Hyaluronic acid, the molecule capable of slowing down the signs of ageing
There is no fountain of eternal youth. But if ever there were claims to this lofty title, hyaluronic acid would be one of the strongest candidates. It is this substance, particularly when obtained naturally and with high purity and concentration, that is capable of slowing down the ageing process, especially in joints and skin. And this is something that cannot be said of many natural molecules.
Objective: healthy ageing
The World Health Organization (WHO) states that every individual, in every corner of the world, should have the opportunity to live a long and healthy life. The WHO defines healthy ageing (1) as the process of developing and maintaining the functional capacity that enables wellbeing in older age.
It is therefore not just a question of living longer, but also of living with operative functional capacities. These intrinsic capacities include physical (mobility, ability to walk independently, to see, hear etc.) and mental (thinking, remembering etc.) capacities. But all of these are affected or reduced in old age. That is why the search for molecules that help to delay the deterioration of these capacities is an excellent short and long-term health strategy.
The importance of hyaluronic acid for health
Water is and will always be the most important nutrient for human beings. Ensuring we get enough intake through diet (water, other beverages and even water-rich foods) is a basic health guideline. But it is also vital to ensure there is an adequate supply of substances that maintain a good level of hydration in cells and body tissues, and this is where hyaluronic acid (HA) comes into play. Its ability to retain water is incredible, and so an adequate supply of HA can prevent dehydration in joints and skin by contributing to their correct function (2) (3) (4).
From a chemical point of view, we are talking about glycosaminoglycan (GAG), a polymer formed by the repeated union of two molecules, D-glucoronic acid and N-acetyl-D-glucosamine (5). Naturally present in all cells of the body, it has a remarkably high concentration in the skin, the vitreous eye humour and the synovial fluid of the joints, where it acts as a natural lubricant (6) (7) (8) (9) (10).
The Scientific Community has been researching this substance for many years. It is naturally produced by the body, but its endogenous manufacture decreases over the years. How its administration, in both injectable and oral form, can slow down the ageing process in different organs and system is the subject of research.
Although it is true that there are studies that show that the administration of HA can protect the ocular surface and improve symptoms of inflammation and dryness in patients suffering from dry eye (11) (12) (13), a disease that affects visual ability (difficulty driving, reading or watching television), most of the bibliographical references cite HA as an effective substance for improving the health of the skin and joints.
Benefits of hyaluronic acid for skin health
Young skin has a turgid, elastic and flexible appearance, due, among other factors, to its high water content. HA’s extraordinary water retention capacity could explain its application as a nutricosmetic and its application as an authentic natural anti-ageing aid (14). Studies show that HA improves skin elasticity, reduces wrinkles and scars (15) (16) and acts as an effective facial rejuvenator (17) (18).
Oral intake of HA supplements can help to relieve dry skin, both when it appears over the years and due to extrinsic factors such as solar radiation, smoking or air pollutants that lead to premature ageing, even in younger skins (19). Furthermore, according to studies, there are no adverse effects linked to oral intake of HA in the established doses, and this molecule clearly improves the condition of the skin by increasing its hydration (20), as well as ensuring the correct repair of skin tissue, aiding its healing (21) (22).
Benefits of hyaluronic acid for joint health
Joint function is related, among other factors, to the properties of the synovial fluid surrounding it, which acts as a natural lubricant and protects the joint from impact and pressure. HA is a particularly abundant component in this synovial fluid (23) so when HA decreases, your joints become more vulnerable and the risk of arthrosis, arthritis and osteoarthritis (OA) (24) increases.
Although intra-articular injections of HA have been used successfully to treat the symptoms of OA (25), they create a mental burden for patients, who must go to a hospital regularly to receive these painful injections, in addition to the possible risk of infection (26) (27).
For this reason, the structural components of the joints and possible oral administration began to be studied as an alternative that places less burden on patients. In this field there is extensive research with glucosamine and chondroitin, but both should be administered in high doses, around 1500 mg and 650 mg respectively (28). However, lower doses of HA, below 240 mg/day, are already effective in treating OA symptoms and joint pain (29) (30), which facilitates adherence to the patient’s treatment.
Numerous studies show that it is possible to re-establish low levels of HA in an arthrosic joint with exogenous administration of HA and achieve a significant improvement in symptoms in people with knee osteoarthritis (31), as well as a decrease in pain and inflammation (32) and, consequently, an improvement in the functionality and flexibility of the joint (improved bending and stretching of the joint) (33). The efficacy and safety of using HA has also been demonstrated in these and other clinical trials (34).
With the progressive ageing of the population, interest in studying the benefits for joint problems has been increasing, with interesting bibliographical references favouring the use of HA nutritional supplements as an adjuvant for the treatment and prevention of OA and its symptoms, with no adverse effects (35).
