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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Musculoskeletal Disorders 1/2015

Hyaluronic acid increases tendon derived cell viability and collagen type I expression in vitro: Comparative study of four different Hyaluronic acid preparations by molecular weight

BMC Musculoskeletal Disorders > Ausgabe 1/2015
Leonardo Osti, Martina Berardocco, Viviana di Giacomo, Graziella Di Bernardo, Francesco Oliva, Anna C. Berardi
Wichtige Hinweise
An erratum to this article can be found at http://​dx.​doi.​org/​10.​1186/​s12891-015-0785-x.
An erratum to this article is available at http://​dx.​doi.​org/​10.​1186/​s12891-015-0785-x.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

LO and ACB made substantial contributions to the conception and design of this manuscript, data acquisition, analysis and interpretation and the drafting of the manuscript. MB carried out the Tendon cell cultures, Tendon derived cells viability and metabolic activity. VdG Apoptosis analyses. GDB participated in tendon derived cells culture. ACB conceived the study and participated in its design and coordination. FO critically revised the manuscript for important intellectual content, and gave the final approval of the version to be published. All authors read and approved the final manuscript.

Authors’ information

Not applicable.



Hyaluronic Acid (HA) has been already approved by Food and Drug Administration (FDA) for osteoarthritis (OA), while its use in the treatment of tendinopathy is still debated. The aim of this study was to evaluate in human rotator cuff tendon derived cells the effects of four different HA on cell viability, proliferation, apoptosis and the expression of collagen type I and collagen type III.


An in vitro model was developed on human tendon derived cells from rotator cuff tears to study the effects of four different HA preparations (Ps) (sodium hyaluronate MW: 500-730 KDa - Hyalgan®, 1000 kDa Artrosulfur HA®, 1600 KDa Hyalubrix® and 2200 KDa Synolis-VA®) at various concentrations. Tendon derived cells morphology were evaluated after 0, 7 and 14 d of culture. Viability, proliferation, apoptosis were evaluated after 0, 24 and 48 h of culture. The expression and deposition of collagen type I and collagen type III were evaluated after 1, 7 and 14 d of culture.


All HAPs tested increased viability and proliferation, in dose dependent manner. HAPs already reduce apoptosis at 24 h compared to control cells (without HAPs). Furthermore, HAPs stimulated the synthesis of collagen type I in a dose dependent fashion over 14 d, without increase in collagen type III; moreover, in the presence of Synolis-VA® the expression and deposition of collagen type I was significantly higher as compare with the other HAPs.


HAPs enhanced viability, proliferation and expression of collagen type I in tendon derived cells.
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