{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T03:38:55Z","timestamp":1791689935645,"version":"4.3.4"},"reference-count":281,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T00:00:00Z","timestamp":1678665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Melrose Personal Research Fund, Sydney, Australia"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>Pentosan polysulfate (PPS), a small semi-synthetic highly sulfated heparan sulfate (HS)-like molecule, shares many of the interactive properties of HS. The aim of this review was to outline the potential of PPS as an interventional therapeutic protective agent in physiological processes affecting pathological tissues. PPS is a multifunctional molecule with diverse therapeutic actions against many disease processes. PPS has been used for decades in the treatment of interstitial cystitis and painful bowel disease, it has tissue-protective properties as a protease inhibitor in cartilage, tendon and IVD, and it has been used as a cell-directive component in bioscaffolds in tissue engineering applications. PPS regulates complement activation, coagulation, fibrinolysis and thrombocytopenia, and it promotes the synthesis of hyaluronan. Nerve growth factor production in osteocytes is inhibited by PPS, reducing bone pain in osteoarthritis and rheumatoid arthritis (OA\/RA). PPS also removes fatty compounds from lipid-engorged subchondral blood vessels in OA\/RA cartilage, reducing joint pain. PPS regulates cytokine and inflammatory mediator production and is also an anti-tumor agent that promotes the proliferation and differentiation of mesenchymal stem cells and the development of progenitor cell lineages that have proven to be useful in strategies designed to effect repair of the degenerate intervertebral disc (IVD) and OA cartilage. PPS stimulates proteoglycan synthesis by chondrocytes in the presence or absence of interleukin (IL)-1, and stimulates hyaluronan production by synoviocytes. PPS is thus a multifunctional tissue-protective molecule of potential therapeutic application for a diverse range of disease processes.<\/jats:p>","DOI":"10.3390\/ph16030437","type":"journal-article","created":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T03:04:46Z","timestamp":1678763086000},"page":"437","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Pentosan Polysulfate Affords Pleotropic Protection to Multiple Cells and Tissues"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2020-0056","authenticated-orcid":false,"given":"Margaret M.","family":"Smith","sequence":"first","affiliation":[{"name":"Raymond Purves Laboratory, Institute of Bone and Joint Research, Kolling Institute of Medical Research, Faculty of Health and Science, University of Sydney at Royal North Shore Hospital, St. Leonards, NSW 2065, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9237-0524","authenticated-orcid":false,"given":"James","family":"Melrose","sequence":"additional","affiliation":[{"name":"Raymond Purves Laboratory, Institute of Bone and Joint Research, Kolling Institute of Medical Research, Faculty of Health and Science, University of Sydney at Royal North Shore Hospital, St. Leonards, NSW 2065, Australia"},{"name":"Graduate Schools of Biomedical Engineering, University of NSW, Sydney, NSW 2052, Australia"},{"name":"Sydney Medical School, Northern Campus, Royal North Shore Hospital, St. Leonards, NSW 2065, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"821","DOI":"10.2165\/00003495-200666060-00006","article-title":"Pentosan polysulfate: A review of its use in the relief of bladder pain or discomfort in interstitial cystitis","volume":"66","author":"Anderson","year":"2006","journal-title":"Drugs"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1016\/j.urology.2004.10.071","article-title":"Randomized, double-blind, dose-ranging study of pentosan polysulfate sodium for interstitial cystitis","volume":"65","author":"Nickel","year":"2005","journal-title":"Urology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1016\/j.juro.2014.09.036","article-title":"Pentosan polysulfate sodium for treatment of interstitial cystitis\/bladder pain syndrome: Insights from a randomized, double-blind, placebo controlled study","volume":"193","author":"Nickel","year":"2015","journal-title":"J. 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