Hyaluronic Acid (Cosmetics grade)|Cosmetics grade Hyaluronic Acid |Hyaluronic Acid Cosmetics grade

Hyaluro-nan injections for osteoarthritis of the knee

Side Effects of Hyaluronic Acid (HA,Hyaluronan,Hyaluronate) - for the Consumer

Role of hyaluronic acid on wound repair process

Inflammation and Hyaluronic Acid: an antagonistic relationship

Side Effects of Hyaluronic Acid (HA,Hyaluronan,Hyaluronate) - for the Consumer

Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade） is a high-molecular-mass polysaccharide found in the extracellular matrix, especially of soft connective tissues. It is synthesized in the plasma membrane of fibroblasts and other cells by addition of sugars to the reducing end of the polymer, whereas the nonreducing end protrudes into the pericellular space. The polysaccharide is catabolized locally or carried by lymph to lymph nodes or the general circulation, from where it is cleared by the endothelial cells of the liver sinusoids. The overall turnover rate is surprisingly rapid for a connective tissue matrix component (t1/2 0.5 to a few days). Hyaluronate has been assigned various physiological functions in the intercellular matrix, e.g., in water and plasma protein homeostasis. Hyaluro-nan production increases in proliferating cells and the polymer may play a role in mitosis. Extensive hyaluronidase-sensitive coats have been identified around mesenchymal cells. They are either anchored firmly in the plasma membrane or bound via Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade）-specific binding proteins (receptors). Such receptors have now been identified on many different cells, e.g., the lymphocyte homing receptor CD 44. Interaction between a hyaluronan receptor and extracellular polysaccharide has been connected with locomotion and cell migration. Hyaluro-nan seems to play an important role during development and differentiation and has other cell regulatory activities. Hyaluronan has also been recognized in clinical medicine. A concentrated solution of hyaluronan (10 mg/ml) has, through its tissue protective and rheological properties, become a device in ophthalmic surgery. Analysis of serum Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade） is promising in the diagnosis of liver disease and various inflammatory conditions, e.g., rheumatoid arthritis. Interstitial edema caused by accumulation of hyaluro-nan may cause dysfunction in various organs.

Hyaluronan
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Hyaluronan:
Mild bruising, heat, redness, swelling, or pain at the injection site; temporary achy feeling; temporary knee inflammation.
Seek medical attention right away if any of these SEVERE side effects occur when using Hyaluro-nan:
Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue).

Hyaluronic Acid (HA,Hyaluronan,Hyaluronate) Side Effects by Body System
Local
Local side effects have included erythema, edema, pain, and other injection site reactions in 0.2% to 2.5% of patients.

Musculoskeletal
Musculoskeletal side effects have included arthralgia, arthritis, arthropathy, Baker's cyst, bursitis, joint disorder, joint effusion, joint stiffness, joint swelling, pseudosepsis, localized osteoarthritis, aggravated osteoarthritis, ecchymosis, and knee arthroplasty.

Pseudosepsis has been characterized as severe joint inflammation with pain and effusion occurring 24 to 72 hours after injection and it may be more likely to occur after the second or third injection or with repeated courses. Nonsteroidal anti-inflammatory drugs, intra-articular steroids, and/or arthrocentesis are often required to treat pseudosepsis.

In a double-blind, controlled trial involving 226 patients with knee osteoarthritis the most frequent cause of discontinuation of sodium Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade） therapy was worsening of knee pain (11% vs. 13% with saline).

Gastrointestinal
Gastrointestinal side effects have included nausea, diarrhea, dyspepsia, and abdominal pain.

Other
The most common side effects have included arthralgia (12.6% vs 17.2% with saline and 0.8% with arthrocentesis), back pain (6.9% vs 12.2% with saline and 4.9% with arthrocentesis), headache (12.1% vs 16.6% with saline and 17.9% with arthrocentesis).
Other side effects have included general fatigue and pain.

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hyaluronan

What is Hyaluronic Acid (HA,Hyaluronan,Hyaluronate)?
Hyaluro-nan is similar to synovial fluid, a substance that occurs naturally in the joints. Synovial fluid acts as a lubricant and shock absorber.
Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade） is injected into the knee joints for the treatment of pain in individuals with osteoarthritis.
Hyaluro-nan may also be used for purposes other than those listed here.

