Advanced formulations of hyaluronic acid and its derivatives for antimicrobial, wound healing, tissue engineering, and anticancer applications

The application of natural and synthetic polymers for improving quality of life has been investigated for several decades. Polysaccharides, particularly hyaluronic acid as a non-sulphated glycosaminoglycan are being employed in the improvement of novel pharmaceutical and therapeutic applications, specifically drug delivery systems. This biopolymer has suitable biocompatibility and biodegradability for novel therapeutic formulations. The molecular weight of hyaluronic acid determines its biological activities as angiogenic, wound healing, and anti-angiogenic. By the bacteriostatic effect, this biopolymer can be employed in antibacterial formulations. In this review, a variety of micro and nanoformulations of hyaluronic acid with antimicrobial and anticancer agents have been discussed by considering their main clinical limitations including side effects of inadvertent arterial occlusion, tissue necrosis, and infections resulting from unsuitable injection hyaluronic acid gel.