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Writer's pictureAthreya Nicolas Ravi

Hyaluronic acid - An Alternative Bone Regeneration Treatment

Bones are composed of specialized bone cells and connective tissue that has been strengthened with calcium. The bone marrow that makes blood cells is also found in the majority of bones. In order to hold our body together and support mobility, bones operate in conjunction with muscles and joints. The musculoskeletal system is what we refer to as. Bones protect the various other organs of the body, produce red and white blood cells, store minerals, provide structure and support for the body, and enable mobility. So as you can imagine they are very important for us. As we grow older The body's skeleton forms and matures into adulthood in a process called modelling. It then completely regenerates the bones about every 10 years. The process of remodelling removes older pieces of bone and replaces them with fresh bone tissue so that the body remains both healthy and strong.



Bone Regeneration

However in the event of a fracture or large amounts of bone damage, the body is forced to carry out this process on a smaller scale so that the bone regrows or is fixed. Unfortunately, as people get older, the immune system's ability to clear out pathogens, eliminate shattered shards, and eventually produce a callus to cover the fracture and promote healing is compromised. Diabetes, Ageing, and radiation treatment all impair this process significantly putting already weakening people at even greater risk. Considering the fact that globally, in 2019, there were 178 million fractures and the trend shows that this number will grow every year not being able to properly heal for tens of millions of people is a significant issue that needs to be quickly dealt with.


New bone regrowth method

When trying to naturally fix itself the body has to undergo a process where soft, protective callus forms to bridge the fracture while blood vessels grow into the area to assist with healing. It is known that radiation inhibits angiogenesis - the stage of blood vessel formation that is essential for bone healing - by lowering the number of white blood cells and other immune system cells. “We are developing ways to allow bones to heal when they otherwise wouldn’t by looking at introducing blood vessels,” said University of Michigan surgery researcher and lead author Alexis Donneys, MD. The method of introducing blood vessels acts as a way to circumvent the issues that are being caused.


Even though some people have bones that cannot naturally fix themselves due to complications, researchers have been trying to overcome this problem. The University of Michigan came up with a possible solution that relies on Hyaluronic acid and deferoxamine


Hyaluronic acid is a naturally occurring gooey, slippery material in your body. Scientists have discovered hyaluronic acid in all parts of the body, particularly in the skin, joints, and eyes. It is often used in skincare treatments. Deferoxamine on the other hand is an iron-binding substance that is a member of the pharmacological class known as heavy metal antagonists. It functions by facilitating the additional iron removal by the gallbladder and kidneys. Unlike Hyaluronic acid can have a negative effect on the body, potentially causing bone dysplasia.


Hyaluronic acid and deferoxamine are delivered as a mixture of stimulants into a fracture to promote bone growth. When it was tested on small animals before human trials the therapy proved itself to be very effective greatly increasing the bone's speed of recovery/regrowth after injury.


Broken bones should mend within a few months for children to adults. However, recuperation is far more challenging for the elderly and for people who have undergone radiation therapy for cancer. For instance, problems from thyroid and salivary gland cancer treatment caused the late film critic Roger Ebert to lose the lower half of his jaw. Only 20% of radiated bone fractures heal, according to the researchers, despite the fact that such massive, intricate bone wounds sometimes necessitate grafts and numerous procedures.“We want to do a lot better for patients to help avoid debilitating and disfiguring complications and to improve their quality of life in a way we haven’t seen yet” said Alexis Donneys.

In order to explore one of the most difficult healing processes, the researchers used the delivery strategy of hyaluronic acid and deferoxamine to treat bone fractures in radiation-exposed animals. According to the researchers, animals treated with hyaluronic acid and deferoxamine for bone fractures had a 91% bone union rate, which was three times higher than the rate in untreated animals. This is remarkable because it means that people at risk are potentially a third as susceptible to long-lasting injuries as before. Giving people at risk more hope is potentially the greatest achievement of this form of therapy.

About the Chemicals

Hyaluronic acid is a naturally occurring gooey, slippery material in your body. Scientists have discovered hyaluronic acid in all parts of the body, particularly in the skin, joints, and eyes. It is often used in skincare treatments. Deferoxamine on the other hand is an iron-binding substance that is a member of the pharmacological class known as heavy metal antagonists. It functions by facilitating the additional iron's removal by the gallbladder and kidneys. Unlike Hyaluronic acid can have a negative effect on the body, potentially causing bone dysplasia.



In conclusion, the treatment uses 2 chemicals that both have polar properties where the hyaluronic acid can be used for skin care but deferoxamine is often known to cause problems. Although the treatment is still not perfect it does help a great deal and as it was seen in the case of Roger Ebert it can definitely help. Steven R. Buchman the coauthor of the study, MD, craniofacial plastic surgeon at Michigan Medicine stated that “If you can grow bone in a nuclear winter, you can grow a bone anywhere”


Written by: Athreya Nicolas Ravi

Edited by: Svasti Tewari



Bibliography

Anderton, Kate. “New device can accelerate bone regeneration in difficult cases.” News-Medical, 7 October 2019, https://www.news-medical.net/news/20191007/New-device-can-accelerate-bone-regeneration-in-difficult-cases.aspx. Accessed 11 August 2022.

“Desferal (deferoxamine) dosing, indications, interactions, adverse effects, and more.” Medscape Reference, https://reference.medscape.com/drug/desferal-deferoxamine-343722. Accessed 14 August 2022.

“Device Accelerates Bone Healing in Difficult Cases.” Dentistry Today, 23 October 2019, https://www.dentistrytoday.com/device-accelerates-bone-healing-in-difficult-cases/. Accessed 11 August 2022.

Dimitriou, Rozalia, and Peter V. Giannoudis. “Bone regeneration: current concepts and future directions - BMC Medicine.” BMC Medicine, 31 May 2011, https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-9-66. Accessed 11 August 2022.

“Hyaluronic Acid: What It Is, Benefits, How To Use & Side Effects.” Cleveland Clinic, 4 May 2022, https://my.clevelandclinic.org/health/articles/22915-hyaluronic-acid. Accessed 14 August 2022.

Kirkendoll, Shantell M. “Surgical Innovation Course Fosters New Approach to Bone Healing.” Health Lab Blog, 1 October 2019, https://labblog.uofmhealth.org/health-tech/surgical-innovation-course-fosters-new-approach-to-bone-healing. Accessed 11 August 2022.


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