation has been wounds when combined with receptors on the cell surface [13] or form dermal fillers to widely used to produce HA but the safety and compatibility with the human body of such improve wrinkles [40]. HA’s high viscoelasticity can decrease friction on the ocular surface HA is of the utmost concern [4,6,24–26]. Numerous toxicity assays of HA have demon- during blinking to treat dry eye [34] and keratoconjunctivitis sicca [41] or improve synovial strated that in terms of cytotoxicity, L929 mouse fibroblast cells have no toxic effect [7,27– fluid quality and reduce joint friction in the treatment of osteoarthritis [42]. 29]. The carcinogenicity of HA was tested by the mouse, and no tumor growth was ob- 2.served HA Identification after delivered and through Quantification oral administration Methods of 200 mg/day for 4 weeks [7,30,31]. Concentrations of 670 mg/kg/day HA in rats and 50 mg/kg/day HA in rats and rabbits Despite its already numerous applications in various fields, it is necessary to prop- delivered through oral administration and subcutaneous administration have exhibited erly inspect and
Load more

Recommended publications
  • Nonpharmacological Treatment of Rhinoconjunctivitis and Rhinosinusitis
    Journal of Allergy Nonpharmacological Treatment of Rhinoconjunctivitis and Rhinosinusitis Guest Editors: Ralph Mösges, Carlos E. Baena-Cagnani, and Desiderio Passali Nonpharmacological Treatment of Rhinoconjunctivitis and Rhinosinusitis Journal of Allergy Nonpharmacological Treatment of Rhinoconjunctivitis and Rhinosinusitis Guest Editors: Ralph Mosges,¨ Carlos E. Baena-Cagnani, and Desiderio Passali Copyright © 2014 Hindawi Publishing Corporation. All rights reserved. This is a special issue published in “Journal of Allergy.” All articles are open access articles distributed under the Creative Commons At- tribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Editorial Board William E. Berger, USA Alan P. Knutsen, USA Fabienne Ranc, France Kurt Blaser, Switzerland Marek L. Kowalski, Poland Anuradha Ray, USA Eugene R. Bleecker, USA Ting Fan Leung, Hong Kong Harald Renz, Germany JandeMonchy,TheNetherlands Clare M Lloyd, UK Nima Rezaei, Iran Frank Hoebers, The Netherlands Redwan Moqbel, Canada Robert P. Schleimer, USA StephenT.Holgate,UK Desiderio Passali, Italy Massimo Triggiani, Italy Sebastian L. Johnston, UK Stephen P. Peters, USA Hugo Van Bever, Singapore Young J. Juhn, USA David G. Proud, Canada Garry Walsh, United Kingdom Contents Nonpharmacological Treatment of Rhinoconjunctivitis and Rhinosinusitis,RalphMosges,¨ Carlos E. Baena-Cagnani, and Desiderio Passali Volume 2014, Article ID 416236, 2 pages Clinical Efficacy of a Spray Containing Hyaluronic Acid and Dexpanthenol after Surgery in the Nasal Cavity (Septoplasty, Simple Ethmoid Sinus Surgery, and Turbinate Surgery), Ina Gouteva, Kija Shah-Hosseini, and Peter Meiser Volume 2014, Article ID 635490, 10 pages The Effectiveness of Acupuncture Compared to Loratadine in Patients Allergic to House Dust ,Mites Bettina Hauswald, Christina Dill, Jurgen¨ Boxberger, Eberhard Kuhlisch, Thomas Zahnert, and Yury M.
