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Hyaluronan, a double-edged sword in kidney diseases.
Aditya Kaul1, Kavya L Singampalli1,2,3, Umang M Parikh1
1Laboratory for Regenerative Tissue Repair, Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital/Baylor College of Medicine, Houston, TX, 77030, USA.
Pediatric Nephrology (Berlin, Germany)
|May 19, 2021
Summary
Hyaluronic acid (HA) exhibits dual roles in kidney disease, influencing fibrosis differently based on its molecular weight. This review clarifies HA
Area of Science:
- Nephrology
- Urology
- Biochemistry
Background:
- Hyaluronic acid (HA) is crucial in extracellular matrix (ECM) organization, inflammation, tissue regeneration, and viral sensing within nephrological and urological contexts.
- HA presents a paradoxical role, sometimes promoting pro-fibrotic and other times anti-fibrotic events, a duality often linked to its varying molecular weights.
- In kidney diseases like acute kidney injury (AKI), chronic kidney disease (CKD), and diabetic nephropathy, HA levels change dynamically during injury and progression.
Purpose of the Study:
- To review and summarize the current literature on hyaluronic acid (HA) in kidney diseases.
- To elucidate the paradoxical, dual effects of HA in nephrological and urological conditions.
- To highlight the significance of HA molecular weight in understanding its varied biological functions, particularly in kidney disease contexts.
Main Methods:
- Literature review of existing studies on hyaluronic acid (HA) in nephrology and urology.
- Analysis of research emphasizing the role of different HA molecular weights in disease pathogenesis.
- Synthesis of findings related to HA's involvement in extracellular matrix organization, inflammation, and tissue regeneration in kidney diseases.
Main Results:
- Hyaluronic acid (HA) is upregulated during the initial phase of kidney injury but decreases as conditions like AKI, CKD, and diabetic nephropathy progress.
- The molecular weight of HA significantly influences its biological activity, leading to differential pro-fibrotic or anti-fibrotic effects.
- Understanding HA's complex role is vital, as kidney diseases necessitate treatments ranging from dialysis to transplantation, especially in pediatric patients.
Conclusions:
- Hyaluronic acid (HA) plays a complex and often contradictory role in the development and progression of kidney diseases.
- The molecular weight of HA is a critical determinant of its fibrotic and regenerative effects in the kidney.
- Further research focusing on HA molecular weight is essential for developing targeted therapies for kidney diseases, benefiting patients facing serious interventions.
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