Low plasma hyaluronan is associated with faster functional decline in patients with amyotrophic lateral sclerosis

Abstract

Objective: Hyaluronan, a glycosaminoglycan that forms a major constituent of the extracellular matrix, has been shown to be increased in the serum of patients with amyotrophic lateral sclerosis (ALS) with longer disease duration. We sought to determine whether measures of venous hyaluronan may serve as a predictive marker for disease progression in patients with ALS. Methods: Sixty-two patients with ALS, and 59 healthy control participants provided a plasma sample for the assessment of hyaluronan. Hyaluronan was compared against functional measures of disability, disease progression, and survival. Results: Hyaluronan was lower in patients with ALS when compared to healthy controls. Plasma hyaluronan was positively correlated with the change in the revised ALS functional rating scale, ΔFRS. Hyaluronan was also found to improve the prognostic power of the ΔFRS. Conclusion: Hyaluronan may serve as a predictive marker for functional decline in patients with ALS. Longitudinal studies are needed to fully explore the prognostic value of hyaluronan as a biomarker for disease progression, and to improve our understanding of components of the extracellular matrix specific to the pathophysiology of ALS.

Keywords:

• Amyotrophic lateral sclerosis
• hyaluronan
• rate of disease progression

Acknowledgements

The authors thank all patients with ALS and healthy control individuals who participated in this study.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

This research was supported through funding by the Royal Brisbane and Women’s Hospital (RBWH) Foundation. STN is supported by a FightMND Mid-career Fellowship and the Australian Institute for Bioengineering and Nanotechnology (AIBN) at the University of Queensland.