    [Show full text]
  • Healon®) on a Nonregeneroting (Feline) Corneal Endothelium
    Effect of 1 % Sodium Hyoluronote (Healon®) on a Nonregeneroting (Feline) Corneal Endothelium Charles F. Bahn,* Robert Grosserode,f^: David C. Musch,f Joseph Feder,f§ Roger F. Meyer, f Donald K. MacCallum.f John H. Lillie,f and Norman M. Rich* A series of experiments were performed to investigate the effect of 1% sodium hyaluronate (Healon®) on the nonregenerating corneal endothelium of the cat. Aqueous humor replacement with 1% sodium hyaluronate resulted in mild, transient elevations of intraocular pressure compared to eyes that were injected with balanced salt solution. Sodium hyaluronate 1% protected the feline endothelium against cell loss incurred by contact with hyaluronate-coated intraocular lenses compared to endothelial contact with lenses that were not coated with sodium hyaluronate. The use of intraoperative 1% sodium hyal- uronate, however, did not protect against endothelial cell loss incurred by penetrating keratoplasty or prevent subsequent skin graft-induced corneal homograft rejections. Homograft rejections were milder, however, in some eyes that received grafts coated with 1% sodium hyaluronate. Image analysis of pho- tographs of trypan blue- and alizarin red-stained corneal buttons after trephining, stretching of Descemet's membrane, rubbing against iris-lens preparations, or immediately after penetrating keratoplasty dem- onstrated that the stretching of the posterior cornea is an important cause of endothelial damage that would not be protected against by a viscoelastic coating. Invest Ophthalmol Vis Sci 27:1485-1494,1986
    [Show full text]
  • VISCO-3 (Sodium Hyaluronate)
    Patient Information VISCO-3TM (Sodium Hyaluronate) Federal law restricts this device to sale by or on the order of a physician. Please make sure to read the following important information carefully. This information does not take the place of your doctor’s advice. If you do not understand this information or want to know more, ask your doctor. Your doctor has determined that the knee pain you are experiencing is caused by osteoarthritis and that you are a candidate for a non-surgical, non-pharmacological, pain-relieving therapy called VISCO-3TM. VISCO-3TM is used for the treatment of pain in osteoarthritis of the knee in patients who have failed to get adequate relief from simple painkillers or from exercise and physical therapy. Contents What is VISCO-3TM? 2 What are the benefits of VISCO-3TM? 2 How is VISCO-3TM given? 2 What should you expect following your series of injections? 2 What other treatments are available for osteoarthritis? 3 Are there any reasons why you should not use VISCO-3TM? 3 Possible complications: 3 Other things you should know about VISCO-3 TM: 4 Summary of Clinical Study: 4 How can you get more information about VISCO-3TM? 5 Page 1 of 5 What is VISCO-3TM? VISCO-3TM is a solution made of highly purified, sodium hyaluronate (hyaluronan). Hyaluronan is a natural chemical found in the body and is found in particularly high amounts in joint tissues and in the fluid (synovial fluid) that fills the joints. The body’s own hyaluronan acts like a lubricant and shock absorber in synovial fluid of a healthy joint.
    [Show full text]
  • (CD-P-PH/PHO) Report Classification/Justifica
    COMMITTEE OF EXPERTS ON THE CLASSIFICATION OF MEDICINES AS REGARDS THEIR SUPPLY (CD-P-PH/PHO) Report classification/justification of medicines belonging to the ATC group R01 (Nasal preparations) Table of Contents Page INTRODUCTION 5 DISCLAIMER 7 GLOSSARY OF TERMS USED IN THIS DOCUMENT 8 ACTIVE SUBSTANCES Cyclopentamine (ATC: R01AA02) 10 Ephedrine (ATC: R01AA03) 11 Phenylephrine (ATC: R01AA04) 14 Oxymetazoline (ATC: R01AA05) 16 Tetryzoline (ATC: R01AA06) 19 Xylometazoline (ATC: R01AA07) 20 Naphazoline (ATC: R01AA08) 23 Tramazoline (ATC: R01AA09) 26 Metizoline (ATC: R01AA10) 29 Tuaminoheptane (ATC: R01AA11) 30 Fenoxazoline (ATC: R01AA12) 31 Tymazoline (ATC: R01AA13) 32 Epinephrine (ATC: R01AA14) 33 Indanazoline (ATC: R01AA15) 34 Phenylephrine (ATC: R01AB01) 35 Naphazoline (ATC: R01AB02) 37 Tetryzoline (ATC: R01AB03) 39 Ephedrine (ATC: R01AB05) 40 Xylometazoline (ATC: R01AB06) 41 Oxymetazoline (ATC: R01AB07) 45 Tuaminoheptane (ATC: R01AB08) 46 Cromoglicic Acid (ATC: R01AC01) 49 2 Levocabastine (ATC: R01AC02) 51 Azelastine (ATC: R01AC03) 53 Antazoline (ATC: R01AC04) 56 Spaglumic Acid (ATC: R01AC05) 57 Thonzylamine (ATC: R01AC06) 58 Nedocromil (ATC: R01AC07) 59 Olopatadine (ATC: R01AC08) 60 Cromoglicic Acid, Combinations (ATC: R01AC51) 61 Beclometasone (ATC: R01AD01) 62 Prednisolone (ATC: R01AD02) 66 Dexamethasone (ATC: R01AD03) 67 Flunisolide (ATC: R01AD04) 68 Budesonide (ATC: R01AD05) 69 Betamethasone (ATC: R01AD06) 72 Tixocortol (ATC: R01AD07) 73 Fluticasone (ATC: R01AD08) 74 Mometasone (ATC: R01AD09) 78 Triamcinolone (ATC: R01AD11) 82
