Increased hyaluronic acid is associated with dermal delayed-type hypersensitivity.

Rabbits sensitized subcutaneously with heat-killed bacilli Calmette-Guerin (BCG) and challenged intradermally with heat-killed BCG or purified protein derivative (PPD) demonstrated classical dermal delayed-type hypersensitivity which peaked two days postchallenge. Animals challenged with BCG developed dermal granulomas as measured by induration and gross observation. Challenge with either PPD or BCG resulted in increased levels of dermal hyaluronic acid (HA) by two days postchallenge. Dermal HA returned to normal levels by seven days postchallenge regardless of the challenge antigen. These results indicated that increased HA is associated with dermal delayed-type sensitivity, but increased HA is not associated with dermal granulomatous hypersensitivity. These results are in contrast to previously reported work which indicates that increased HA is associated with both pulmonary delayed hypersensitivity and pulmonary granulomatous hypersensitivity.