CHEST Guidelines-The-Therapeutic-Potential-of-Hyaluronan-in-COPD

The-Therapeutic-Potential-of-Hyaluronan-in-COPD_20

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The article discusses the therapeutic potential of hyaluronan (HA) in the treatment of Chronic Obstructive Pulmonary Disease (COPD). It references the important role of alpha-1 antitrypsin deficiency (AATD) in understanding COPD, highlighting a protease-antiprotease imbalance that affects lung elastin fibers, instrumental in maintaining lung structure. Desmosine and isodesmosine (DI) serve as biomarkers for elastin degradation, aiding in understanding COPD progression and treatment efficacy.<br /><br />Recent studies emphasize HA aerosol’s capacity to decrease elastin degradation in COPD patients, with preliminary evidence showing reductions in DI levels. This suggests HA can slow disease progression, offering a complementary approach alongside existing treatments.<br /><br />The article also explores the biochemistry of HA, part of glycosaminoglycans, which are key structural and functional matrix components interacting with collagen and elastin. HA’s hydration properties and molecular structure allow it to integrate into lung matrices, potentially acting as a barrier against elastin-degrading proteases.<br /><br />Prior animal studies support HA’s protective role, while human trials have shown promising preliminary results with minimal adverse effects. HA’s non-toxicity allows it to be prescribed early in COPD diagnosis, potentially altering disease progression.<br /><br />Despite promising results, challenges remain in understanding HA’s mechanism fully and inconsistencies in studies related to DI levels as COPD biomarkers. Additional research and clinical trials, such as the ongoing trial on AATD-related COPD, may further validate HA’s efficacy and broaden its use to non-AATD COPD, providing significant clinical benefits in preserving lung structure and function.

Keywords

hyaluronan

COPD

alpha-1 antitrypsin deficiency

protease-antiprotease imbalance

elastin degradation

desmosine

isodesmosine

glycosaminoglycans

biomarkers

clinical trials