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Engström-Laurent, Anna
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Publications (10 of 22) Show all publications
Hellman, U., Engström-Laurent, A., Larsson, A. & Lindqvist, U. (2019). Hyaluronan concentration and molecular mass in psoriatic arthritis: biomarkers of disease severity, resistance to treatment, and outcome. Scandinavian Journal of Rheumatology
Open this publication in new window or tab >>Hyaluronan concentration and molecular mass in psoriatic arthritis: biomarkers of disease severity, resistance to treatment, and outcome
2019 (English)In: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objective: Low molecular mass hyaluronan causes inflammatory processes and can act as a pro-inflammatory cytokine in skin and other sites of activity in psoriatic arthritis (PsA). This study investigated whether the molecular mass distribution of hyaluronan (HA) in skin and the quantity of circulating HA are related to the clinical inflammatory picture in PsA with active disease and to the effect of treatment with anti-tumour necrosis factor-α (anti-TNF-α) adalimumab.

Methods: Twenty patients with TNF-α-naïve active polyarticular PsA were included in this prospective clinical trial of treatment with 40 mg s.c. adalimumab according to standard procedure. Clinical activity, patients’ assessments, and skin biopsies were captured at inclusion and at the 12 week follow-up. Ten healthy individuals were recruited for comparison of HA analyses. Histochemistry of skin inflammation, serum HA, and molecular mass of HA were determined.

Results: Overall improvements in clinical parameters were observed. Eight of 18 patients reached minimum disease activity after 12 weeks and disease activity was significantly reduced (p < 0.0001). Patients with elevated serum HA values were significantly older, had later onset of arthritis and more deformed joints, still had swollen joints after treatment, and had more circulating inflammatory biomarkers. More severe disease pathology showed a wide spectrum of high-molecular-mass HA accompanied by low mass HA. The treatment appears partly to normalize the HA mass distribution.

Conclusion: HA concentration and mass seem to be two possible factors in the inflammatory pathology of PsA acting as biomarkers for disease severity, resistance to treatment, and worse outcome.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2019
National Category
Rheumatology and Autoimmunity
Research subject
rheumatology
Identifiers
urn:nbn:se:umu:diva-158612 (URN)10.1080/03009742.2019.1577490 (DOI)000471466100001 ()31032710 (PubMedID)
Funder
Swedish Research CouncilSwedish Research Council FormasTorsten Söderbergs stiftelseRagnar Söderbergs stiftelse
Available from: 2019-05-02 Created: 2019-05-02 Last updated: 2019-07-09
Opheim, L. R., Hellman, U., Engström-Laurent, A. & Laurent, C. (2016). Hyaluronan in Human Vocal Folds in Smokers and Nonsmokers: A Histochemical Study. Journal of Voice, 30(3), 255-262
Open this publication in new window or tab >>Hyaluronan in Human Vocal Folds in Smokers and Nonsmokers: A Histochemical Study
2016 (English)In: Journal of Voice, ISSN 0892-1997, E-ISSN 1873-4588, Vol. 30, no 3, p. 255-262Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES/HYPOTHESIS: To study the hyaluronan occurrence in human vocal folds, with special regards to gender and smoking and to discuss the implications of findings.

STUDY DESIGN: This is a descriptive/morphologic study.

METHODS: Sixteen cadaveric vocal folds from eight individuals between 58 and 90 years old (six women and two men) were removed and studied morphologically. Three of the individuals had been cigarette smokers. A direct method for hyaluronan histochemistry using a hyaluronan-binding protein probe (HABP) was used to visualize the polysaccharide. Five examiners performed an analysis of the intensities of hyaluronan staining, independently.

RESULTS: We observed intense hyaluronan staining of the vocal folds of which those from women stained considerably stronger than those from men. Stratified squamous epithelium stained for hyaluronan in all sections, whereas respiratory epithelium only stained weakly or not at all. The highest accumulation of hyaluronan occurred subepithelially in the lamina propria, corresponding to Reinke's space. It was observed that vocal folds from smokers were more intensively stained than those from nonsmokers.

