Press release
Monday, February 1, 2021
A natural product of the body, hyaluronan is a new class of biological products that significantly improves lung health in patients with severe COPD.
Researchers at the National Institutes of Health and their collaborators found that inhaling unfragmented hyaluronan improves lung function in patients suffering from severe exacerbation of chronic obstructive pulmonary disease (COPD). Hyaluronan, a sugar secreted by living tissues that acts as a scaffold for cells, is also used in cosmetics as a skin moisturizer and as a nasal spray to moisturize the lungs. Used as a treatment, hyaluronan shortened the time that COPD patients in intensive care needed breathing support, reduced their number of days in the hospital, and saved money by reducing their hospital stay.
The study, published online in Respiratory Research, is a good example of how examining the impact of environmental pollution on the lungs can lead to viable treatments. A few years ago, co-senior author Stavros Garantziotis, MD, medical director of the Clinical Research Unit at the National Institute of Environmental Health Sciences (NIEHS), part of the NIH, showed that exposure to pollution acts like hyaluronan in the lungs. to decompose into smaller fragments. These fragments irritate the lung tissue and activate the immune system, leading to constriction and inflammation of the airways. He determined that inhaling healthy, fragment-free hyaluronan reduces inflammation by overcoming smaller fragments of hyaluronan.
Garantziotis provided an analogy for how inflammation occurs. He said that hyaluronan surrounds cells like mortar surrounds bricks. The introduction of pollution causes cracks in the mortar, breaking it into smaller pieces.
“These smaller pieces irritate the body and activate the immune system, leading to inflammation,” Garantziotis said. “Reintroducing full-length hyaluronan, like a fresh layer of mortar, means it’s less irritating and reduces the amount of inflammation.”
Because hyaluronan has been approved in Italy for airway hydration, Garantziotis has worked with colleagues in Rome to see if inhaling large hyaluronan could improve lung function in critically ill COPD patients. He explained that patients used a respirator similar to a continuous positive airway pressure (CPAP) device to treat acute exacerbation of COPD. This device provided support for breathing by blowing air into the airways through a mask.
“Inhaled hyaluronan qualifies as a stimulant aid for patients with exacerbated COPD because it is safe and easy to administer,” said lead co-author Raffaele Incalzi, MD, Department of Medicine, University Campus Bio-Medico and Didactic Hospital, Rome. Moreover, it acts locally, only in the bronchial tree and therefore can not interfere with any systemic drug. “
Garantziotis also wanted to know what causes airway constriction in the lungs of COPD patients. He theorized that thick mucus may be involved. Collaborating with scientists at the University of Alabama at Birmingham (UAB), they grew airway cells from patients with emphysema in culture and analyzed how mucus moves into cells. They saw that the mucus flowed more easily after the administration of hyaluronan.
Co-author Steven Rowe, MD, director of the Gregory Fleming James Cystic Fibrosis Research Center at UAB, said that if patients with severe COPD take hyaluronan, treatment would improve mucus transport and help them recover.
Current treatments for lung disease include inhaled steroids, antibiotics and bronchodilators, so using a molecule that is already in the body is a new concept. The goal now for Garantziotis is to study this treatment in more patients in the US so that they can understand the optimal conditions and doses that will produce the greatest benefit.
About the National Institute of Environmental Health Sciences (NIEHS): NIEHS supports research to understand the effects of the environment on human health and is part of the National Institutes of Health. For more information on NIEHS or environmental health topics, visit https://www.niehs.nih.gov/ or subscribe to a news list.
About the National Institutes of Health (NIH): NIH, the national medical research agency, includes 27 institutes and centers and is a component of the US Department of Health and Human Services. NIH is the leading federal agency that conducts and supports basic, clinical, and translational medical research and investigates the causes, treatments, and cures of both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
Grant numbers: Z01ES102605, Z01ES102465, R35HL135816, P30DK072482
About the National Institutes of Health (NIH):
NIH, the national medical research agency, includes 27 institutes and centers and is a component of the US Department of Health and Human Services. NIH is the first federal agency to conduct and support basic, clinical, and translational medical research and investigate the causes, treatments, and treatments for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
NIH … Transforming discovery into health®
References
Galdi F, Pedone C, McGee CA, George M, Rice AB, Hussain SS, Vijaykumar K, Boitet ER, Tearney GJ, McGrath JA, Brown AR, Rowe SM, RA Heaters, Garantziotis S. 2021. Improves high molecular weight hyaluronan inhaled respiratory failure in acute exacerbation of COPD: a pilot study. Respir Res: doi: 10.1186 / s12931-020-01610-x.