Classifications

• • C—CHEMISTRY; METALLURGY
  • C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
  • C08B—POLYSACCHARIDES; DERIVATIVES THEREOF
  • C08B37/00—Preparation of polysaccharides not provided for in groups C08B1/00 - C08B35/00; Derivatives thereof
  • C08B37/006—Heteroglycans, i.e. polysaccharides having more than one sugar residue in the main chain in either alternating or less regular sequence; Gellans; Succinoglycans; Arabinogalactans; Tragacanth or gum tragacanth or traganth from Astragalus; Gum Karaya from Sterculia urens; Gum Ghatti from Anogeissus latifolia; Derivatives thereof
  • C08B37/0063—Glycosaminoglycans or mucopolysaccharides, e.g. keratan sulfate; Derivatives thereof, e.g. fucoidan
  • C08B37/0072—Hyaluronic acid, i.e. HA or hyaluronan; Derivatives thereof, e.g. crosslinked hyaluronic acid (hylan) or hyaluronates
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
  • A61K31/715—Polysaccharides, i.e. having more than five saccharide radicals attached to each other by glycosidic linkages; Derivatives thereof, e.g. ethers, esters
  • A61K31/726—Glycosaminoglycans, i.e. mucopolysaccharides
  • A61K31/728—Hyaluronic acid
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
  • A61K31/715—Polysaccharides, i.e. having more than five saccharide radicals attached to each other by glycosidic linkages; Derivatives thereof, e.g. ethers, esters
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
  • A61K31/715—Polysaccharides, i.e. having more than five saccharide radicals attached to each other by glycosidic linkages; Derivatives thereof, e.g. ethers, esters
  • A61K31/737—Sulfated polysaccharides, e.g. chondroitin sulfate, dermatan sulfate
• • C—CHEMISTRY; METALLURGY
  • C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
  • C08B—POLYSACCHARIDES; DERIVATIVES THEREOF
  • C08B37/00—Preparation of polysaccharides not provided for in groups C08B1/00 - C08B35/00; Derivatives thereof
  • C08B37/0006—Homoglycans, i.e. polysaccharides having a main chain consisting of one single sugar, e.g. colominic acid
  • C08B37/0009—Homoglycans, i.e. polysaccharides having a main chain consisting of one single sugar, e.g. colominic acid alpha-D-Glucans, e.g. polydextrose, alternan, glycogen; (alpha-1,4)(alpha-1,6)-D-Glucans; (alpha-1,3)(alpha-1,4)-D-Glucans, e.g. isolichenan or nigeran; (alpha-1,4)-D-Glucans; (alpha-1,3)-D-Glucans, e.g. pseudonigeran; Derivatives thereof
• • C—CHEMISTRY; METALLURGY
  • C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
  • C08B—POLYSACCHARIDES; DERIVATIVES THEREOF
  • C08B37/00—Preparation of polysaccharides not provided for in groups C08B1/00 - C08B35/00; Derivatives thereof
  • C08B37/0006—Homoglycans, i.e. polysaccharides having a main chain consisting of one single sugar, e.g. colominic acid
  • C08B37/0009—Homoglycans, i.e. polysaccharides having a main chain consisting of one single sugar, e.g. colominic acid alpha-D-Glucans, e.g. polydextrose, alternan, glycogen; (alpha-1,4)(alpha-1,6)-D-Glucans; (alpha-1,3)(alpha-1,4)-D-Glucans, e.g. isolichenan or nigeran; (alpha-1,4)-D-Glucans; (alpha-1,3)-D-Glucans, e.g. pseudonigeran; Derivatives thereof
  • C08B37/0012—Cyclodextrin [CD], e.g. cycle with 6 units (alpha), with 7 units (beta) and with 8 units (gamma), large-ring cyclodextrin or cycloamylose with 9 units or more; Derivatives thereof
• • C—CHEMISTRY; METALLURGY
  • C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
  • C08B—POLYSACCHARIDES; DERIVATIVES THEREOF
