Abstract
Background: Hyaluronic acid (HA) is an abundant molecule in the human lung, which plays a key role in airway remodeling in COPD. Depending on its molecular weight, HA exhibits either pro-inflammatory or anti-inflammatory effects.
Aims and objectives: The aim of our study was to investigate if serum levels of HA and serum enzymatic activity of hyaluronidase (HYAL) can be used as systemic biomarkers to predict COPD progression and severity.
Methods: We prospectively evaluated 638 patients with stable COPD for ≥ 6 weeks, GOLD II-IV, > 10 PY seeking care in pulmonary tertiary hospitals in 8 European countries and included in the PROMISE cohort. The primary outcome of the study was exacerbation and/or death. Median observation time was 24 months. Serum levels of HA were measured at baseline by ELISA and hyaluronidase activity in serum by reverse HA zymography.
Results: Serum levels of HA were positively correlated with FEV1% pred (p=0.002) and FEV/FVC (p=0.025) while HYAL activity was negatively correlated with FEV1% pred (p=0.034). Furthermore, HA was associated significantly (p<0.001) with the time to death (Exp(B) 1.019 95% CI 1.009-1.029). Cox-regression multivariate analysis revealed that this association was independent of adjusted Charlson score, annual exacerbation rate and BODE index components.
Conclusions: Our results indicate that HA and its degrading enzyme HYAL may be related to COPD progression and severity.
- Copyright ©ERS 2015