Healing Response to Hyaluronic Acid Supplemented with Selected Amino Acids: A Pooled Analysis of Two Clinical Studies
Background/Objectives: Diabetes is associated with impaired wound healing, with consequences for tissue recovery across surgical procedures. In the oral context, hyaluronic acid-based adjunctive therapies have shown promise in improving early post-extraction healing in diabetes; however, clinical evidence remains limited. Different supplemented HA-based formulations yield heterogenous healing outcomes. Moreover, whether age or diabetes duration influences the effect of these adjunctive therapies remains to be established. Methods: We conducted an individual-participant-data pooled analysis of two randomized controlled trials that evaluated the use of hyaluronic acid supplemented with two different sets of selected amino acids; individual data from each trial was combined into a single dataset. Results: In this pooled analysis, modified healing index scores improved significantly over time. When each intervention was evaluated relative to its corresponding control, hyaluronic acid plus six pro-collagen synthesis amino acids produced a significantly greater improvement in healing response over time than the other HA-based formulation, after adjustment for age (Greenhouse–Geisser: time × treatment: F = 5.821, p < 0.001) and diabetes duration (Greenhouse–Geisser: time × treatment: F = 4.939, p < 0.001). Neither age nor diabetes duration significantly modified the healing trajectory (Greenhouse–Geisser: time × age: F = 2.536, p = 0.083; time × diabetes duration: F = 0.131, p = 0.878). No clear association with age or diabetes duration was observed. Conclusions: Supplementing hyaluronic acid with six selected amino acids associated with a significantly faster post-extraction tissue recovery in patients with diabetes. Moreover, treatment choice was relevant regardless of age or years since diabetes diagnosis.
Authors
- Renato Pol (ORCID: https://orcid.org/0000-0001-7446-9897)
- Paolo Giacomo Arduino (ORCID: https://orcid.org/0000-0002-8798-7834)
- Giorgio Reggiardo (ORCID: https://orcid.org/0000-0003-4237-6797)
- Vincenzo Nobile (ORCID: https://orcid.org/0000-0001-9147-302X)
- Marta Bezzi (ORCID: https://orcid.org/0000-0002-9256-0552)
- Davide Camisassa (ORCID: https://orcid.org/0000-0002-9253-9112)
- T. Ruggiero (ORCID: https://orcid.org/0000-0003-3948-0243)
- Francesco Erovigni (ORCID: https://orcid.org/0000-0001-9684-3499)
- Ettore Cogno
Institutions
- Politecnico di Torino (IT)
- Consorzio per Valutazioni Biologiche e Farmacologiche (IT)
- Indena (Italy) (IT)
- University of Turin (IT)
Publication Details
- Journal
- Journal of Functional Biomaterials
- Published
- 2026-07-24
- DOI
- https://doi.org/10.3390/jfb17080354
- Primary Topic
- Wound Healing and Treatments
- Type
- article
- Field-Weighted Citation Impact
- 0.00