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reHA is a medical device formulation of high-molecular-weight sodium hyaluronate (hyaluronic acid) developed by Salf S.p.A. and investigated by the Azienda Ospedaliero-Universitaria di Bologna for the treatment of decompensated liver cirrhosis and ascites. While reHA is CE-marked for the prevention of post-surgical adhesions, it is being repurposed for intraperitoneal administration in patients with cirrhosis to stabilize the peritoneal membrane and modulate the local inflammatory environment. The mechanism of action involves the physical properties of hyaluronic acid as a lubricant and barrier, as well as its biological activity as a ligand for receptors such as CD44 and the hyaluronan-mediated motility receptor (RHAMM). By binding to these receptors, reHA may reduce the production of pro-inflammatory cytokines and improve the integrity of the peritoneal mesothelium, thereby potentially decreasing the accumulation of ascitic fluid and improving clinical outcomes in patients with advanced liver disease.
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