The objective of this study was to evaluate and compare the biocompatibility profiles of
hyaluronic acid (HA)
viscosupplements from avian and non-mammalian sources. Inflammatory and immune reactions were assessed in models of both clinically relevant and stringent immunological exposure conditions. Experiments were conducted to evaluate tissue reactions and immunological responses and assess antibody formation with the capacity to bind directly to and cross-react with the different
viscosupplements. Mice were exposed to
viscosupplements using the air pouch
inflammation model and specific immunization using Freund's complete adjuvant (FCA). Murine pouch membrane tissue reactions revealed generally mild to moderate responses, with cellular infiltration and
cytokine profiles of pouch tissue characteristic of predominantly fibroblastic responses rather than marked inflammatory reactions. In vitro testing indicated that pouch
injections did not elicit detectable T-cell proliferative responses, while antibody assays revealed that mice immunized with
viscosupplements in FCA and subsequently boosted were capable of mounting an antibody response with a range of specificities. High reactivity to avian
serum albumin was seen in sera from mice injected with HA from an avian source, while low positive reactivity to the
bacterial antigen Staphylococcal Lipotechoic
Acid was observed in sera from mice injected with HA from bacterial sources. These specificities did not indicate any propensity to cross-react, suggesting that patients with adverse immune responses to HA from an avian source should be unresponsive to subsequent injection with HA from a non-avian source. Overall, the findings demonstrate that
viscosupplements exhibit good biocompatibility profiles in the murine air pouch, but when provoked to elicit immunological reactions exhibit unique antigenic spectra. These findings suggest that an immunologically mediated immune reaction directed against
avian proteins should not necessarily be a
contraindication for the administration of non-avian
viscosupplements.