Only purified, high molecular weight hyaluronan created from extra cellular microbial sources has been shown to be orally absorbed and distributed to the joints.9 Specifically only MHB3 hyaluronan has demonstrated symptom relief, chondro-protection, and disease modification in placebo controlled studies:36,37,38,39,40

In the review entitled "Will the Real Hyaluronan Please Stand Up?" published in the Journal of Applied Nutrition, Dr. Luke R. Bucci, Ph.D., CNS, CCN and Dr. Amy A. Turpin, M.Sc. stated the following:

"However, dietary supplements containing HA are not equivalent due to the inherent properties of the three major types of HA commercially available as dietary supplement materials. Consumers and health care professionals need to be aware of the different types of HA and their very large differences in properties (even before ingestion). One source, hydrolyzed chicken sternal cartilage, is clearly unlike native HA, does not match the biological properties of native HA, and consequently should not be represented as HA to consumers on product labels. Rooster comb HA is significantly smaller than native HA (about 10-20% the size of native HA), and is tightly bound to connective tissue proteins. This type of HA does not match the literature on properties and benefits of native HA because of its smaller size and tight binding to proteins. Finally, high molecular weight, purified HA is available from vegetarian-compatible and animal sources, virtually identical to native HA and pharmaceutical preparations of HA. This material is analogous to the HA used to generate the extensive body of knowledge on HA, both its roles and its therapeutic effects in OA. HA from the microbial fermentation method of preparation has published evidence for uptake into joints after oral administration. From all considerations, purified, high molecular weight HA from microbial fermentation in dietary supplement products has the highest likelihood for matching the known attributes of HA. The real HA - purified, high molecular weight - can stand up now." 42

From the study entitled "Evaluation of MHB3 hyaluronan's Effects on Molecular Weight of Circulating Hyaluronan":

"MHB3 hyaluronan administered 5 days/week by oral gavage increased the size distribution of hyaluronan in the plasma. Specifically, the proportion of hyaluronan that is high molecular weight - anti-inflammatory - is increased, and the proportion of hyaluronan that is low molecular weight - pro-inflammatory - is decreased. The fundamental mechanism underlying these findings remains to be elucidated, but the findings are consistent with earlier studies showing similar benefits with injected hyaluronan. This is the first controlled study of an oral biomacromolecule demonstrating an increase in circulating high molecular weight hyaluronan." 38

From the study entitled "Evaluation of MHB3TM among Patients with Chronic Joint Symptoms":

"The daily supplementation of hyaluronan with MHB3 relieves joint pain and inflammation contributing to an improved range of motion and an increase in daily activity among the majority of subjects with Chronic Joint Symptoms." 36

From the study entitled "Evaluation of a Modified Hyaluronan Biopolymer (MHB3TM) on Cartilage Loss and Osteophyte Formation in a Knee Instability Model":

"This is the first time, to our knowledge, that an orally administered, exogenous hyaluronan biopolymer (MHB3) has been shown to have cartilage and bone protecting benefits including osteophyte prevention." 37

From the study entitled "Evaluation of MHB3TM on the Development of Osteopenia":

"MHB3 administered 5 days/week by oral gavage significantly reduces the development of osteopenia associated with estrogen depletion, as detected by levels f N-terminal collagen peptides in serum." 39

From the study entitled "Effects of a Modified Hyaluronan Biopolymer (MHB3TM) on Cartilage Loss in a Monoarthritis Model":

"The results of this study strongly support the disease modifying and chondroprotective benefits of the oral hyaluronan biopolymer MHB3 when used in an established model of osteoarthritis. This is the first time that an orally administered, exogenous hyaluronan biopolymer has been shown to have such benefits." 40

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