Myeloma and hyaluronic acid

January 18 2010 post. In December, a blog reader, thanks!, sent me a warning about hyaluronic acid and multiple myeloma. She sent me the link to this 2001 study, whose full text is available online:

First of all, what is hyaluronic acid, or HA? Well, it is a major component of our connective tissue, with a lubricating and cushioning function, mainly (from what I read). It is found mostly in our skin (>extracellular matrix) and joints and cartilage (>synovial fluid). As we get older, our levels of HA decline…our skin becomes dehydrated, joints get creaky etc. Well, there is a ton of online information on HA, so I will stop here…

…except to note that HA is used as a surgical aid in eye surgery, such as cataract, detached retina and glaucoma surgery, and also in arthritis treatments—the treatment of osteoarthritis of the knee, in particular. I even found a study in which HA was used to treat plaque-induced gingivitis…

I was most interested, though, to read that it is a common ingredient in many skin care products. This rang a bell: I remembered seeing Italian TV ads promoting products that supposedely can give you the skin of Emma Watson (of “Harry Potter” fame) and lips like Angelina Jolie’s. And yes, these products contain, drum roll!, acido ialuronico. Since I have never been interested in stuff like that, I paid no attention. But this morning, doing a bit of research for this post, I came across scores of websites promoting hyaluronic acid injections and creams and supplements. Vitacost, e.g., sells 76 HA-containing products—moisturizing creams, hand&body lotions, “healthy joint” or “healthy skin” supplements…gee whiz…mind-boggling.

Okay, enough. Let’s have a quick look at the above-mentioned study. I was particularly interested in the first experiment described in the Results section: three different myeloma cell lines were “starved” of IL-6, which, as we know, is a crucial myeloma growth factor. Then, when the cells began dying left and right, IL-6 was added to the mix. The cells stopped dying, of course.

Then HA was added as well, and the myeloma cells began to thrive again, even in the absence of IL-6: The addition of HA significantly reduced the percentage of apoptotic cells on the three cell lines tested.

You don’t have to read the whole study, which is very technical and detailed. If you have a bit of time, though, do have a look at the Discussion part, which highlights how myeloma cells rely on the bone marrow microenvironment for their survival. The penultimate paragraph (“Further investigations are needed…” etc.) is of particular interest, since it provides an explanation (a partial one) as to why myeloma cells accumulate in the bone marrow. Interesting.

Another interesting excerpt: […] an abnormally low or high concentration of HA in the serum of patients with multiple myeloma is associated with a significantly shorter median survival than those with an intermediate HA concentration. Did you notice that it seems to be bad to have both ”low” and “high” levels of HA? Eh. [My next project: find out if and how our HA levels can be measured…]

In essence, according to the above-mentioned study, HA is a survival and proliferation factor for human myeloma cells.

Well, if that isn’t a good reason to be happy with, and proud of!, our wrinkles, I don’t know what is! Throw those creams and supplements straight into the rubbish bin or give them to someone who doesn’t have myeloma or any other type of cancer…

P.S. A couple of more recent studies. This 2008 study ( describes how HA is implicated in the resistance of myeloma cells to dexamethasone (not a good thing for myeloma patients taking Dex!). And this 2005 study provides more proof of HA involvement in drug resistance (in addition to myeloma cell survival):

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