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Hyaluronic acid in viscous malignant mesothelioma pleural effusion

Hui Min Cheah1,2, Deirdre Fitzgerald1,2,3, Amber Louw4,5

  • 1Pleural Medicine Unit Center for Respiratory Health, University of Western Australia Perth WA Australia.

Respirology Case Reports
|December 11, 2020
PubMed

Insights

Malignant pleural effusions (MPEs) in mesothelioma can be extremely viscous due to high hyaluronic acid (HA) content. This viscosity hinders drainage, but hyaluronidase treatment shows promise in reducing MPE viscosity.

Area of Science:

  • Oncology
  • Pulmonology
  • Biochemistry

Background:

  • Malignant pleural effusion (MPE) is a frequent complication of mesothelioma.
  • Viscous MPEs pose significant management challenges, impeding effective drainage.

Observation:

  • Two cases of mesothelioma with unusually viscous MPEs were observed.
  • The high viscosity prevented spontaneous drainage using indwelling pleural catheters.

Findings:

  • Ex vivo analysis revealed exceptionally high concentrations of hyaluronic acid (HA) in the effusions.
  • Treatment with hyaluronidase, an enzyme that degrades HA, significantly reduced fluid viscosity.
  • Deoxyribonuclease treatment did not affect fluid viscosity, indicating HA's specific role.

Implications:

  • Hyaluronic acid is a key contributor to the high viscosity of MPEs in mesothelioma.
  • Targeting HA degradation may offer novel therapeutic strategies for managing viscous MPEs.
  • Further research into counteracting HA properties could improve MPE management and patient outcomes.
Keywords:
Hyaluronic acidhyaluronidasemalignant pleural effusionmesotheliomaviscosity

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