Am. J. Respir. Crit. Care Med., Vol 153, No. 1, Jan 1996, 312-316.
Subcutaneous administration of hyaluronan reduces the number of infectious exacerbations in patients with chronic bronchitis
P Venge, B Pedersen, L Hakansson, R Hallgren, G Lindblad and R Dahl
Department of Clinical Chemistry, University Hospital, Uppsala, Sweden.
Hyaluronan (HA) is a high molecular weight glycosaminoglycan found in large
amounts in the skin, joints, and other organs. Previous studies have shown
that HA stimulates neutrophil functions both in vitro and in vivo. The
object of this study was to test the hypothesis that HA administration
subcutaneously might reduce the number of bacterial infections in humans
with an increased susceptibility to such infections. For this purpose we
have studied 29 patients with chronic bronchitis and recurrent acute
exacerbations of their disease. The patients were randomly separated into
two groups. One group had HA for 6 mo followed by 6 mo of placebo, and the
other group started with placebo treatment followed by HA. The treatment
periods occurred during two consecutive winter periods. HA-treated patients
had significantly fewer acute exacerbations (p = 0.01) than did
placebo-treated patients. Likewise the consumption of antibiotics and other
signs of bacterial infections were reduced. In the crossover study the
placebo-treated patients again had much higher numbers of acute
exacerbations than did the HA-treated patients (p < 0.0001). It is
concluded that HA reduces the number of infectious exacerbations in
patients with chronic bronchitis, possibly by enhancing cellular host
defense mechanisms. HA is a new endogenous substance that can be used to
stimulate host defense reactions and reduce the need of antibiotics. Before
being recommended for clinical use, however, our results should be
confirmed by further studies.