    [Show full text]
  • Prediction of Premature Termination Codon Suppressing Compounds for Treatment of Duchenne Muscular Dystrophy Using Machine Learning
    Prediction of Premature Termination Codon Suppressing Compounds for Treatment of Duchenne Muscular Dystrophy using Machine Learning Kate Wang et al. Supplemental Table S1. Drugs selected by Pharmacophore-based, ML-based and DL- based search in the FDA-approved drugs database Pharmacophore WEKA TF 1-Palmitoyl-2-oleoyl-sn-glycero-3- 5-O-phosphono-alpha-D- (phospho-rac-(1-glycerol)) ribofuranosyl diphosphate Acarbose Amikacin Acetylcarnitine Acetarsol Arbutamine Acetylcholine Adenosine Aldehydo-N-Acetyl-D- Benserazide Acyclovir Glucosamine Bisoprolol Adefovir dipivoxil Alendronic acid Brivudine Alfentanil Alginic acid Cefamandole Alitretinoin alpha-Arbutin Cefdinir Azithromycin Amikacin Cefixime Balsalazide Amiloride Cefonicid Bethanechol Arbutin Ceforanide Bicalutamide Ascorbic acid calcium salt Cefotetan Calcium glubionate Auranofin Ceftibuten Cangrelor Azacitidine Ceftolozane Capecitabine Benserazide Cerivastatin Carbamoylcholine Besifloxacin Chlortetracycline Carisoprodol beta-L-fructofuranose Cilastatin Chlorobutanol Bictegravir Citicoline Cidofovir Bismuth subgallate Cladribine Clodronic acid Bleomycin Clarithromycin Colistimethate Bortezomib Clindamycin Cyclandelate Bromotheophylline Clofarabine Dexpanthenol Calcium threonate Cromoglicic acid Edoxudine Capecitabine Demeclocycline Elbasvir Capreomycin Diaminopropanol tetraacetic acid Erdosteine Carbidopa Diazolidinylurea Ethchlorvynol Carbocisteine Dibekacin Ethinamate Carboplatin Dinoprostone Famotidine Cefotetan Dipyridamole Fidaxomicin Chlormerodrin Doripenem Flavin adenine dinucleotide
    [Show full text]
  • Hyaluronic Acid Introduced 2003
    Hyaluronic Acid Introduced 2003 What Is It? Are There Any Potential Drug Interactions? Hyaluronic acid, or HA, is a naturally occurring polymer found in every tissue of At this time, there are no known adverse reactions when taken in conjunction the body. It is particularly concentrated in the skin (almost 50% of all HA in the with medications. body is found in the skin) and synovial fluid. It is composed of alternating units of n-acetyl-d-glucosamine and d-glucuronate. This polymer’s functions include Hyaluronic acid attracting and retaining water in the extracellular matrix of tissues, in layers of skin, and in synovial fluid.* each vegetarian capsule contains v 3 hyaluronic acid (low molecular weight) ..............................................................................70 mg Features Include other ingredients: hypo-allergenic plant fiber (cellulose), vegetarian capsule (cellulose, water) 1–2 capsules per day, in divided doses, with or between meals. Clinically Researched Absorption: In nature, HA is a large molecular weight compound, ranging in size from 500,000-6,000,000 daltons. This is too large to ® be absorbed in the small intestines. HyaMax sodium hyaluronate provides a Hyaluronic acid liquid low molecular weight source of hyaluronic acid produced through fermentation. ® In a pharmacokinetic study, orally administered HyaMax hyaluronic acid was 2 ml (0.06 fl oz) (2 full droppers) contains v incorporated into joints, connective tissue and skin, with a particular affinity for hyaluronic acid (low molecular weight) ..............................................................................10 mg cartilaginous joints.* other ingredients: purified water, apple juice concentrate, citric acid, natural apple flavor, potassium sorbate, purified stevia extract Uses For Hyaluronic Acid serving size: 2 ml (0.06 fl oz) Skin Health: For skin cells, the ability of HA to attract and retain water is servings per container: 29 essential for proper cell-to-cell communication, hydration, nutrient delivery, and 1-2 servings daily, with or between meals.