CONCLUSIONS: Hyaluronan is found in all layers of the human vocal fold. Contradictory to earlier studies, hyaluronan was visualized in squamous epithelium, where it may function as an impact protector. The occurrence of hyaluronan in smokers may have implications in the development of vocal fold inflammation and tumor initiation as hyaluronan is an important molecule in these processes.

Keywords
Vocal folds, Hyaluronan, Smoking, Cigarette, Histochemistry
National Category
Cell and Molecular Biology
Identifiers
urn:nbn:se:umu:diva-111028 (URN)10.1016/j.jvoice.2015.05.007 (DOI)000376232400002 ()26471808 (PubMedID)
Available from: 2015-11-02 Created: 2015-11-02 Last updated: 2018-06-07Bibliographically approved
Kerje, S., Hellman, U., Do, L., Larsson, G., Kämpe, O., Engström-Laurent, A. & Lindqvist, U. (2016). Is low molecular hyaluronan an early indicator of disease in avian systemic sclerosis?. Connective Tissue Research, 57(5), 337-346
Open this publication in new window or tab >>Is low molecular hyaluronan an early indicator of disease in avian systemic sclerosis?
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2016 (English)In: Connective Tissue Research, ISSN 0300-8207, E-ISSN 1607-8438, Vol. 57, no 5, p. 337-346Article in journal (Refereed) Published
Abstract [en]

AIM OF THE STUDY: To further elucidate the pathogenesis of systemic sclerosis (SSc) an experimental avian model was used. University of California at Davies line 200-chicken (UCD-200) spontaneously develops a SSc like disease that has most features of human SSc with vascular effects, inflammation, autoimmunity and fibrosis. The first signs of disease in UCD-200 are swelling and ischemic lesions of the comb, a tissue containing high amounts of the glycosaminoglycan hyaluronan. The aim was to evaluate inflammatory and fibrotic processes of the disease with regard to the molecular weight of hyaluronan.

MATERIAL AND METHODS: Comb biopsies from UCD-200 and healthy White Leghorn (WL) chickens as controls at different ages were studied with histochemical localization of hyaluronan, hyaluronidase 1, CD3, IgY and collagen I and III. Hyaluronan molecular weight distribution was estimated with gas phase electrophoretic analysis.

RESULTS: At 2 days of age hyaluronan was visualized in UCD-200 at the dermal part of the comb with no simultaneous staining of Hyal-1. In adult UCD-200 the comb skin was almost totally devoid of hyaluronan compared to WL of the same age. An increase of low molecular weight (LMW) hyaluronan was detected in comb tissue from UCD-200 at 1 day, 1, 2, 4 weeks in contrast to adult animals.

CONCLUSIONS: An early inflammatory process involving LMW hyaluronan was confirmed as a possible profibrotic process. This indicates that hyaluronan might be an important participant in early inflammatory events of SSc in UCD-200 chicken and that disappearance of hyaluronan in skin predisposes to fibrosis.

Place, publisher, year, edition, pages
Taylor & Francis, 2016
Keywords
Avian model, hyaluronan, inflammation, systemic sclerosis, UCD-200 chicken
National Category
Other Basic Medicine Orthopaedics Cell and Molecular Biology
Identifiers
urn:nbn:se:umu:diva-121000 (URN)10.1080/03008207.2016.1182997 (DOI)000383444600002 ()27135250 (PubMedID)
Available from: 2016-05-24 Created: 2016-05-24 Last updated: 2018-06-07Bibliographically approved
Do, L., Dahl, C. P., Kerje, S., Hansell, P., Mörner, S., Lindqvist, U., . . . Hellman, U. (2015). High Sensitivity Method to Estimate Distribution of Hyaluronan Molecular Sizes in Small Biological Samples Using Gas-Phase Electrophoretic Mobility Molecular Analysis.. International Journal of Cell Biology, Article ID 938013.
Open this publication in new window or tab >>High Sensitivity Method to Estimate Distribution of Hyaluronan Molecular Sizes in Small Biological Samples Using Gas-Phase Electrophoretic Mobility Molecular Analysis.
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2015 (English)In: International Journal of Cell Biology, ISSN 1687-8876, E-ISSN 1687-8884, article id 938013Article in journal (Refereed) Published
Abstract [en]

