Clinical correlations and prognosis based on hyaluronic acid serum levels in patients with progressive systemic sclerosis

Abstract

The serum levels of hyaluronic acid (sHA) were measured using an affinoimmunoenzymatic assay in patients with distal (n = 16) and proximal (n = 15) progressive systemic sclerosis (PSS) and in 31 controls. The severity of PSS was evaluated using a standardized organ-involvement score. The mean sHA was significantly higher in the patients with PSS than in controls (mean +/- SD:80 +/- 43.4 micrograms/l vs. 42.3 +/- 19.1 micrograms/l, P less than 0.001). sHA was significantly higher in patients with proximal PSS than in patients with distal PSS (106.4 +/- 44.6 micrograms/l vs. 55.4 +/- 23.8 micrograms/l, P less than 0.001). A positive correlation was found between sHA and the disease score (r = 0.67, P less than 0.001). sHA was also correlated with lung diffusion capacity for carbon monoxide (r = 0.70, P less than 0.001), but only in the those patients who had abnormal lung function, and therefore presumably had lung PSS involvement. We suggest that sHA could be an indicator of the degree of systemic involvement in PSS. Its prognostic value and possible use in the follow up of patients with PSS remain to be clarified.

Hyaluronic Acid in Progressive Systemic Sclerosis

“…High levels of HA in serum of PSS patients were pre viously reported by Levesque et al [7]. Using the affinoimmunoenzymatic assay, these authors found a positive correlation between the serum HA level and the disease severity score |7|.…”

Hyaluronan in skin

“…In systemic sclerosis, which is characterized by an excessive accumulation of collagen in the skin and other organs, an increase of dermatan sulphate and a decrease of HYA has been reported [14][15][16]. The increase in dermatan sulphate was correlated with the clinical severity and the extent of sclerosis [14,16].…”

“…The increase in dermatan sulphate was correlated with the clinical severity and the extent of sclerosis [14,16]. In localized scleroderma HYA is increased at the active edges of the lesions but is reduced in the centre where dermatan sulphate and chondroitin sulphate are elevated instead.…”

Overexpression of c-Met and CD44v6 Receptors Contributes to Autocrine TGF-β1 Signaling in Interstitial Lung Disease

“…HA levels are elevated in serum of ILD patients (12,13) and in the lung after bleomycin treatment (14 -16). CD44 participates in the activation of leukocytes and parenchymal cells in areas of inflammation, suggesting a role for CD44 in tissue remodeling and fibrosis (17,18).…”

“…Increased deposition of interstitial HA has also been correlated with tissue function in progressive fibrosis, including ILD (12,13,23). Progressive ILD requires the generation of an invasive myofibroblast phenotype that requires TGF-␤1, where hyaluronan synthase 2 and CD44 are critical downstream components of TGF-␤1-induced fibrosis (14).…”