Trafficking of hyaluronan in the interstitium and its possible implications

The mechanisms underlying the pathological changes in lymphedematous tissue are far from clear, and it is becoming apparent that plasma proteins may not be the only key factors responsible for holding water in the interstitium. This review focuses on an "old" macromolecule--hyaluronan (HA) which is one of the major components of the interstitium and has a close relationship with the lymphatic system. Growing recognition of the multiple functions of this macromolecule for important physiological and pathological events may be helpful in identifying the crucial changes in tissues subjected to lymphatic circulation insufficiency and ultimately in the search for rational therapeutic approaches to prevent or reverse these tissues changes.