    [Show full text]
  • Management of Joint Disease in the Sport Horse
    1 MANAGEMENT OF JOINT DISEASE IN THE SPORT HORSE Management of Joint Disease in the Sport Horse C. WAYNE MCILWRAITH Colorado State University, Ft. Collins, Colorado INTRODUCTION The joint is an organ, and there are a number of ways in which traumatic damage occurs, ultimately resulting in degradation of articular cartilage. It was recognized in 1966 that articular cartilage change that accompanied osteochondral fragmentation could also be associated with concurrent traumatic damage to the attachment of the joint capsule and ligaments (Raker et al., 1966). However, there was little association made between primary disease in the synovial membrane and fibrous joint capsule and the development of osteoarthritic change in the articular cartilage until an experimental study demonstrated that cartilage degradation could occur in the horse in the absence of instability or trau- matic disruption of tissue and that loss of glycosaminoglycan (GAG) staining was associated with early morphologic breakdown at the surface of the cartilage (McIlwraith and Van Sickle, 1984). Surveys have confirmed that approximately 60% of lameness problems are related to osteoarthritis (National Animal Health Monitoring Systems, 2000; Caron and Genovese, 2003). Rapid resolution of synovitis and capsuli- tis is a critical part of the medical treatment of joint disease because of the principal role of synovitis in causing cartilage matrix breakdown. The goal of treatment of traumatic entities of the joint is twofold: (1) returning the joint to normal as quickly as possible, and (2) preventing the occurrence or reduction of the severity of osteoarthritis. In other words, treatment is intended to (1) reduce pain (lameness), and (2) minimize progression of joint deterioration.
    [Show full text]
  • (HA) Viscosupplementation on Synovial Fluid Inflammation in Knee Osteoarthritis: a Pilot Study
    Send Orders for Reprints to [email protected] 378 The Open Orthopaedics Journal, 2013, 7, 378-384 Open Access Hyaluronic Acid (HA) Viscosupplementation on Synovial Fluid Inflammation in Knee Osteoarthritis: A Pilot Study Heather K. Vincent*,1, Susan S. Percival2, Bryan P. Conrad1, Amanda N. Seay1, Cindy Montero1 and 1 Kevin R. Vincent 1Department of Orthopaedics and Rehabilitation, Interdisciplinary Center for Musculoskeletal Training and Research, 2Department of Food Sciences and Nutrition, University of Florida, Gainesville, FL 32608, USA Abstract: Objective: This study examined the changes in synovial fluid levels of cytokines, oxidative stress and viscosity six months after intraarticular hyaluronic acid (HA) treatment in adults and elderly adults with knee osteoarthritis (OA). Design: This was a prospective, repeated-measures study design in which patients with knee OA were administered 1% sodium hyaluronate. Patients (N=28) were stratified by age (adults, 50-64 years and elderly adults, 65 years). Ambulatory knee pain values and self-reported physical activity were collected at baseline and month six. Materials and Methods: Knee synovial fluid aspirates were collected at baseline and at six months. Fluid samples were analyzed for pro-inflammatory cytokines (interleukins 1, 6,8,12, tumor necrosis factor-, monocyte chemotactic protein), anti-inflammatory cytokines (interleukins 4, 10 13), oxidative stress (4-hydroxynonenal) and viscosity at two different physiological shear speeds 2.5Hz and 5Hz. Results: HA improved ambulatory knee pain in adults and elderly groups by month six, but adults reported less knee pain- related interference with participation in exercise than elderly adults. A greater reduction in TNF- occurred in adults compared to elderly adults (-95.8% ± 7.1% vs 19.2% ± 83.8%, respectively; p=.044).