  • C08B37/00—Preparation of polysaccharides not provided for in groups C08B1/00 - C08B35/00; Derivatives thereof
  • C08B37/0006—Homoglycans, i.e. polysaccharides having a main chain consisting of one single sugar, e.g. colominic acid
  • C08B37/0009—Homoglycans, i.e. polysaccharides having a main chain consisting of one single sugar, e.g. colominic acid alpha-D-Glucans, e.g. polydextrose, alternan, glycogen; (alpha-1,4)(alpha-1,6)-D-Glucans; (alpha-1,3)(alpha-1,4)-D-Glucans, e.g. isolichenan or nigeran; (alpha-1,4)-D-Glucans; (alpha-1,3)-D-Glucans, e.g. pseudonigeran; Derivatives thereof
  • C08B37/0021—Dextran, i.e. (alpha-1,4)-D-glucan; Derivatives thereof, e.g. Sephadex, i.e. crosslinked dextran
• • C—CHEMISTRY; METALLURGY
  • C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
  • C08B—POLYSACCHARIDES; DERIVATIVES THEREOF
  • C08B37/00—Preparation of polysaccharides not provided for in groups C08B1/00 - C08B35/00; Derivatives thereof
  • C08B37/006—Heteroglycans, i.e. polysaccharides having more than one sugar residue in the main chain in either alternating or less regular sequence; Gellans; Succinoglycans; Arabinogalactans; Tragacanth or gum tragacanth or traganth from Astragalus; Gum Karaya from Sterculia urens; Gum Ghatti from Anogeissus latifolia; Derivatives thereof
  • C08B37/0063—Glycosaminoglycans or mucopolysaccharides, e.g. keratan sulfate; Derivatives thereof, e.g. fucoidan
  • C08B37/0069—Chondroitin-4-sulfate, i.e. chondroitin sulfate A; Dermatan sulfate, i.e. chondroitin sulfate B or beta-heparin; Chondroitin-6-sulfate, i.e. chondroitin sulfate C; Derivatives thereof
• • C—CHEMISTRY; METALLURGY
  • C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
  • C08L—COMPOSITIONS OF MACROMOLECULAR COMPOUNDS
  • C08L3/00—Compositions of starch, amylose or amylopectin or of their derivatives or degradation products
  • C08L3/02—Starch; Degradation products thereof, e.g. dextrin
• • C—CHEMISTRY; METALLURGY
  • C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
  • C08L—COMPOSITIONS OF MACROMOLECULAR COMPOUNDS
  • C08L5/00—Compositions of polysaccharides or of their derivatives not provided for in groups C08L1/00 or C08L3/00
  • C08L5/02—Dextran; Derivatives thereof
• • C—CHEMISTRY; METALLURGY
  • C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
  • C08L—COMPOSITIONS OF MACROMOLECULAR COMPOUNDS
  • C08L5/00—Compositions of polysaccharides or of their derivatives not provided for in groups C08L1/00 or C08L3/00
  • C08L5/08—Chitin; Chondroitin sulfate; Hyaluronic acid; Derivatives thereof
• • C—CHEMISTRY; METALLURGY
  • C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
  • C08L—COMPOSITIONS OF MACROMOLECULAR COMPOUNDS
  • C08L5/00—Compositions of polysaccharides or of their derivatives not provided for in groups C08L1/00 or C08L3/00
  • C08L5/16—Cyclodextrin; Derivatives thereof

Definitions

• the present invention relates to the field of products based on hyaluronic acid.
• Hyaluronic acid is a negatively charged straight-chain polysaccharide, made up of a repetition of n disaccharide units (-4GlcUA ⁇ 1-3GlcNAc ⁇ 1-), in which D-glucuronic acid (GlcUA) and N-acetyl-D-glucosamine (GlcNAc) are joined with alternating ⁇ -1,3 and ⁇ -1,4 glycosidic bonds.
• HA is a highly water-soluble polysaccharide and solutions of HA display a non-Newtonian type of viscoelastic behaviour. These properties depend on the molecular weight (and therefore, as HA is a linear polymer, on the length of the chain), the concentration, the pH and the ionic strength.
