Research.
Every peer-reviewed study on fascia in one place — graded for strength of evidence, summarised in plain language for clinicians, researchers, and curious patients.
We grade studies from A to 1A+++ using the Fascia Research Database rubric — 1A+++ is the strongest.
- A++2023
Functional organization of extracellular hyaluronan, CD44 and RHAMM
Mary K Cowman, Eva A TurleyIn this comprehensive review, the authors explore how hyaluronan (HA) and its receptors, CD44 and RHAMM, organize the space immediately surrounding cells. In healthy tissue, these components maintain a stable environmen…
hyaluronanCD44extracellular matrixRHAMMpericellular matrix - A+++2022
Hyaluronan homeostasis and its role in pain and muscle stiffness
Adam Amir, Soo Kim, Antonio Stecco, Michael P Jankowski, Preeti RaghavanThis narrative review explores the role of hyaluronan (HA) in the musculoskeletal system. HA is a key component of the extracellular matrix in muscles and fascia, where it normally functions as a lubricant and shock abs…
hyaluronanpainmuscle stiffness - A2020
A Hyaluronan-binding Peptide (P15-1) Reduces inflammatory and catabolic events in IL-1beta-treated human articular chondrocytes
Claire Shortt, Leonard G Luyt, Eva A Turley, Mary K Cowman, Thorsten KirschInflammation in osteoarthritis drives cartilage degradation. In this laboratory study, researchers investigated whether a peptide (P15-1) combined with hyaluronan (HA) could protect human cartilage cells in a simulated…
hyaluronaninflammationchondrocytesP15-1IL-1beta - A++2019
Hyaluronic Acid: Molecular Mechanisms and Therapeutic Trajectory
Ramesh C Gupta, Rajiv Lall, Ajay Srivastava, Anita SinhaThis narrative review explores hyaluronic acid (HA), a naturally occurring substance found in connective tissues and synovial fluid. HA is essential for joint lubrication and viscoelasticity, but its concentration and m…
hyaluronanwound healingHyaluronic acidosteoarthritiscancer therapy - A2019
Quantifying muscle glycosaminoglycan levels in patients with post-stroke muscle stiffness using T1p MRI
Rajiv G Menon, Preeti Raghavan, Ravinder R RegatteThis study is the first to quantify the amount of hyaluronan, a key component for gliding movements within fascia. Researchers measured hyaluronan in tissue samples from various human anatomical sites and found that the…
hyaluronanStrokestiffnesshyaluronidase - 1A++2019
Evaluation of hyaluronan content in areas of densification compared to adjacent areas of fascia
E J Hughes, K McDermott, M F FunkThis entry is currently a title only, so a full summary is not available. Based on the title, the researchers appear to have evaluated and compared the hyaluronan content in areas of fascial densification with the conte…
hyaluronanfasciadensificationcenters of coordination - B2019
TMEM2: a missing link in hyaluronan catabolism identified?
Yu Yamaguchi, Hayato Yamamoto, Yuki Tobisawa, Fumitoshi IrieHyaluronan (HA) is a large molecule in our connective tissues that is broken down and replaced very quickly. Scientists have long understood that large HA molecules are first chopped into smaller pieces on the surface o…
hyaluronanhyaluronidaseTMEM2HA catabolism - 1A+2018
The Fasciacytes- A New Cell Devoted To Fascial Gliding Regulation
Carla Stecco, Caterina Fede, Veronica Macchi, Andrea Porzionato, Lucia Petrelli, Carlo Biz, Robert Stern, Raffaele De C…Researchers have identified a new type of cell within fascia, which they have named "fasciacytes." This study presents evidence that these specialized cells are responsible for producing hyaluronan, a key component of t…
hyaluronanfasciafasciacytesextracellular matrix - A2018
Elevated expression of hyaluronan synthase 2 associates with decreased survival in diffusely infiltrating astrocytomas
Mari Valkonen, Hannu Haapasalo, Kirsi Rilla, Kristiina Tyynelä-Korhonen, Ylermi Soini , Sanna Pasonen-SeppänenAstrocytomas are the most common type of brain tumor in adults. In this retrospective study, researchers investigated hyaluronan, a key component of the brain's extracellular matrix, and its related enzymes in 163 tumor…
hyaluronanHyaluronan synthaseAstrocytomaPrognosisGlioma - A+2017
Hyaluronan as a therapeutic target in human diseases
Jiurong Liang, Dianhua Jiang, Paul W NobleThis narrative review explores the role of hyaluronan, a major component of the extracellular matrix involved in tissue injury and repair. Its function varies significantly with its size; fragmented hyaluronan can promo…
hyaluronan - A+++2016
Fascial Manipulation® for chronic aspecific low back pain: a single blinded randomized controlledtrial.
