COPD: Hyaluronan is a New Natural Way to Treat Inflammation of Airways Interview with:

Stavros Garantziotis MD Division of Intramural Research National Institute of Environmental Health Sciences Research Triangle Park, NC

Dr. Garantziotis

Stavros Garantziotis MD
Division of Intramural Research
National Institute of Environmental Health Sciences
Research Triangle Park, NC What is the background for this study? How does hyaluronan differ from other medications for COPD? Is it used for other medical conditions?

Response: Hyaluronan is a natural sugar found in the human body, including in the lung. We have found that when the lungs are exposed to pollution, this sugar breaks down, and the breakdown fragments cause inflammation in the lung. We also found that if we give back the natural form of hyaluronan, it protects the lung from inflammation. Patients suffering from COPD also have a lot of hyaluronan breakdown in their lungs. We therefore reasoned, that giving them back the natural form of hyaluronan, as an inhalation treatment, would help them reduce inflammation. We tested this, as a first step, in the treatment acute inflammation of the lungs in COPD patients who are suffering an exacerbation of their disease.

Hyaluronan is different from existing medications in that it is a natural product of the body. It is used in Europe for conditions like cystic fibrosis, and after sinus surgery to humidify the airways. Because it is given by inhalation, it acts locally in the lungs. What are the main findings?

Response: We treated patients who had a severe COPD exacerbation, and were in the intensive care unit on breathing support through a mask (this is called “non-invasive ventilation”). We treated patients with the usual treatment (antibiotics, steroids, bronchodilators) and in addition they received either inhaled hyaluronan or placebo by inhalation.

Patients that received inhaled hyaluronan could breathe on their own on average a day sooner, and were able to leave the hospital 2-3 days earlier. We found that their lung function improved on hyaluronan, and they also appeared to have less inflammation in their body overall.

We then found that hyaluronan improves the ability of the airways to clear mucus, which is a big part of COPD exacerbations. We think this is at least one way how hyaluronan helped our patients. What should readers take away from your report?

Response: Hyaluronan is a new natural, safe and effective way to treat inflammation of the airways. What recommendations do you have for future research as a result of this work?

Response: Hyaluronan should be further tested in lung diseases that are caused by inflammation and mucus thickening, like asthma, cystic fibrosis, and infections of the airways. Is there anything else you would like to add?

Response: This research started by looking into the effects of pollution on the lungs. The same treatment that works against pollution-induced lung disease works in COPD. This is a powerful reminder that pollution contributes to lung disease. If we can prevent pollution, we will also do away with a lot of the lung diseases, like asthma and COPD, that cause so many health problems today.


Galdi, F., Pedone, C., McGee, C.A. et al. Inhaled high molecular weight hyaluronan ameliorates respiratory failure in acute COPD exacerbation: a pilot study. Respir Res 2230 (2021).




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Last Updated on February 10, 2021 by Marie Benz MD FAAD