Choose an effective hyaluronic acid
According to scientific studies, hyaluronic acid is an excellent ally for combating skin ageing, a natural anti-ageing tool that also allows you to take care of joints and visual health. But it is important to respect certain quality criteria when selecting a particular supplement made from HA: ideally non-synthetic, of natural origin, for example obtained through yeast fermentation; it is also essential to ensure that the purity of the product is high, for example to obtain a product with a purity greater than 90% HA, because it is this active natural molecule that these benefits are associated with.
HA supplements are intended for adults, with the exception of pregnant or breastfeeding women, and are not a substitute for a balanced and varied diet. Before taking it, if you have any pathology or if you are on a course of chronic medication, consult your doctor or therapist beforehand.
(1) What is Healthy Ageing? WHO, https://www.who.int/ageing/healthy-ageing/en/
(2) Skin hydration and hyaluronic acid, Masson F, https://www.ncbi.nlm.nih.gov/pubmed/20435251
(3) Ions in hyaluronic acid solutions, Ferenc Horkay, Peter J. Basser, David J. Londono, Anne-Marie Hecht, and Erik Geissler https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2792326/
(4) Hyaluronan and homeostasis: a balancing act. Tammi MI, Day AJ, Turley EA. https://www.ncbi.nlm.nih.gov/pubmed/11717316/
(5) Hyaluronan: its nature, distribution, functions and turnover. Fraser JR, Laurent TC, Laurent UB. https://www.ncbi.nlm.nih.gov/pubmed/9260563/
(6) Localization of epidermal hyaluronic acid using the hyaluronate binding region of cartilage proteoglycan as a specific probe. Tammi R, Ripellino JA, Margolis RU, Tammi M. https://www.ncbi.nlm.nih.gov/pubmed/2450149
(7) Hyaluronan in skin: aspects of aging and its pharmacologic modulation. Stern R, Maibach HI. https://www.ncbi.nlm.nih.gov/pubmed/18472055
(8) Glycosaminoglycans from bovine eye vitreous humour and interaction with collagen type II. Peng Y, Yu Y, Lin L, Liu X, Zhang X, Wang P, Hoffman P, Kim SY, Zhang F, Linhardt RJ. https://www.ncbi.nlm.nih.gov/pubmed/29305777
(9) HYALURONATE IN NORMAL HUMAN SYNOVIAL FLUID, David Hamerman and Hilda Schuster https://www.ncbi.nlm.nih.gov/pmc/articles/PMC293057/
(10) THE HYALURONIC ACID OF SYNOVIAL FLUID IN RHEUMATOID ARTHRITIS Charles Ragan and Karl Meyer https://www.ncbi.nlm.nih.gov/pmc/articles/PMC439575/
(11) Efficacy of eyedrops containing cross-linked hyaluronic acid and coenzyme Q10 in treating patients with mild to moderate dry eye. Postorino EI, Rania L, Aragona E, Mannucci C, Alibrandi A, Calapai G, Puzzolo D, Aragona P. https://www.ncbi.nlm.nih.gov/pubmed/28777385
(12) Safety and Efficacy of an Artificial Tear Containing 0.3% Hyaluronic Acid in the Management of Moderate-to-Severe Dry Eye Disease.
López-de la Rosa A, Pinto-Fraga J, Blázquez Arauzo F, Urbano Rodríguez R, González-García MJ. https://www.ncbi.nlm.nih.gov/pubmed/27243353
(13) Targeted delivery of hyaluronic acid to the ocular surface by a polymer-peptide conjugate system for dry eye disease.
Lee D, Lu Q, Sommerfeld SD, Chan A, Menon NG, Schmidt TA, Elisseeff JH, Singh A. https://www.ncbi.nlm.nih.gov/pubmed/28363785
(14) Hyaluronic acid: A key molecule in skin aging. Papakonstantinou E, Roth M, Karakiulakis G. https://www.ncbi.nlm.nih.gov/pubmed/23467280
(15) Hyaluronic acid in the treatment and prevention of skin diseases: molecular biological, pharmaceutical and clinical aspects. Weindl G, Schaller M, Schäfer-Korting M, Korting HC. https://www.ncbi.nlm.nih.gov/pubmed/15452406
(16) Ingestion of an Oral Hyaluronan Solution Improves Skin Hydration, Wrinkle Reduction, Elasticity, and Skin Roughness: Results of a Clinical Study, Imke Göllner, PhD, Werner Voss, MD, Ulrike von Hehn, and Susanne Kammerer, MD https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871318/
(17) Hyaluronic acid, a promising skin rejuvenating biomedicine: A review of recent updates and pre-clinical and clinical investigations on cosmetic and nutricosmetic effects.
Bukhari SNA, Roswandi NL, Waqas M, Habib H, Hussain F, Khan S, Sohail M, Ramli NA, Thu HE, Hussain Z. https://www.ncbi.nlm.nih.gov/pubmed/30287361
(18) Oral hyaluronan relieves wrinkles: a double-blinded, placebo-controlled study over a 12-week period.