What is the most important information I should know about hyaluronan?
Talk to your doctor before using hyaluro-nan if you have an allergy to birds or bird products, feathers, or chicken or egg products.
What should I discuss with my health care provider before using hyaluro-nan?
Talk to your doctor before using Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade） if you have an allergy to birds or bird products, feathers, or chicken or egg products.
Hyaluro-nan should not be used if there is an infection or skin disease at the site of injection.

It is not known whether hyaluronan will be harmful to an unborn baby. Do not use hyaluro-nan without first talking to your doctor if you are pregnant or could become pregnant during treatment. It is not known whether Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade） will be harmful to a nursing baby. Do not use hyaluro-nan without first talking to your doctor if you are breast-feeding a baby.

How should I use Hyaluronic Acid (HA,Hyaluronan,Hyaluronate)?
Hyaluro-nan is administered by a healthcare professional as an intra-articular (into the joint) injection.

Temporary pain or swelling of the affected joint may occur after injection of hyaluro-nan.
Avoid strenuous activity or prolonged (longer than one hour) weight-bearing activity such as jogging, tennis, lifting weights, or standing for 48 hours following an injection, unless otherwise directed by your doctor.

What happens if I miss a dose?
Contact your doctor if a dose of Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade） is missed.

What happens if I overdose?
An overdose of hyaluro-nan is unlikely to threaten life. Contact your doctor or seek emergency medical attention if an overdose of hyaluronan is suspected.

What should I avoid while using hyaluronan?
Avoid strenuous activity or prolonged (longer than one hour) weight-bearing activity such as jogging, tennis, lifting weights, or standing for 48 hours following an injection, unless otherwise directed by your doctor.

Hyaluronic Acid (HA,Hyaluronan,Hyaluronate) side effects
Notify your doctor immediately if you experience a rare but serious allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives) to hyaluro-nan.
Other less serious Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade） side effects may also occur. Talk to your doctor if you experience
temporary pain or swelling of the affected joint;
rash or bruising at the injection site; or an overall achy feeling.

Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade） side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

Hyaluronic Acid (HA,Hyaluronan,Hyaluronate) Dosing Information
Usual Adult Dose for Osteoarthritis:
2 mL intra-articularly into the knee once a week for 3 to 4 weeks.
If joint effusion is present, it should be removed before injection. A new syringe should be used for the injection.

What other drugs will affect hyaluro-nan?
It is not known whether other medications will interact with Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade）. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products during treatment with hyaluro-nan.

Where can I get more Hyaluronic Acid (HA,Hyaluronan,Hyaluronate) information?
Your pharmacist has additional information about Hyaluronic Acid written for health professionals that you may read.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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Hyaluronan injections for osteoarthritis of the knee

How Hyaluronic Acid Works
Hyaluro-nan is a substance that doctors inject directly into your knee joint, where it may help supplement the knee joint's natural synovial fluid, relieving pain and improving your ability to use the knee. This treatment is also called viscosupplementation.
After an injection, some people may experience pain or swelling.

Why Hyaluronic Acid Is Used
Doctors use Hyaluronic Acid to treat osteoarthritis of the knee that has not improved with other treatment (such as acetaminophen and physical therapy).

How Well Hyaluronic Acid Works
Results of some studies have shown that hyaluro-nan injections have improved the symptoms of osteoarthritis and joint function in some people.1 Results in other studies have been inconclusive about the effectiveness of hyaluro-nan injections.2

Hyaluronic Acid Side Effects
Hyaluro-nan injections may cause pain or swelling. Tell your doctor if you are allergic to birds, feathers, or egg products.
The long-term effects of repeated hyaluro-nan injections into the knee joint are not known.

Article Source:

http://www.webmd.com/osteoarthritis/

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Hyaluro-nan Functions

Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade） is an anionic, non-sulfated glycosaminoglycan distributed widely throughout connective, epithelial, and neural tissues. It is unique among glycosaminoglycans in that it is unsulphated, forms in the plasma membrane instead of the Golgi and can be very large with its molecular weight often reaching the millions.One of the chief components of the extracellular matrix, hyaluro-nan contributes significantly to cell proliferation and migration, and may also be involved in the progression of some malignant tumors.

