Hyaluronan primes the oxidative burst in human neutrophils

J Leukoc Biol. 2020 Aug;108(2):705-713. doi: 10.1002/JLB.3MA0220-216RR. Epub 2020 May 18.


Hyaluronan (HA) is a glycosaminoglycan that in its natural, high molecular mass (HMM) form, promotes tissue repair and homeostasis. With inflammation, HA metabolism and HMM HA fragmentation to low molecular mass (LMM) forms is greatly enhanced. Considerable evidence suggests that LMM HA may act as a damage-associated molecular pattern to initiate innate immune responses. However, the responsiveness of myeloid cells to LMM HA is controversial and largely unknown for neutrophils. Peripheral blood cells from healthy donors were incubated ex vivo with pharmaceutical grade HA of different molecular mass (HMM, LMM, and HA fragments <10 kDa). Key innate immune functions were assessed, namely production of cytokines and reactive oxygen species release (ROS), granule mobilization, and apoptosis. None of the tested sizes of HA altered cytokine production by PBMC and neutrophils. Also, HA had no effect on neutrophil granule mobilization and apoptosis. In contrast, HA primed neutrophils for rapid and robust release of ROS in response to a secondary stimulus (N-formyl-methionyl-leucyl phenylalanine). Priming occurred within 20 min of exposure to HA and was similar for all tested molecular mass. The observed effect was independent of granule mobilization and associated with the activation of intracellular signaling pathways involving Src family kinases, glycogen synthase kinase-3, and the proline-rich Akt substrate of 40 kDa. Our findings provide new evidence that HA, irrespective of molecular mass, is a specific priming agent of the neutrophil oxidative burst, which is a critical, early component of an innate immune response.

Keywords: NADPH-oxidase; glycosaminoglycans; innate immunity; peripheral blood cells; reactive oxygen species.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Apoptosis / drug effects
  • Apoptosis / immunology
  • Cytokines / metabolism
  • Humans
  • Hyaluronic Acid / metabolism*
  • Hyaluronic Acid / pharmacology
  • Inflammation Mediators / metabolism
  • Leukocytes, Mononuclear / drug effects
  • Leukocytes, Mononuclear / immunology
  • Leukocytes, Mononuclear / metabolism
  • NADPH Oxidases / metabolism
  • Neutrophils / drug effects
  • Neutrophils / immunology*
  • Neutrophils / metabolism*
  • Oxidation-Reduction
  • Phosphorylation
  • Reactive Oxygen Species / metabolism
  • Respiratory Burst / immunology*
  • Signal Transduction


  • Cytokines
  • Inflammation Mediators
  • Reactive Oxygen Species
  • Hyaluronic Acid
  • NADPH Oxidases