Mirco Branchini, Francesca Lopopolo, Ernesto Andreoli, Ivano Loreti, Aurélie M Marchand, Antonio SteccoThis randomized controlled trial compared Fascial Manipulation® combined with standard physiotherapy to physiotherapy alone for patients with chronic non-specific low back pain. The group receiving Fascial Manipulation®…
hyaluronanBack PainFascial manipulation - A2016
Hyaluronan concentration and size distribution in human knee synovial fluid: variations with age and cartilage degeneration
Michele M Temple-Wong, Shuwen Ren, Phu Quach, Bradley C Hansen, Albert C Chen, Akihiko Hasegawa, Darryl D D’Lima, Jim K…This study investigated how the lubricant hyaluronan in knee joint fluid changes with age and cartilage wear. Researchers analyzed synovial fluid from human donors aged 23 to 91 without diagnosed osteoarthritis. They fo…
hyaluronanAgingSynovial fluidDegeneration - B2015
Platelet hyaluronidase-2: an enzyme that translocates to the surface upon activation to function in extracellular matrix degradation
Sami Albeiroti, Katayoun Ayasoufi, [...], Carol A de la MottePlatelets play a key role in responding to tissue injury. This study explores how they interact with hyaluronan, a major component of the extracellular matrix that is involved in inflammation. Researchers demonstrated t…
hyaluronanextracellular matrixDegradationhyaluronidas-2HYAL2 - A2015
Hyaluronan’s Role in Fibrosis: A Pathogenic Factor or a Passive Player?
S Albeiroti, A Soroosh, C A de la MotteThis 2015 review article explores the role of hyaluronan (HA) in fibrosis, a condition where excessive connective tissue buildup impairs organ function. HA is a key component of the extracellular matrix, known for its h…
hyaluronanfasciafibrosis - B2015
Hyaluronan Controls the Deposition of Fibronectin and Collagen and Modulates TGF-β1 Induction of Lung Myofibroblasts
Stephen P Evanko, Susan Potter-Perigo, Loreen J Petty, Gail A Workman, Thomas N WightThis study investigated how hyaluronan (HA), a key component of the extracellular matrix, influences the formation of myofibroblasts—cells involved in tissue scarring and fibrosis. Researchers observed that while HA lev…
hyaluronanMyofibroblastTGF-β14-methyl umbelliferonefibronectin; collagen - A2015
Hyaluronan, inflammation and breast cancer progression
Katryn L Schwertfeger, Mary K Cowman, Patrick G Telmer, Eva A Turley, James B McCarthyThis narrative review explores the link between inflammation, the tissue component hyaluronan (HA), and breast cancer progression. Cancer cells and surrounding host cells can create an inflamed microenvironment that hel…
hyaluronaninflammationCD44fasciaBreast cancer - B2015
Hyaluronan Regulates Bone Morphogenetic Protein-7- dependent Prevention and Reversal of Myofibroblast Phenotype
Adam C Midgley, Lucy Duggal, Robert Jenkins, Vincent Hascall, Robert Steadman, Aled O Phillips, Soma MeranThis study on human lung fibroblasts investigated how a protein called BMP7 might counteract fibrosis. Researchers found that BMP7 can prevent and even reverse the formation of myofibroblasts, which are cells that contr…
hyaluronanMyofibroblastTGF-beta1 - C2015
Hyaluronic acid and wound healing
M G Neuman, R M Nanau, L Oruna-Sanchez, G CotoIn this systematic review, researchers compiled studies on hyaluronic acid (HA) and wound healing published from 2010–2014. The review found that HA is used for tissue regeneration, either alone or in combination with o…
hyaluronanwound healing - A++2015
Size Matters: Molecular Weight Specificity of Hyaluronan Effects in Cell Biology