    [Show full text]
  • Bulk Drug Substances Under Evaluation for Section 503A
    Updated July 1, 2020 Bulk Drug Substances Nominated for Use in Compounding Under Section 503A of the Federal Food, Drug, and Cosmetic Act Includes three categories of bulk drug substances: • Category 1: Bulk Drug Substances Under Evaluation • Category 2: Bulk Drug Substances that Raise Significant Safety Concerns • Category 3: Bulk Drug Substances Nominated Without Adequate Support Updates to Section 503A Categories • Removal from category 3 o Artesunate – This bulk drug substance is a component of an FDA-approved drug product (NDA 213036) and compounded drug products containing this substance may be eligible for the exemptions under section 503A of the FD&C Act pursuant to section 503A(b)(1)(A)(i)(II). This change will be effective immediately and will not have a waiting period. For more information, please see the Interim Policy on Compounding Using Bulk Drug Substances Under Section 503A and the final rule on bulk drug substances that can be used for compounding under section 503A, which became effective on March 21, 2019. 1 Updated July 1, 2020 503A Category 1 – Bulk Drug Substances Under Evaluation • 7 Keto Dehydroepiandrosterone • Glycyrrhizin • Acetyl L Carnitine/Acetyl-L- carnitine • Kojic Acid Hydrochloride • L-Citrulline • Alanyl-L-Glutamine • Melatonin • Aloe Vera/ Aloe Vera 200:1 Freeze Dried • Methylcobalamin • Alpha Lipoic Acid • Methylsulfonylmethane (MSM) • Artemisia/Artemisinin • Nettle leaf (Urtica dioica subsp. dioica leaf) • Astragalus Extract 10:1 • Nicotinamide Adenine Dinucleotide (NAD) • Boswellia • Nicotinamide
    [Show full text]
  • Novel Heparin-Like Sulfated Polysaccharides
    ^ ^ ^ ^ I ^ ^ ^ ^ ^ ^ II ^ ^ ^ II ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ I ^ European Patent Office Office europeen des brevets EP 0 940 410 A1 EUROPEAN PATENT APPLICATION (43) Date of publication: (51) |nt CI * C08B 37/08, A61 K 31/73, 08.09.1999 Bulletin 1999/36 A61 K 47/36 A61 1_ 27/00 (21) Application number: 99200468.9 (22) Date of filing: 23.03.1995 (84) Designated Contracting States: • Magnani, Agnese AT BE CH DE DK ES FR GB GR IE IT LI LU MC NL 153010 San Rocco A. Philli (IT) PT SE • Cialdi, Gloria Deceased (IT) (30) Priority: 23.03.1994 IT PD940054 (74) Representative: (62) Document number(s) of the earlier application(s) in Crump, Julian Richard John et al accordance with Art. 76 EPC: FJ Cleveland, 9591 31 58.2 / 0 702 699 40-43 Chancery Lane London WC2A1JQ(GB) (71) Applicant: FIDIA ADVANCED BIOPOLYMERS S.R.L. Remarks: 72100 Brindisi (IT) »This application was filed on 18 - 02 - 1999 as a divisional application to the application mentioned (72) Inventors: under INID code 62. • Barbucci, Rolando »The application is published incomplete (there is no 53100 Siena (IT) claim number 9)as filed (Article 93 (2) EPC). (54) Novel heparin-like sulfated polysaccharides (57) The invention provides sulfated derivatives of jects and pharmaceutical compositions comprising polysaccharides such as hyaluronic acid and hyaluronic these derivatives. The invention further provides for the acid esters exhbiting anticoagulant, antithrombotic and use of these derivatives in the manufacture of pharma- angiogenic activity, for use in the biomedical area. The ceutical compositions, biomedical objects, biomaterials, invention further provides complex ions, biomedical ob- and controlled drug release systems.