Hyaluronan is a negatively charged polydisperse polysaccharide where both its size and tissue concentration play an important role in many physiological and pathological processes. The various functions of hyaluronan depend on its molecular size. Up to now, it has been difficult to study the role of hyaluronan in diseases with pathological changes in the extracellular matrix where availability is low or tissue samples are small. Difficulty to obtain large enough biopsies from human diseased tissue or tissue from animal models has also restricted the study of hyaluronan. In this paper, we demonstrate that gas-phase electrophoretic molecular mobility analyzer (GEMMA) can be used to estimate the distribution of hyaluronan molecular sizes in biological samples with a limited amount of hyaluronan. The low detection level of the GEMMA method allows for estimation of hyaluronan molecular sizes from different parts of small organs. Hence, the GEMMA method opens opportunity to attain a profile over the distribution of hyaluronan molecular sizes and estimate changes caused by disease or experimental conditions that has not been possible to obtain before.

National Category
Medical Biotechnology (with a focus on Cell Biology (including Stem Cell Biology), Molecular Biology, Microbiology, Biochemistry or Biopharmacy)
Identifiers
urn:nbn:se:umu:diva-111029 (URN)10.1155/2015/938013 (DOI)26448761 (PubMedID)
Available from: 2015-11-02 Created: 2015-11-02 Last updated: 2018-06-07Bibliographically approved
Andersén, P., Bäckström, T., Dahlquist, G., Damber, J.-E., Engström-Laurent, A., Gustafson, Y., . . . Widmark, A. (2014). Svensk medicinsk forskning behöver inte mer styrning. Läkartidningen, 111(22-23), 980-981
Open this publication in new window or tab >>Svensk medicinsk forskning behöver inte mer styrning
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2014 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 111, no 22-23, p. 980-981Article in journal (Other (popular science, discussion, etc.)) Published
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:umu:diva-101461 (URN)24946479 (PubMedID)
Available from: 2015-03-31 Created: 2015-03-31 Last updated: 2018-06-07Bibliographically approved
Hellström, M., Hellström, S., Engström-Laurent, A. & Bertheim, U. (2014). The structure of the basement membrane zone differs between keloids, hypertrophic scars and normal skin: A possible background to an impaired function. Journal of Plastic, Reconstructive & Aesthetic Surgery, 67(11), 1564-1572
Open this publication in new window or tab >>The structure of the basement membrane zone differs between keloids, hypertrophic scars and normal skin: A possible background to an impaired function
2014 (English)In: Journal of Plastic, Reconstructive & Aesthetic Surgery, ISSN 1748-6815, E-ISSN 1532-1959, Vol. 67, no 11, p. 1564-1572Article in journal (Refereed) Published
Abstract [en]

Scar tissues were collected from patients with keloids, hypertrophic scars and mature scars. Normal skin was obtained from healthy individuals. Clinical attributes were used to select which tissue to obtain but the distribution of the specific hyaluronan (HA) staining was then used for the definite classification of the various scar types. Light microscopic and ultrastructural analyses were performed with an HA-binding probe, antibodies for collagen I and III and staining for mast cells. Ultrastructural studies of keloids revealed an altered collagen structure in the dermal layers, with an abundance of collagen fibres of similar diameter in both the reticular dermis (RD) and the papillary dermis (PD) compared to normal skin. Furthermore, the keloids displayed epidermal changes, which involved the basement membrane (BM), with fewer hemidesmosomes and an altered shape of desmosomes in the entire enlarged spinous layer. The frequency of mast cells found in keloids was lower than in other scar tissues and normal skin. These alterations in epidermis could influence the hydrodynamic and cell regulatory properties of the wounded skin with impaired function and insufficient regulative capacity to hinder the ever-growing collagen tissue that is characteristic for keloids. (C) 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Keywords
Human skin, Keloids, Hyaluronan, Collagens, Hypertrophic scar, Mast cells
National Category
Surgery
Identifiers
urn:nbn:se:umu:diva-98448 (URN)10.1016/j.bjps.2014.06.014 (DOI)000345527100028 ()2-s2.0-84908250348 (Scopus ID)
Available from: 2015-02-03 Created: 2015-01-22 Last updated: 2018-06-07Bibliographically approved
Lindqvist, U., Pihl-Lundin, I. & Engström Laurent, A. M. (2012). Dermal Distribution of Hyaluronan in Psoriatic Arthritis: Coexistence of CD44, MMP3 and MMP9. Acta Dermato-Venereologica, 92(4), 372-377
Open this publication in new window or tab >>Dermal Distribution of Hyaluronan in Psoriatic Arthritis: Coexistence of CD44, MMP3 and MMP9
2012 (English)In: Acta Dermato-Venereologica, ISSN 0001-5555, E-ISSN 1651-2057, Vol. 92, no 4, p. 372-377Article in journal (Refereed) Published
Abstract [en]