• HA Owing to its biological properties and functions, HA has high added value (its commercial value greatly exceeds that of the other natural polysaccharides), with applications that range from the medical sector to cosmeceuticals and nutraceuticals. Its viscoelastic properties, coupled with the complete absence of toxicity or immunogenicity (the structure of HA is always the same in all living organisms in which it is present), have led to varied and extensive applications.
• the performance depends on the molecular weight of the HA.
• the average molecular weight of HA and the polydispersity index Mw/Mn (which measures the width of the curve of molecular weight distribution, where Mn is the number-average molecular weight, defined as the total weight of all the polymer molecules in a sample divided by the total number of molecules, and Mw is the weight-average molecular weight, which takes into account the varying mass of the molecules present) must be the gold standards to be considered when developing production processes for HA and strategies for application.
• L-HA low molecular weight HA
• H-HA high molecular weight HA
• the present invention describes cooperative hybrid complexes between L-HA and H-HA, designated with the acronym L/H-HA, their characteristics, the production process thereof and use thereof in the area of medicine, cosmetics and foodstuffs.
• Weak forces such as hydrogen bonds or hydrophobic interactions, can give rise to very stable interactions between molecules, if these are of the cooperative type.
• Cooperativeness develops when it is possible for multiple bonds to form between the molecules, and being weak, they break randomly thereafter, but can immediately reform owing to the existence of intact vicinal bonds, which maintain the structural components of the bond at a distance useful for its reformation.
• the molecules of HA in solution are characterized by cooperative phenomena of interaction based on formation of hydrophobic bonds and interchain hydrogen bonds, and the cooperativeness of these interactions depends on the length and therefore on the molecular weight of the chains.
• the long chains of H-HA give stable interactions between them, which involve all the molecules present in solution, giving rise to a three-dimensional network, whereas molecules of L-HA give interactions that are less stable, leading to systems of aggregation that do not simultaneously involve all the molecules present, which instead interact in clusters.
• This differing mode of aggregation of H-HA and L-HA in solution is responsible for the large differences in rheological behaviour, such as for example the viscosity of solutions of HA, which is a very important property for numerous applications, especially in the medical field.
• solutions of stable L/H-HA cooperative hybrids according to the invention are characterized by viscosities that do not change over time and that are notably lower than before the thermal cycle.
• the molecular weight of HA used in constructing L/H-HA hybrid systems critically determines their rheological characteristics; the greater the difference in molecular weight between the L-HA and H-HA used, the greater, at equal concentration, is the decrease in viscosity of the hybrid system relative to that of the H-HA.
• Cooperative hybrid L/H-HA complexes characterized by a decrease in viscosity, can be obtained if the molecular weight of the L-HA is between 1 ⁇ 10 4 and 1 ⁇ 10 6 Da and that of the H-HA is given by the formula MW H-HA ⁇ MW L-HA /0.9.
• the complexes according to the invention normally have a viscosity from 1.1 to 200-fold less than that of a solution containing the H-HA hyaluronic acid alone used for forming the complex
• the thermal profile that leads to the formation of cooperative hybrid L/H-HA systems starting from solutions containing L-HA and H-HA envisages that the solution is first heated to temperatures between 80 and 160° C., preferably between 100 and 120° C. and then cooled rapidly to room temperature.
• the L/H-HA hybrid systems thus obtained are stable over time, attesting to maintenance of their rheological characteristics.
• the solutions of L/H-HA hybrid complexes according to the present invention can easily be obtained by mixing aqueous solutions of H-HA and L-HA of desired molecular weight and submitting the resultant solution to the thermal cycle indicated above; preferably the concentration of the solution of L-HA is between 0.01 and 50% w/w while that of the solution of H-HA is between 0.01 and 10% w/w.