    [Show full text]
  • Intra-Articular Corticosteroid and Hyaluronic Acid Injections in the Management of Osteoarthritis
    78 Review / Derleme Intra-Articular Corticosteroid and Hyaluronic Acid Injections in the Management of Osteoarthritis Osteoartrit Tedavisinde ‹ntraartiküler Kortikosteroid ve Hyaluronik Asit Enjeksiyonlar› G. Guy VANDERSTRAETEN, Martine De MUYNCK, Luc Vanden BOSCCHE, Tina DECORTE Ghent University Hospital, Department of Physical Medicine and Rehabilitation, Ghent, Belgium Summary Özet Intra-articular corticosteroid injections have long been used to treat oste- Eklem içi kortikosteroid enjeksiyonlar› osteoartrit tedavisinde uzun sü- oarthritis, whereas intra-articular hyaluronic acid injections for only a few reden beri kullan›lmaktad›r. Oysa eklem içi hyaluronik asit injeksiyonlar› years. In the literature, evidence-based reports on the efficacy of these sadece son y›llarda kullan›l›r hale gelmifltir. Literatürde bu ajanlar›n et- compounds are non-existent. In the presence of acute hydrops in an oste- kinli¤i aç›s›ndan kan›ta dayal› raporlar bulunmamaktad›r. Osteoartritli oarthritic knee an intra-articular corticosteroid injection following aspirati- bir dizde akut efüzyon varl›¤›nda eklemden aspirasyonu takiben eklem on of the joint can be considered. A maximum of 3 injections can be admi- içi kortikosteroid uygulamas› düflünülebilir. 8-10 günlük aralar ile en faz- nistered at intervals of 8 to 10 days, to be repeated every 6 months if ab- la 3 enjeksiyon uygulanabilir ve e¤er çok gerekli ise her 6 ayda bir tek- solutely necessary. A patient with a dry and painful osteoarthritic knee can rarlanabilir. Kuru ve a¤r›l› bir diz ise haftal›k aralar ile uygulanan eklem be a candidate for intra-articular hyaluronic acid injections at weekly inter- içi hyaluronik asit enjeksiyonu için aday olabilir.
    [Show full text]
  • Recent Advances in Equine Osteoarthritis Annette M Mccoy, DVM, MS, Phd, DACVS; University of Illinois College of Veterinary Medicine
    Recent Advances in Equine Osteoarthritis Annette M McCoy, DVM, MS, PhD, DACVS; University of Illinois College of Veterinary Medicine Introduction It is widely recognized that osteoarthritis (OA) is the most common cause of chronic lameness in horses and that it places a significant burden on the equine industry due to the cost of treatment and loss of use of affected animals. Depending on the disease definition and target population, the reported prevalence of OA varies. It was reported at 13.9% in a cross-sectional survey of horses in the UK, but at 97% (defined by loss of range of motion) in a group of horses over 30 years of age. Among Thoroughbred racehorses that died within 60 days of racing, 33% had at least one full-thickness cartilage lesion in the metacarpophalangeal joint, and the severity of cartilage lesions strongly correlated with a musculoskeletal injury leading to death. The majority of the horses in this study were less than 3 years of age, emphasizing the importance of OA in young equine athletes. Unfortunately, a major challenge in managing OA is that by the time clinical signs occur (i.e. lameness), irreversible cartilage damage has already occurred. Although novel treatment modalities are being tested that show promise for modulation of the course of disease, such as viral vector delivery of genes that produce anti-inflammatory products, there are no generally accepted treatments that can be used to reliably reverse its effects once a clinical diagnosis has been made. Thus, there is much research effort being put both into the development of improved diagnostic markers and the development of new treatments for this devastating disease.
    [Show full text]