Jaime M Cyphert, Carol S Trempus, Stavros GarantziotisThis narrative review summarizes current knowledge about hyaluronan, a molecule whose biological effects are dependent on its size. Unlike many other molecules, hyaluronan's signaling properties are determined not by ch…
hyaluronanCell signalingmolecular size - A2015
The content and size of hyaluronan in biological fluids and tissues
Mary K Cowman, Hong-Gee Lee, Kathryn L Schwertfeger, James B McCarthy,, Eva A TurleyHyaluronan is a simple sugar polymer found throughout the body's tissues and fluids. It is typically produced as a very large, high-molecular-mass molecule. This narrative review notes that during processes like inflamm…
hyaluronanfasciaquantificationassaymolecular mass - A++2014
Ingested hyaluronan moisturizes dry skin
Chinatsu Kawada, Takushi Yoshida, Hideto Yoshida, Ryosuke Matsuoka, Wakako Sakamoto, Wataru Odanaka, Toshihide Sato, Ta…This review article summarizes research on how oral hyaluronan (HA) supplements may influence skin hydration levels. Studies suggest that a daily intake of 120–240 mg of hyaluronic acid can contribute to increased moist…
hyaluronanhaHyaluronic acidSkinsupplementation - 1A+2014
Painful Connections: Densification Versus Fibrosis of Fascia
P G Pavan, Antonio Stecco, R Stern, Carla SteccoIn this review article, the authors describe two types of fascial changes that can cause pain: densification and fibrosis. Densification is described as a reversible alteration in the viscosity of the loose connective t…
hyaluronanfasciafibrosisdensificationConnective tissue - A2013
Hyaluronan: A Simple Polysaccharide with Diverse Biological Functions
Kevin T Dicker, Lisa A Gurski, Swati Pradhan-Bhatt, Robert L Witt, Mary C Farach-Carson, Xinqiao JiaThis review paper describes hyaluronan (HA), a simple sugar molecule found abundantly throughout the body's connective tissues. Despite its simple structure, HA has a surprising array of biological functions. It helps o…
hyaluronanfasciawound healingsynthasehyaluronidase - A2013
Plantar fascia anatomy and its relationship with Achilles tendon and paratenon
Carla Stecco, Marco Corradin, Veronica Macchi, Aldo Morra, Andrea Porzionato, Carlo Biz, Raffaele De CaroThis study investigated the detailed anatomy of the plantar fascia and its connection to the Achilles tendon. Dissections of human cadavers revealed that the fascia is more closely linked to the paratenon (the tendon's…
hyaluronanfasciaFasciacyteachilles tendonparatenon - A++2013
Mathematical Analysis of the Flow of Hyaluronic Acid Around Fascia During Manual Therapy Motions
Max Roman, Hans Chaudhry, Bruce Bukiet, Antonio Stecco,Thomas FindleyThis study used a mathematical model to simulate how different manual therapy techniques affect the flow of hyaluronic acid (HA) within fascia. The researchers compared constant sliding, perpendicular vibration, and tan…
hyaluronanfasciaManual Therapyfluid flowvibration - B2012
Hyaluronan differently modulates TLR-4 and the inflammatory response in mouse chondrocytes
Giuseppe M Campo, Angela Avenoso, Angela D’Ascola, Vera Prestipino, Michele Scuruchi, Giancarlo Nastasi, Alberto Calatr…This study on mouse cartilage cells investigated how different sizes of hyaluronan (HA) affect inflammation. Researchers found that small HA fragments increased the production of several inflammatory markers. In contras…
hyaluronancytokinesNF-kBtoll-like receptor-4chondrocytes - B2012