The average 70 kg (154 lbs) person has roughly 15 grams of hyaluro-nan in their body, one-third of which is turned over (degraded and synthesized) every day.Hyaluro-nic acid is also a component of the group A streptococcal extracellular capsule,and is believed to play a role in virulence.
Until the late 1970s, Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade） was described as a "goo" molecule, a ubiquitous carbohydrate polymer that is part of the extracellular matrix.For example, hyaluro-nan is a major component of the synovial fluid and was found to increase the viscosity of the fluid. Along with lubricin, it is one of the fluid's main lubricating components.

Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade） is an important component of articular cartilage, where it is present as a coat around each cell (chondrocyte). When aggrecan monomers bind to hyaluro-nan in the presence of link protein, large highly negatively-charged aggregates form. These aggregates imbibe water and are responsible for the resilience of cartilage (its resistance to compression). The molecular weight (size) of hyaluro-nan in cartilage decreases with age, but the amount increases.

Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade） is also a major component of skin, where it is involved in tissue repair. When skin is excessively exposed to UVB rays, it becomes inflamed (sunburn) and the cells in the dermis stop producing as much hyaluro-nan, and increase the rate of its degradation. Hyaluro-nan degradation products also accumulate in the skin after UV exposure.

While it is abundant in extracellular matrices, hyaluronan also contributes to tissue hydrodynamics, movement and proliferation of cells, and participates in a number of cell surface receptor interactions, notably those including its primary receptors, CD44 and RH-AMM. Upregulation of CD44 itself is widely accepted as a marker of cell activation in lymphocytes. Hyaluro-nan's contribution to tumor growth may be due to its interaction with CD44. Receptor CD44 participates in cell adhesion interactions required by tumor cells.

Although Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade） binds to receptor CD44, there is evidence that hyaluro-nan degradation products transduce their inflammatory signal through Toll-like receptor 2 (TLR2), TLR4 or both TLR2, and TLR4 in macrophages and dendritic cells. TLR and hyaluro-nan play a role in innate immunity.

High concentrations of hyaluro-nan in the brains of young rats, and reduced concentrations in the brains of adult rats suggest that hyaluro-nan plays an important role in brain development.

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Role of hyaluronic acid on wound repair process

Skin provides a mechanical barrier to the external environment and acts to prevent the ingress of infectious agents.Once injured, the beneath tissues are exposed to infection; therefore, rapid and effective healing is of crucial significance to re-construct a barrier function. Skin wound healing is a complex process and includes many interacting processes initiated by haemostasis and the release of platelet-derived factors.The following stages are inflammation, granulation tissue formation, reepithelization and remodeling.Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade） is likely to play a multifaceted role in mediation of these cellular and matrix events. The proposed roles of H-A in this sequence of skin wound healing events are elucidated in details below.

Inflammation
Many biological factors, such as growth factors, cytokines, eicosanoids and so on, are generated in the inflammation process. These factors are necessary for the subsequent steps of wound healing due to their roles in promoting migration of inflammatory cells, fibroblasts, and endothelial cells into the wound site.

The wound tissue in the early inflammatory phase of wound repair is abounding with H-A, probably a reflection of increased synthesis.Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade） acts as a promoter of early inflammation, which is crucial in the whole skin wound-healing process. In a murine air pouch model of carrageenan/IL-1-induced inflammation, HA was observed to enhance cellular infiltration.Kobayashi and colleagues showed a dose-dependent increase of the proinflammatory cytokines TNF-α and IL-8 production by human uterine fibroblasts at H-A concentrations of 10μg/ml to 1 mg/ml via a CD44-mediated mechanism. Endothelial cells, in response to inflammatory cytokines such as TNF-α, and bacterial lipopolysaccharide, also synthesize Hyaluronic Acid (HA,Hyaluronan,Hyaluronate):side effects,use,works,Information, which has been shown to facilitate primary adhesion of cytokine-activated lymphocytes expressing the Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade）-binding variants of CD44 under laminar and static flow conditions.It is interesting to note that H-A has contradictory duo-functions in the inflammatory process. It not only can promote the inflammation, as stated above, but also can moderate the inflammatory response, which may contribute to the stabilization of granulation tissue matrix, as described in the following part.

