Exploration of bioactive additives for hyaluronan based hydrogels : A literature study

Abstract: Hyaluronan (HA) is a substance that is commonly used in biomedical applications in the form of hydrogels. One of these biomedical applications is dermatological fillers where HA is cross-linked with 1,4-Butanediol diglycidyl ether (BDDE) to reduce its rapid turnover within tissue. The filler gives a volumetric effect that can fill out wrinkles. This literature study was conducted in collaboration with Galderma to determine if there is research that explores additives to HA hydrogels that give both volumetric and biological effects when applied as filler. Biological effects that improve the skin's appearance and complexion such as a rejuvenation of the skin was preferable. Both polynucleotides and mannitol show great potential to act as additives in injectable hyaluronan hydrogels.  The main effect of polynucleotides (PN) added in hydrogels is that it is collagen stimulating and provides a more natural tissue regeneration. Rheological properties of the filler change with the addition of PN, where elasticity, viscosity and viscoelasticity have been shown to increase. PNs show no toxicity and are considered safe to inject. The study of mannitol has shown that it does not give a volumetric effect after the injected hydrogel has been broken down. What mannitol can help with, is to prolong the life of the hydrogel and reduce the swelling that is a common side effect after an injection. In addition to this, mannitol is a safe substance to inject.