Relationship of circulating hyaluronic acid levels to disease control in asthma and asthmatic pregnancy

Noémi Eszes, Gergely Toldi, Anikó Bohács, István Ivancsó, V. Müller, J. Rigó, G. Losonczy, B. Vásárhelyi, L. Tamási

Research output: Contribution to journalArticle

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Abstract

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 =20.437, 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.

Original languageEnglish
Article numbere94678
JournalPLoS One
Volume9
Issue number4
DOIs
Publication statusPublished - Apr 15 2014

Fingerprint

Disease control
hyaluronic acid
asthma
Hyaluronic Acid
disease control
Asthma
pregnancy
Pregnancy
Airway Resistance
Area Under Curve
Physiological Phenomena
Immune Tolerance
Pregnancy Complications
acid value
immunosuppression
eosinophils
blood serum
fibrosis
Eosinophils
ROC Curve

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Relationship of circulating hyaluronic acid levels to disease control in asthma and asthmatic pregnancy. / Eszes, Noémi; Toldi, Gergely; Bohács, Anikó; Ivancsó, István; Müller, V.; Rigó, J.; Losonczy, G.; Vásárhelyi, B.; Tamási, L.

In: PLoS One, Vol. 9, No. 4, e94678, 15.04.2014.

Research output: Contribution to journalArticle

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abstract = "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 =20.437, 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.",
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AU - Eszes, Noémi

AU - Toldi, Gergely

AU - Bohács, Anikó

AU - Ivancsó, István

AU - Müller, V.

AU - Rigó, J.

AU - Losonczy, G.

AU - Vásárhelyi, B.

AU - Tamási, L.

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