Hällgren R, Eklund A, Engström-Laurent A, Schmekel B
Br Med J (Clin Res Ed). 1985 Jun 15;290(6484):1778-81. doi: 10.1136/bmj.290.6484.1778.
Hyaluronate (hyaluronic acid) was not detectable in bronchoalveolar lavage fluid from smoking or nonsmoking healthy volunteers but was present in fluid from 23 patients with sarcoidosis; the mean concentration was 16 micrograms/1 returned fluid (range less than or equal to 5-430) or, expressed in relation to the amount of albumin recovered, 0.22 micrograms/mg albumin (range less than or equal to 0.05-3.6). The serum hyaluronate concentrations in the patients with sarcoidosis were normal. There was a significant inverse correlation between vital lung capacity and hyaluronate concentrations in bronchoalveolar lavage fluid (p less than 0.001), and patients with abnormal lung volumes had hyaluronate concentrations that were on average six times higher than those in patients with normal vital capacity. Duration of disease, pulmonary radiological findings, and markers for macrophage activation (angiotensin converting enzyme) and lymphocyte activation (beta 2 microglobulin) were not correlated with bronchoalveolar lavage fluid hyaluronate. It was concluded that in sarcoidosis release of hyaluronate into the airways is related to lung volume and therefore to the course of the disease. Increased synthesis of hyaluronate in lung parenchyma may reflect activation of fibroblasts, and measurements of hyaluronate may have clinical value for prognosis and treatment.
在吸烟或不吸烟的健康志愿者的支气管肺泡灌洗液中未检测到透明质酸盐（透明质酸），但在23例结节病患者的灌洗液中存在；平均浓度为每回收液体16微克（范围≤5 - 430），或以回收的白蛋白量表示为每毫克白蛋白0.22微克（范围≤0.05 - 3.6）。结节病患者的血清透明质酸盐浓度正常。支气管肺泡灌洗液中的透明质酸盐浓度与肺活量之间存在显著的负相关（p < 0.001），肺容积异常的患者其透明质酸盐浓度平均比肺活量正常的患者高6倍。疾病持续时间、肺部放射学表现以及巨噬细胞活化标志物（血管紧张素转换酶）和淋巴细胞活化标志物（β2微球蛋白）与支气管肺泡灌洗液透明质酸盐无关。得出的结论是，在结节病中，透明质酸盐向气道的释放与肺容积相关，因此与疾病进程相关。肺实质中透明质酸盐合成增加可能反映成纤维细胞的活化，透明质酸盐的测量对于预后和治疗可能具有临床价值。