• Cooperative hybrid L/H-HA complexes in the solid state can be obtained from solutions containing them in various ways:
• Cooperative hybrid complexes similar to those described above, characterized by low values of dynamic viscosity, can moreover be obtained by high-temperature thermal treatment of aqueous solutions of H-HA with low molecular weight polysaccharides, such as chondroitin, chondroitin sulphate, dextrins, cyclodextrins, dextrans.
• low molecular weight polysaccharides such as chondroitin, chondroitin sulphate, dextrins, cyclodextrins, dextrans.
• the cooperative hybrid L/H-HA complexes are, because of their rheological characteristics, of considerable interest in some biomedical applications, for example: biorevitalization of the skin by intradermal injections of HA; techniques of viscosupplementation for resolving pathological situations connected with inflammatory disorders of the joints; intra-bladder treatment of cystitis; treatment of vaginal inflammatory diseases; treatment of alveolar diseases; treatment of oral diseases.
• the cooperative hybrid L/H-HA complexes behave as systems for slow release of L-HA and H-HA, because the chemical complexity of the microenvironment, characterized by the presence of other species in solution and the enormous surfaces of the cellular structures, permit gradual resolution of the intermolecular interactions that characterize the complex, making both L-HA and H-HA available in context ab initio, molecular species that in vivo have differentiated roles, L-HA that of signalling by interaction with receptors present on the cell surfaces and H-HA as a fundamental constituent of the extracellular matrix.
• Non-limiting examples are given below, describing the production, characteristics and use of the cooperative hybrid L/H-HA complexes.
• H-HA MW 1.4 ⁇ 10 6 Da; Mw/Mn 1.5
• L-HA MW 3.3 ⁇ 10 4 Da; Mw/Mn 1.8
• MW and polydispersity index Mw/Mn are determined using a size-exclusion chromatography system equipped with a multidetector, consisting of a four-bridge viscosimeter, a refractometer, a right angle light scattering detector (RALS) and a low angle light scattering detector (LALS), patented by the American group Viscotek (www.viscotek.com).
• the signal measured with the LALS is proportional to the molecular weight and the concentration, that measured with the viscosimetric detector is proportional to the sample concentration and the intrinsic viscosity, while the refractometer provides measurement of the concentration.
• Table 1 Measurement of the dynamic viscosity of solutions with a concentration of 1% w/v of L-HA (MW 3.3 ⁇ 10 4 Da; Mw/Mn 1.8) and H-HA (MW 1.4 ⁇ 10 6 Da; Mw/Mn 1.5) and of the corresponding stable cooperative L/H-HA complexes with a concentration of 1% w/v and L-HA/H-HA ratio of 1:1 w/w.
• the thermal treatment cycle in autoclave envisages a heating phase in 10 min from 25° C. to T max , remaining at T max for a specified time and a cooling phase from T max to 25° C. in 10 min.
• the measurements of ⁇ are taken immediately after the thermal treatment.
• Cooperative hybrid L/H-HA complexes of different composition are prepared by dissolving H-HA (MW 1.4 ⁇ 10 6 Da; Mw/Mn 1.5) and L-HA (MW 3.3 ⁇ 10 4 Da; Mw/Mn 1.8) in 100 mL of water, as shown in Table 2.
• the resultant solutions are submitted to the following thermal cycle in autoclave: from 25° C. to 120° C. in 10 min, for 10 min at 120° C., from 120° C. to 25° C. in 10 min.
• the dynamic viscosity of the samples, the MW and the polydispersity index Mw/Mn of L-HA, H-HA and L/H-HA are determined as described in example 1.
• the data in Table 2 demonstrate the dependence of the viscosity of L/H-HA cooperative complexes on the L-HA/H-HA ratio: the higher the ratio, the lower the viscosity.
• Table 2 Measurement of the dynamic viscosity ⁇ of cooperative hybrid L/H-HA complexes with different L-HA/H-HA ratio.
• concentration of H-HA MW 1.4 ⁇ 10 6 Da; Mw/Mn 1.5
• L-HA MW 3.3 ⁇ 10 4 Da; Mw/Mn 1.8
• the thermal treatment cycle in autoclave envisages a heating phase of 10 min from 25° C. to T max , remaining at T max for a specified time and a cooling phase from T max to 25° C. in 10 min.