Granulation and organization of the granulation tissue matrix
Granulation tissue is the perfused, fibrous connective tissue that replaces a fibrin clot in healing wounds. It typically grows from the base of a wound and is able to fill wounds of almost any size it heals. Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade） is abundant in granulation tissue matrix. A variety of cell functions that are essential for tissue repair may attribute to this H-A-rich network. These functions include facilitation of cell migration into the provisional wound matrix, cell proliferation and organization of the granulation tissue matrix. Absolutely, initiation of inflammation is extremely crucial for the formation of granulation tissue, therefore the pro-inflammatory role of H-A as discussed above also contribute to this stage of wound healing.
H-A and cell migration
Cell migration is essential for the formation of granulation tissue.The early stage of granulation tissue is dominated by a HA-rich extracellular matrix, which is regarded as a conductive environment for migration of cells into this temporary wound matrix. Contributions of H-A to cell migration may attribute to its physicochemical properties as stated above, as well as its direct interactions with cells. For the former scenario, Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade） provides an open hydrated matrix that facilitates cell migration, whereas, in the latter scenario, directed migration and control of the cell locomotory mechanisms are mediated via the specific cell interaction between H-A and cell surface H-A receptors. As discussed before, the three principal cell surface receptors for H-A are CD44, RH-AMM, and ICAM-1. RH-AMM is more related to cell migration. It forms links with several protein kinases associated with cell locomotion, for example, extracellular signal-regulated protein kinase (ERK), p125fak, and pp60c-src.During fetal development, the migration path through which neural crest cells migrate is rich in H-A. Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade） is closely associated with the cell migration process in granulation tissue matrix, and studies show that cell movement can be inhibited, at least partially, by H-A degradation or blocking H-A receptor occupancy.

By providing the dynamic force to the cell, HA synthesis has also been shown to associate with cell migration.Basically, H-A is synthesized at the plasma membrane and released directly into the extracellular environment. This may contribute to the hydrated microenvironment at sites of synthesis, and is essential for cell migration by facilitating cell detachment.

Role of H-A in moderation of the inflammatory response
Although inflammation is an integral part of granulation tissue formation, for normal tissue repair to proceed, inflammation needs to be moderated. The initial granulation tissue formed is highly inflammatory with a high rate of tissue turnover mediated by matrix degrading enzymes and reactive oxygen metabolites that are products of inflammatory cells.Stabilization of granulation tissue matrix can be achieved by moderating inflammation. H-A functions as an important moderator in this moderation process, which contradicts its role in inflammatory stimulation, as described above. Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade） can protect against free-radical damage to cells. This may attribute to its free-radical scavenging property, a physicochemical characteristic shared by large polyionic polymers. In a rat model of free-radical scavenging property investigated by Foschi D. and colleagues, H-A has been shown to reduce damage to the granulation tissue.

In addition to the free-radical scavenging role, H-A may also function in the negative feedback loop of inflammatory activation through its specific biological interactions with the biological constituents of inflammation.TNF-α, an important cytokine generated in inflammation, stimulates the expression of TSG-6 (TNF-stimulated gene 6) in fibroblasts and inflammatory cells. TSG-6, a H-A-binding protein, also forms a stable complex with the serum proteinase inhibitor IαI (Inter-α-inhibitor) with a synergistic effect on the latter’s plasmin-inhibitory activity. Plasmin is involved in activation of the proteolytic cascade of matrix metalloproteinases and other proteinases leading to inflammatory tissue damage. Therefore, the action of TSG-6/ IαI complex, which may be additionally organized by binding to H-A in the extracellular matrix, may serve as a potent negative feedback loop to moderate inflammation and stabilize the granulation tissue as healing progresses. In the murine air pouch model of carragenan/IL-1 (Interleukin-1β)-induced inflammation, where Hyaluronic Acid (HA,Hyaluronan,Hyaluronate) has been shown to have a proinflammatory property, reduction of inflammation can be achieved by administrating TSG-6, and the result is comparable with systemic dexamethasone treatment.

