Press release
Monday, February 1, 2021
Naturally produced by the body, hyaluronan represents a new class of biological products that significantly improves lung health in patients with severe COPD.
Researchers at the National Institutes of Health and colleagues found that inhalation of non-fragmented hyaluronan improves lung function in patients suffering from severe exacerbation of chronic obstructive pulmonary disease (COPD). Hyaluronan, a sugar secreted by living tissue that acts as a support for cells, is also used in cosmetics as a moisturizer for the skin and as a nasal spray to hydrate the pulmonary airways. Used as a treatment, hyaluronan reduced the time that COPD patients in intensive care needed respiratory support, decreased the number of days in the hospital and saved money by reducing hospital stay.
The study, published online in Respiratory Research, is a good example of how examining the impacts of environmental pollution on the lungs can lead to viable treatments. Several years ago, senior co-author Stavros Garantziotis, MD, medical director of the Clinical Research Unit of the National Institute of Environmental Health Sciences (NIEHS), part of the NIH, showed that exposure to pollution causes hyaluronan in the lungs decompose into smaller fragments. These fragments irritate the lung tissue and activate the immune system, causing constriction and inflammation of the airways. He determined that inhaling non-fragmented hyaluronan reduces inflammation by overcoming the smaller hyaluronan fragments.
Garantziotis offered an analogy of 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,” said Garantziotis. “Reintroducing complete hyaluronan, as a new layer of mortar, means that it is less irritating and reduces the amount of inflammation.”
As hyaluronan was approved in Italy for airway hydration, Garantziotis worked with colleagues in Rome to see if life-size inhalation of hyaluronan could improve lung function in critically ill patients with COPD. He explained that patients were using a respiratory device similar to a continuous positive airway pressure (CPAP) machine to treat acute exacerbation of COPD. This device provided respiratory support by blowing air into the airways through a mask.
“Inhaled hyaluronan qualifies as a stimulating aid for patients with exacerbated COPD because it is safe and easy to administer,” said senior co-author Raffaele Incalzi, MD, Department of Medicine, Campus Bio-Medico University and Teaching Hospital, Rome . “In addition, it acts locally, only in the bronchial tree and, therefore, cannot interfere with any systemic drugs.”
Garantziotis also wanted to know what was causing the airway constriction in the lungs of patients with COPD. He theorized that thick mucus may be involved. Collaborating with scientists at the University of Alabama at Birmingham (UAB), they cultured airway cells from cultured emphysema patients and watched how mucus moved in the cells. They found that mucus flowed more easily after hyaluronan administration.
Co-author Steven Rowe, MD, director of the Gregory Fleming James Cystic Fibrosis Research Center at UAB, said that if severe COPD patients took hyaluronan, the treatment would improve mucus transport and aid recovery.
Current treatments for lung disease include inhaled steroids, antibiotics and bronchodilators; therefore, 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 USA, so that he can understand the ideal conditions and the dosage that will produce the greatest benefit.
About the National Institute of Environmental Health Sciences (NIEHS): The 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 list of news.
About the National Institutes of Health (NIH): NIH, the country’s medical research agency, includes 27 institutes and centers and is a component of the United States Department of Health and Human Services. NIH is the leading federal agency that conducts and supports basic, clinical and translational medical research, and is investigating the causes, treatments and cures for common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
Concession numbers: Z01ES102605, Z01ES102465, R35HL135816, P30DK072482
About the National Institutes of Health (NIH):
NIH, the country’s medical research agency, includes 27 institutes and centers and is a component of the United States Department of Health and Human Services. NIH is the leading federal agency that conducts and supports basic, clinical and translational medical research, and is investigating the causes, treatments and cures for 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, Incalzi RA, Garantziotis S. 2021. High-weight hyaluronan improvements molecular inhaled respiratory failure in acute COPD exacerbation: a pilot study. Respir Res: doi: 10.1186 / s12931-020-01610-x.