title: The role of hyaluronan in the pathobiology and treatment of respiratory disease.
abstract: Hyaluronan, a ubiquitous naturally occurring glycosaminoglycan, is a major component of the extracellular matrix, where it participates in biological processes that include water homeostasis, cell-matrix signaling, tissue healing, inflammation, angiogenesis, and cell proliferation and migration. There are emerging data that hyaluronan and its degradation products have an important role in the pathobiology of the respiratory tract. We review the role of hyaluronan in respiratory diseases and present evidence from published literature and from clinical practice supporting hyaluronan as a novel treatment for respiratory diseases. Preliminary data show that aerosolized exogenous hyaluronan has beneficial activity against airway inflammation, protects against bronchial hyperreactivity and remodeling, and disrupts the biofilm associated with chronic infection. This suggests a role in airway diseases with a predominant inflammatory component such as rhinosinusitis, asthma, chronic obstructive pulmonary disease, cystic fibrosis, and primary ciliary dyskinesia. The potential for hyaluronan to complement conventional therapy will become clearer when data are available from controlled trials in larger patient populations.
authors.affiliation: Clinical Research Program, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina; garantziotis@niehs.nih.gov.
authors.forename: Stavros
authors.initials: S
authors.lastname: Garantziotis
authors.affiliation: Clinic of Pediatric Pneumology and Phthisiology, University Hospital Bratislava, Bratislava, Slovakia;
authors.forename: Martin
authors.initials: M
authors.lastname: Brezina
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Insubria, Ospedale di Circolo, Fondazione Macchi, Varese, Italy; and.
authors.forename: Paolo
authors.initials: P
authors.lastname: Castelnuovo
authors.affiliation: Laboratory of Clinical Chemistry and Microbiology, IRCCS Galeazzi Orthopaedic Institute, Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Drago
mesh_terms: D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D006801:Humans; D006820:Hyaluronic Acid / Q000502:physiology* / Q000627:therapeutic use; D008168:Lung / Q000378:metabolism / Q000473:pathology*; D012140:Respiratory Tract Diseases / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology; D015398:Signal Transduction
chemical_list: D000893:Anti-Inflammatory Agents; D006820:Hyaluronic Acid
keywords: asthma; bacterial biofilm; chronic obstructive pulmonary disease; cystic fibrosis; hyaluronan; inflammation; respiratory tract diseases