Reepithelization
H-A plays an important role in the normal epidermis. H-A also has crucial functions in the reepithelization process due to several of its properties: It serves as an integral part of the extracellular matrix of basal keratinocytes, which are major constitutes of epidermis; its free-radical scavenging function and its role in keratinocyte proliferation and migration.

In normal skin, Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade） is found in relative high concentrations in the basal layer of the epidermis where proliferating keratinocytes are found.CD44 is collocated with H-A in the basal layer of epidermis where additionally it has been shown to be preferentially expressed on plasma membrane facing the H-A-rich matrix pouches.Maintaining the extracellular space and providing an open as well as hydrated structure for the passage of nutrients are the main functions of H-A in epidermis. Tammi R. and other colleagues found that H-A content increases at the presence of retinoic acid (vitamin A). The proposed effects of retinoic acid that are against skin photo-damage and aging may be correlated at least in part with an increase of skin Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade） content, giving rise to increase of tissue hydration. It has been suggested that the free-radical scavenging property of H-A contributes to protection against solar radiation, supporting the role of CD44 acting as a H-A receptor in the epidermis..

Epidermal H-A also functions as a manipulator in the process of keratinocyte proliferation, which is essential in normal epidermal function as well as during reepithelization in tissue repair. In the wound healing process, HA is expressed in the wound margin, in the connective tissue matrix, and collocating with CD44 expression in migrating keratinocytes. Kaya et al. found that suppression of CD44 expression by an epidermis-specific antisense transgene resulted in animals with defective Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade） accumulation in the superficial dermis, accompanied by distinct morphologic alterations of basal keratinocytes and defective keratinocyte proliferation in response to mitogen and growth factors. Decrease in skin elasticity, impaired local inflammatory response, and impaired tissue repair were also observed.There observations are strongly supportive of the important roles H-A and CD44 have in skin physiology and tissue repair.

Fetal wound healing and scarring
Lack of fibrous scarring is the primary feature of fetal wound healing. Even for longer periods, H-A content in fetal wounds is still higher than that in adult wounds, which suggests that H-A may, at least in part, reduce collagen deposition and therefore leading to reduced scarring.[38] This suggestion is in agreement with the research of West et al., who showed that in adult and late gestation fetal wound healing, removal of Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade） results in fibrotic scarring.Though the exact role of H-A in skin scarring is still under investigation, based on all the facts that have been observed, it must be a great contributor to the less fibrous scarring.

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Inflammation and Hyaluronic Acid: an antagonistic relationship

Inflammation and Hyaluro-nic Acid are antagonistically related. Inflammation destroys H-A, and H-A, injected into joints, decreases inflammation. In addition, it appears inflammation may reduce a cells ability to produce H-A. An understanding of the mechanisms of inflammation in the body requires an understanding of H-A and the many roles it plays in the body.

Over the past few years, Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade） has become a buzzword synonymous with youth, beauty, pain relief, and accelerated healing. Found highly concentrated in our skin, corneas, cartilage, and joints, our body produces about 5000mg of this substance daily, and, once produced, it has a half life of about a day. At a cost of $500 per 1000mg injectable, or $120 per 1000 mg in pill form (excluding filler), the pure H-A our bodies produce has a value of about $6000 per day!

Our cells don't always produce H-A efficiently. When H-A production dwindles, or when inflammation processes degrade H-A, we often suffer from joint pain, myofascial rigidity, skin aging, dryness and wrinkles. Since H-A is also closely associated with coherence of the cell wall and intracellular barriers, and transport of nutrients to tissues without vasculature such as tendons, deficient Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade） may also contribute to impeded muscle and tendon healing and such things as leaky-gut syndrome.

Controlled research by Ronald J. Riegel, DVM, using the inflamed hocks of genetically similar horses going through very similar training, and eating the same diet, shows that Infratonic Therapy[TM] reduces inflammation as measured by infrared thermography, accelerates recovery of damaged muscle cells, as measured by serum CPK and AST, (indicating increased cell wall coherence) and substantially increases production of Hyaluronic Acid (Cosmetics grade)（Cosmetics grade Hyaluronic Acid , Hyaluronic Acid Cosmetics grade） in joints. Infratonic Therapy can be applied to the local area of pain or inflammation, projecting a therapeutic signal several inches into the body, through thick muscle groups and into joints.

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