Dermal extracellular matrix (Hyaluronic acid and tissue water) (Dermal ECM)

The dermal extracellular matrix (ECM) is a complex structural network primarily composed of collagen, elastin, and glycosaminoglycans, with hyaluronic acid (HA) being the most prominent polysaccharide (Source: PubMed, PMID: 24331461). HA is a non-sulfated glycosaminoglycan that plays a critical role in maintaining skin hydration due to its exceptional capacity to bind and retain tissue water, holding up to 1,000 times its weight in water (Source: NIH StatPearls, "Hyaluronic Acid"). This hydration is essential for maintaining the viscoelastic properties, volume, and turgor of the skin. In clinical practice, the dermal ECM and its HA content are targeted to treat skin aging, volume loss, and dehydration. Therapeutic interventions include the use of exogenous HA fillers to restore volume and humectants to improve surface hydration (Source: FDA, "Dermal Fillers"). Conversely, the enzyme hyaluronidase is used to degrade endogenous or injected HA, facilitating the diffusion of co-administered drugs or reversing the effects of fillers (Source: PubMed, PMID: 25877718). Changes in the composition of the dermal ECM are central to the pathology of photoaging and various connective tissue disorders.

Other names

Dermal matrixHyaluronanIntercellular substance of the dermisDermal ground substanceSkin extracellular matrix

Drugs targeting this system typically act by either enzymatically degrading the hyaluronic acid polymer to increase tissue permeability, as seen with hyaluronidase which cleaves beta-1,4-glycosidic bonds (Source: StatPearls, "Hyaluronidase"), or by acting as humectants and osmotic agents to increase and retain tissue water content within the matrix, as seen with hyaluronic acid fillers and glycerin (Source: PubMed, PMID: 24331461).