Hyaluronan injection in murine osteoarthritis prevents TGFbeta 1-induced synovial neovascularization and fibrosis and maintains articular cartilage integrity by a CD44-dependent mechanism
Jun Li, Daniel J Gorski, Wendy Anemaet, Jennifer Velasco, Jun Takeuchi, John D Sandy, Anna PlaasIn this mouse study, researchers investigated how hyaluronan (HA) injections might protect joints in osteoarthritis. They found that even though the injected HA was cleared from the knee joint in under two hours, a sing…
hyaluronanCD44fibrosisTGF-beta1osteoarthritis - A2012
A RHAMM Mimetic Peptide Blocks Hyaluronan Signaling and Reduces Inflammation and Fibrogenesis in Excisional Skin Wounds
Cornelia Tolg, Sara R Hamilton, Ewa Zalinska, Lori McCulloch, Ripal Amin, Natalia Akentieva, Francoise Winnik, Rashmin…In this animal study, researchers investigated how to reduce scarring during skin wound healing. They developed a peptide, P15-1, designed to interfere with signals from fragmented hyaluronan, a molecule involved in inf…
hyaluronaninflammationfasciaextracellular matrixfibrosis - B2011
The effect of molecular weight on hyaluronan’s cartilage boundary lubricating ability e alone and in combination with proteoglycan 4
J J Kwiecinski, S G Dorosz, T E Ludwig, S Abubacker, Mary K Cowman, T A SchmidtThis study investigated the lubricating ability of hyaluronan (HA) in articular cartilage, focusing on how its molecular weight affects function. Researchers found that higher molecular weight hyaluronan was more effect…
hyaluronanCartilage boundary lubricationProteoglycan 4 (PRG4) - A2011
Hyaluronan as an Immune Regulator in Human Diseases
Paul W Noble, Jiurong Liang, Dianhua JiangThis 2011 narrative review explores the role of hyaluronan (HA) in the immune system. While intact HA is a normal part of the extracellular matrix, fragments of HA produced during tissue injury can act as signals. These…
hyaluronanfascia - B2011
Severe lung fibrosis requires an invasive fibroblast phenotype regulated by hyaluronan and CD44
Yuejuan Li, Dianhua Jiang, Jiurong Liang, Eric B Meltzer, Alice Gray, Riu Miura, Lise Wogensen, Yu Yamaguchi, Paul W No…This study investigated the mechanisms behind severe lung fibrosis, a condition where excessive connective tissue builds up in the lungs. Using a mouse model, researchers found that fibroblasts, a type of connective tis…
hyaluronanCD44fibrosis - A2011
High and Low Molecular Weight Hyaluronic Acid Differentially Regulate Human Fibrocyte Differentiation
A S Maharjan, D Pilling, R H GomerFollowing tissue injury, immune cells called monocytes can differentiate into fibrocytes, a cell type involved in healing and fibrosis. This study investigated how different sizes of hyaluronic acid (HA) affect this pro…
hyaluronanfasciafibrocyte differentiationmonocyte - B2011
Fascia redefined: anatomical features and technical relevance in fascial flap surgery
Carla Stecco, Cesare Tiengo, Antonio Stecco, Andrea Porzionato, Veronica Macchi, Robert Stern, Raffaele De CaroFascia has traditionally been seen as a passive wrapping, but this review redefines it as a dynamic tissue with its own complex blood supply and innervation. The authors detail the specific characteristics of different…
hyaluronanfasciaConnective tissueaponeurosisFlaps - A2011
Hyaluronan: From Extracellular Glue to Pericellular Cue
B P TooleHyaluronan is traditionally seen as a biological 'goo' that lubricates joints and holds connective tissues together. This review describes how hyaluronan also functions as an important signaling molecule, or cue, in the…
hyaluronanfasciasignal transductioncancer