• the measurements of ⁇ are taken immediately after the thermal treatment.
• Aqueous solutions of H-HA (MW 1.4 ⁇ 10 6 Da; Mw/Mn 1.5), L-HA (MW 3.3 ⁇ 10 4 Da; Mw/Mn 1.8) and L-HA (MW 2.2 ⁇ 10 5 Da; Mw/Mn 1.7) are prepared at 2% w/v in distilled water, which are used for preparing the various solutions given in Table 3.
• the resultant solutions are submitted to the following thermal cycle in autoclave: from 25 to 120° C. in 10 min, for 10 min at 120° C., from 120 to 25° C. in 10 min.
• the dynamic viscosity ⁇ of the samples, the MW and the polydispersity index Mw/Mn of L-HA, H-HA and L/H-HA are determined as described in example 1.
• Table 3 Measurement of the dynamic viscosity ⁇ of cooperative hybrid L/H-HA complexes with L-HA/H-HA ratio of 1 w/w, constructed with L-HA of different MW.
• Aqueous solutions of H-HA (MW 1.4 ⁇ 10 6 Da; Mw/Mn 1.5), L-HA (MW 3.3 ⁇ 10 4 Da; Mw/Mn 1.8) and L-HA (MW 2.2 ⁇ 10 5 Da; Mw/Mn 1.7) are prepared at 2% w/v in distilled water, which are used for preparing the various solutions given in the table.
• the resultant solutions are submitted to the following thermal cycle in autoclave: from 25 to 120° C. in 10 min, for 10 min at 120° C., from 120 to 25° C. in 10 min.
• Aqueous solutions of H-HA (MW 1.4 ⁇ 10 6 Da; Mw/Mn 1.5), L-HA (MW 3.3 ⁇ 10 4 Da; Mw/Mn 1.8) and L-HA (MW 2.2 ⁇ 10 5 Da; Mw/Mn 1.7) are prepared at 2% w/v in distilled water, which are used for preparing the various solutions given in Table 4.
• Half of the resultant solutions are maintained at temperature and the other half are first submitted to the following thermal cycle in autoclave: from 25 to 120° C. in 10 min, for 10 min at 120° C., from 120 to 25° C. in 10 min and are then maintained at room temperature.
• the dynamic viscosity ⁇ is measured over time, for both series of samples.
• the MW, the polydispersity index Mw/Mn of L-HA, H-HA and L/H-HA and the dynamic viscosity ⁇ of the samples are determined as described in example 1.
• Table 4 Kinetics of the dynamic viscosity ⁇ of cooperative hybrid L/H-HA complexes with L-HA/H-HA ratio of 1 w/w, constructed with L-HA of different MW.
• Aqueous solutions of H-HA (MW 1.4 ⁇ 10 6 Da; Mw/Mn 1.5), L-HA (MW 3.3 ⁇ 10 4 Da; Mw/Mn 1.8) and L-HA (MW 2.2 ⁇ 10 5 Da; Mw/Mn 1.7) are prepared at 2% w/v in distilled water, which are used for preparing the various solutions given in the table.
• Half of the resultant solutions are maintained at temperature and half are first submitted to the following thermal cycle in autoclave: from 25 to 120° C. in 10 min, for 10 min at 120° C., from 120 to 25° C. in 10 min and are then maintained at room temperature.
• the aqueous solution of the cooperative hybrid L/H-HA complex obtained as described in example 1 with a thermal cycle that envisages exposure to a T max of 120° C. for 10 min, is treated with 2 volumes of anhydrous ethanol, added slowly and with stirring. A white pulverulent precipitate is obtained, which sediments rapidly and can be dried under vacuum with heating. The process leads to formation of a white dry powder, at a yield of 99% relative to the theoretical value.
• the cooperative hybrid L/H-HA complex in powder if dissolved in water at a concentration of 1% w/w, gives a solution that has the same value of dynamic viscosity ⁇ as the solution precipitated initially.
