TY - JOUR T1 - Serum levels of hyaluronic acid are associated with COPD severity and predict survival JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.01183-2018 SP - 1801183 AU - Eleni Papakonstantinou AU - Ioannis Bonovolias AU - Michael Roth AU - Michael Tamm AU - Desiree Schumann AU - Florent Baty AU - Renaud Louis AU - Branislava Milenkovic AU - Wim Boersma AU - Bram Stieltjes AU - Konstantinos Kostikas AU - Francesco Blasi AU - Joachim G. Aerts AU - Gernot G.U. Rohde AU - Alicia Lacoma AU - Antoni Torres AU - Tobias Welte AU - Daiana Stolz Y1 - 2019/01/01 UR - http://erj.ersjournals.com/content/early/2019/02/06/13993003.01183-2018.abstract N2 - Ηyaluronic acid (HA) and its degradation products play an important role in lung pathophysiology and airway remodelling in COPD.We investigated if HA and its degrading enzyme hyaluronidase-1 (HYAL-1) are associated with COPD severity and outcome.Serum HA was assessed in a discovery cohort of 80 COPD patients at stable state and exacerbations. HA, HYAL-1 and HYAL-1 enzymatic activity were evaluated at stable state, exacerbations and 4 weeks after exacerbations, in 638 COPD patients, from the PROMISE validation cohort.In the discovery cohort, serum HA was higher at exacerbations, compared with stable disease (p=0.015). In the validation cohort, HA was higher at moderate and severe exacerbations than at baseline (p<0.001) and remained higher after 4 weeks (p<0.001). HA was strongly predictive for overall survival since it was associated with time to death (p<0.001) independently of adjusted Charlson-score, annual exacerbation rate and BODE-index. Serum HYAL-1 was increased at moderate (p=0.004) and severe (p=0.003) exacerbations but decreased after 4 weeks (p<0.001). HYAL-1 enzymatic activity, at stable state, was inversely correlated with FEV1% predicted (p=0.034) and survival time (p=0.017).Serum HA is associated with COPD severity and predicts overall survival. Degradation of HA is associated with airflow limitation and impairment of lung function.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Papakonstantinou has nothing to disclose.Conflict of interest: Dr. Bonovolias has nothing to disclose.Conflict of interest: Dr. Roth has nothing to disclose.Conflict of interest: Dr. Tamm has nothing to disclose.Conflict of interest: Dr. Schumann has nothing to disclose.Conflict of interest: Dr. Baty has nothing to disclose.Conflict of interest: Dr. Louis has nothing to disclose.Conflict of interest: Dr. Milenkovic has nothing to disclose.Conflict of interest: Dr. Boersma has nothing to disclose.Conflict of interest: Dr. Stieltjes has nothing to disclose.Conflict of interest: Dr. Kostikas has nothing to disclose.Conflict of interest: Dr. Blasi has nothing to disclose.Conflict of interest: Dr. Aerts has nothing to disclose.Conflict of interest: Dr. Rohde has nothing to disclose.Conflict of interest: Dr. Lacoma has nothing to disclose.Conflict of interest: Dr. Torres has nothing to disclose.Conflict of interest: Dr. Welte has nothing to disclose.Conflict of interest: Dr. Stolz has nothing to disclose. ER -