Effects of Intra-Articular Administration of High-Molecular-Weight Linear Hyaluronic Acid on Synovial Fluid

Marcela Dos Santos Ribeiro1, Vittoria Guerra Altheman1, Victória Ferreira Alexandre1

  • 1Department of Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University (FMVZ/UNESP), Botucatu 18618-618, SP, Brazil.

Synovitis is an inflammatory disorder in horses that contributes to cartilage degradation and osteoarthritis. This study evaluated the effects of intra-articular administration of high-molecular-weight (HMW), linear (non-cross-linked) hyaluronic acid (HA) in an equine model of lipopolysaccharide (LPS)-induced acute synovitis. In this randomized blinded study, acute synovitis was induced in radiocarpal joints of 16 adult horses using LPS (0.25 ng). After 12 h, joints were treated intra-articularly with either 2 mL of phosphate-buffered saline (PBS; control group) or 2 mL of HMW-HA (20 mg/mL; 2280 kDa; treatment group). Horses underwent orthopedic, ultrasonographic, and synovial fluid evaluations. Horses treated with HMW-HA exhibited lower synovial membrane thickening and reduced lameness scores compared with controls. Synovial fluid analysis demonstrated increased concentrations of HMW-HA during the acute inflammatory phase in treated joints. Reduced chondroitin sulfate release was also detected following HMW-HA administration. Lower lipid peroxidation levels (TBARS) were observed in the treated group at 24 h and 14 days. Intra-articular administration of high-molecular-weight linear hyaluronic acid was associated with increased synovial availability of HMW-HA during the acute inflammatory phase, attenuation of pain-related clinical signs and synovial membrane thickening, and modulation of the redox environment. These findings support a modulatory role of linear HMW-HA in the intra-articular environment.

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