Relationship of Circulating Hyaluronic Acid Levels to Disease Control in Asthma and Asthmatic PregnancyReportar como inadecuado

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Uncontrolled asthma is a risk factor for pregnancy-related complications. Hyaluronic acid HA, a potential peripheral blood marker of tissue fibrosis in various diseases, promotes eosinophil survival and plays a role in asthmatic airway inflammation as well as in physiological processes necessary to maintain normal pregnancy; however the level of circulating HA in asthma and asthmatic pregnancy is unknown. We investigated HA levels in asthmatic patients N = 52; asthmatic pregnant AP N = 16; asthmatic non-pregnant ANP N = 36 and tested their relationship to asthma control. Serum HA level was lower in AP than in ANP patients 27 24.7–31.55 vs. 37.4 30.1–66.55 ng-mL, p = 0.006; the difference attenuated to a trend after its adjustment for patients’ age p = 0.056. HA levels and airway resistance were positively r = 0.467, p = 0.004, HA levels and Asthma Control Test ACT total score inversely r = −0.437, p = 0.01 associated in ANP patients; these relationships remained significant even after their adjustments for age. The potential value of HA in the determination of asthma control was analyzed using ROC analysis which revealed that HA values discriminate patients with ACT total score ≥20 controlled patients and <20 uncontrolled patients with a 0.826 efficacy AUC, 95% CI: 0.69–0.97, p = 0.001 when 37.4 ng-mL is used as cut-off value in ANP group, and with 0.78 efficacy AUC, 95% CI: 0.65–0.92, p = 0.0009 in the whole asthmatic cohort. In conclusion circulating HA might be a marker of asthma control, as it correlates with airway resistance and has good sensitivity in the detection of impaired asthma control. Decrease of HA level in pregnancy may be the consequence of pregnancy induced immune tolerance.

Autor: Noémi Eszes, Gergely Toldi, Anikó Bohács, István Ivancsó, Veronika Müller, János Rigó Jr., György Losonczy, Barna Vásá



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