• the aqueous solution of the cooperative hybrid L/H-HA complex, obtained as described in example 1 with a thermal cycle that envisages exposure to a T max of 120° C. for 10 min is lyophilized.
• a spongy mass is obtained, which is easily transformed into a white powder by mechanical treatment.
• the yield of lyophilized powder coincides with the theoretical value.
• the cooperative hybrid L/H-HA complex lyophilized in powder if dissolved in water at a concentration 1% w/w, gives a solution that has the same value of dynamic viscosity ⁇ as the solution precipitated initially.
• Aqueous solutions of H-HA (MW 1.4 ⁇ 10 6 Da; Mw/Mn 1.5), chondroitin (C; MW 6.6 ⁇ 10 4 Da; Mw/Mn 1.4) and chondroitin sulphate (CS; MW 3.8 ⁇ 10 4 Da; Mw/Mn 1.4) are prepared at 2% w/v in distilled water, which are used for preparing the various solutions given in Table 5.
• the resultant solutions are submitted to the following thermal cycle in autoclave: from 25 to 120° C. in 10 min, for 10 min at 120° C., from 120 to 25° C. in 10 min.
• the dynamic viscosity ⁇ of the samples, the MW and the polydispersity index Mw/Mn of L-HA, H-HA and L/H-HA are determined as described in example 1.
• Table 5 Measurement of the dynamic viscosity ⁇ of cooperative hybrid C/H-HA and CS/H-HA complexes.
• Aqueous solutions of H-HA (MW 1.4 ⁇ 10 6 Da; Mw/Mn 1.5), C (MW 6.6 ⁇ 10 4 Da; Mw/Mn 1.4) and CS (MW 3.8 ⁇ 10 4 Da; Mw/Mn 1.4) are prepared at 2% w/v in distilled water, which are used for preparing the various solutions given in the table.
• the resultant solutions are submitted to the following thermal cycle in autoclave: from 25 to 120° C. in 10 min, for 10 min at 120° C., from 120 to 25° C. in 10 min.
• 4g of the cooperative hybrid complex obtained as described in example 1 is dissolved in 100 mL of saline, heating at 120° C. for 10 min, and then drying the complex by lyophilization, as described in example 5.
• the hyaluronic acid used is of pharmaceutical grade for injection and all the manipulations are carried out in conditions that guarantee sterility and apyrogenicity of the solution.
• the solution containing 40 mg/mL of L/H-HA complexes is introduced into 1 mL syringes fitted with a gauge 30 needle.
• the treatment of biorevitalization of the face is conducted on 10 informed volunteers, who have obvious signs of cutaneous ageing of the face.
• the experimental design envisages that each subject undergoes an identical treatment of biorevitalization by subcutaneous microinjection on the right side of the face with the formulation of the invention (1 mL) and on the left side with a primary product already marketed (1 mL).
• the results obtained, objectivized instrumentally, demonstrate the superiority of the treatment with the stable cooperative L/H-HA complex, both in terms of quality and duration of the treatment.
• 4g of the cooperative hybrid complex obtained as described in example 1 is dissolved in 100 mL of saline, heating at 120° C. for 10 min, and then drying the complex by lyophilization, as described in example 5.
• the hyaluronic acid used is of pharmaceutical grade for injection and all the manipulations are carried out in conditions that guarantee sterility and apyrogenicity of the solution.
• the solution containing 40 mg/mL of L/H-HA complexes is introduced into 1 mL syringes fitted with a gauge 30 needle.
• the viscosupplementation treatment is conducted on 5 informed volunteers, with a bilateral knee disorder, the therapeutic indication being infiltration of hyaluronic acid in the joint.
• the experimental design envisages that each subject receives identical treatment of viscosupplementation in the right joint with the formulation of the invention (1 mL) and in the left joint with a primary product already marketed (1 mL).
• the results obtained, objectivized instrumentally, demonstrate the superiority of the treatment with the stable cooperative L/H-HA complex, both in terms of rapid reduction of pain and efficacy of resolution of the pathological condition.

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