Oe M, Sakai S, Yoshida H, Okado N, Kaneda H, Masuda Y, Urushibata O. https://www.ncbi.nlm.nih.gov/pubmed/28761365
(19) Ingested hyaluronan moisturizes dry skin. Kawada C, Yoshida T, Yoshida H, Matsuoka R, Sakamoto W, Odanaka W, Sato T, Yamasaki T, Kanemitsu T, Masuda Y, Urushibata O. https://www.ncbi.nlm.nih.gov/pubmed/25014997
(20) Ingestion of hyaluronans (molecular weights 800 k and 300 k) improves dry skin conditions: a randomized, double blind, controlled study.
Kawada C, Yoshida T, Yoshida H, Sakamoto W, Odanaka W, Sato T, Yamasaki T, Kanemitsu T, Masuda Y, Urushibata O. https://www.ncbi.nlm.nih.gov/pubmed/25834304
(21) The role of hyaluronan in wound healing. Frenkel JS https://www.ncbi.nlm.nih.gov/pubmed/22891615
(22) The properties of hyaluronan and its role in wound healing. Anderson I https://www.ncbi.nlm.nih.gov/pubmed/12030177
(23) Hyaluronic acid in synovial fluid. I. Molecular parameters of hyaluronic acid in normal and arthritis human fluids. Balazs EA, Watson D, Duff IF, Roseman S. https://www.ncbi.nlm.nih.gov/pubmed/6046018/
(24) The role of hyaluronic acid (hyaluronan) in health and disease: interactions with cells, cartilage and components of synovial fluid. Ghosh P. https://www.ncbi.nlm.nih.gov/pubmed/8162648
(25) Efficacy and safety of hyaluronic acid in the management of osteoarthritis: Evidence from real-life setting trials and surveys. Maheu E, Rannou F, Reginster JY. https://www.ncbi.nlm.nih.gov/pubmed/26806183
(26) Potential mechanism of action of intra-articular hyaluronan therapy in osteoarthritis: are the effects molecular weight dependent? Ghosh P, Guidolin D. https://www.ncbi.nlm.nih.gov/pubmed/12219318
(27) Intraarticular injection of hyaluronan as treatment for knee osteoarthritis: what is the evidence? Brandt KD, Smith GN Jr, Simon LS. https://www.ncbi.nlm.nih.gov/pubmed/10857778
(28) Effects of glucosamine in patients with osteoarthritis of the knee: a systematic review and meta-analysis, Toru Ogata, Yuki Ideno, Masami Akai, Atsushi Seichi, Hiroshi Hagino, Tsutomu Iwaya, Toru Doi, Keiko Yamada, Ai-Zhen Chen, Yingzi Li, and Kunihiko Hayashicorresponding author https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6097075/
(29) Oral administration of polymer hyaluronic acid alleviates symptoms of knee osteoarthritis: a double-blind, placebo-controlled study over a 12-month period. Tashiro T, Seino S, Sato T, Matsuoka R, Masuda Y, Fukui N. https://www.ncbi.nlm.nih.gov/pubmed/23226979
(30) Effect of a natural extract of chicken combs with a high content of hyaluronic acid (Hyal-Joint) on pain relief and quality of life in subjects with knee osteoarthritis: a pilot randomized double-blind placebo-controlled trial. Kalman DS, Heimer M, Valdeon A, Schwartz H, Sheldon E. https://www.ncbi.nlm.nih.gov/pubmed/18208600
(31) Oral administration of polymer hyaluronic acid alleviates symptoms of knee osteoarthritis: a double-blind, placebo-controlled study over a 12-month period.
Tashiro T1, Seino S, Sato T, Matsuoka R, Masuda Y, Fukui N. https://www.ncbi.nlm.nih.gov/pubmed/23226979
(32) Evaluation of the effects of a supplementary diet containing chicken comb extract on symptoms and cartilage metabolism in patients with knee osteoarthritis
ISAO NAGAOKA, KUNIHIRO NABESHIMA, SAYA MURAKAMI, TETSURO YAMAMOTO, KEITA WATANABE, AKIHITO TOMONAGA, and HIDEYO YAMAGUCHI https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3445888/
(33) Oral hyaluronan relieves knee pain: a review Mariko Oe, Toshiyuki Tashiro, Hideto Yoshida, Hiroshi Nishiyama, Yasunobu Masuda, Koh Maruyama, Takashi Koikeda, Reiko Maruya, and Naoshi Fukui https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4729158/
(34) Oral intake of a liquid high-molecular-weight hyaluronan associated with relief of chronic pain and reduced use of pain medication: results of a randomized, placebo-controlled double-blind pilot study. Jensen GS, Attridge VL, Lenninger MR, Benson KF. https://www.ncbi.nlm.nih.gov/pubmed/25415767
(35) Oral hyaluronan relieves knee pain: a review Mariko Oe, Toshiyuki Tashiro, Hideto Yoshida, Hiroshi Nishiyama, Yasunobu Masuda, Koh Maruyama, Takashi Koikeda, Reiko Maruya, and Naoshi Fukui https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4729158/