Hyaluronic acid molecular weight is a therapeutic switch for spinal cord injury: high weight blocks scarring, low weight promotes regeneration

After spinal cord injury, the extracellular matrix transforms from a supportive substrate into a barrier. Hyaluronic acid is central to this transformation—but the same molecule can either help or hurt depending on its size.

The emerging picture: high molecular weight HA suppresses glial scar formation, while engineered HA hydrogels create regeneration-permissive bridges. Molecular weight is the therapeutic switch.

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