Psoriatic arthritis is a chronic systemic disease in which patients develop persistent inflammation of the skin and joints, leading to disability and joint damage. The extracellular component hyaluronan (HA) plays an important role in regulatory processes such as inflammation, wound healing and tumour progression. At any site of inflammation HA can be depolymerized to low-molecular weight fragments, which, in turn, induce an array of inflammatory mediators that can lead to chronic inflammation. This study describes the serum concentration and dermal distribution of HA, its receptor CD44 and the metalloproteinases 3 and 9 in skin biopsies from patients with different types of psoriatic arthritis. Fifty-one patients with psoriatic arthritis were included in the study and classified as oligo- or poly-arthritic PsA with and without treatment. Biopsies were obtained from both involved and non-involved skin and compared with biopsies from healthy individuals. Serum HA was analysed for estimation of the total turnover of HA. The main findings were an overall redistribution of HA in both involved and non-involved psoriatic skin and an epidermal imbalance between HA and CD44. The structurally and functionally important basement membrane zone was found to be disintegrated and devoid of HA irrespective of the type of articular involvement, treatment or skin affection.

Place, publisher, year, edition, pages
Uppsala: Acta Dermato-Venereologica, 2012
Keywords
hyaluronan, CD44, MMPs, psoriatic arthritis, basement membrane, inflammation
National Category
Dermatology and Venereal Diseases
Identifiers
urn:nbn:se:umu:diva-57827 (URN)10.2340/00015555-1286 (DOI)000306575400012 ()
Available from: 2012-08-17 Created: 2012-08-16 Last updated: 2018-06-08Bibliographically approved
Hellström, M., Engström-Laurent, A., Mörner, S. & Johansson, B. (2012). Hyaluronan and collagen in human hypertrophic cardiomyopathy: a morphological analysis. Cardiology Research and Practice, 2012, 545219
Open this publication in new window or tab >>Hyaluronan and collagen in human hypertrophic cardiomyopathy: a morphological analysis
2012 (English)In: Cardiology Research and Practice, ISSN 2090-8016, E-ISSN 2090-0597, Vol. 2012, p. 545219-Article in journal (Refereed) Published
Abstract [en]

The hypertrophic cardiomyopathy (HCM) disease process is not only limited to cardiomyocyte abnormalities but also engages the extracellular matrix. Hyaluronan (HA) and its receptor CD44 are involved in cellular growth and tissue proliferation but have so far been less studied in myocardial hypertrophy. In HCM, collagens are abundant but their histological distribution and relation to hyaluronan have not been described. Material and Methods. Myocardial specimens from 5 patients with symptomatic left ventricular tract obstruction undergoing myectomy due to HCM were processed for histochemistry and immunohistochemistry. Results. HA staining was more intense in HCM patients. The histological distribution of HA was the same in patients and controls, that is, interstitial staining including the space between cardiomyocytes, in fibrous septa, and in the adventitia of intramyocardial blood vessels. CD44 was not detected in the myocardium of patients or controls. Collagen I showed the same general localisation as HA but detailed distribution differed. Conclusions. This is the first study that describes the distribution of hyaluronan in human HCM. HA staining is more intense in HCM patients but without coexpression of its receptor CD44, at least not in the chronic phase of HCM. HA and collagen I have the same localisation.

National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-65089 (URN)10.1155/2012/545219 (DOI)22900226 (PubMedID)
Available from: 2013-02-05 Created: 2013-02-05 Last updated: 2019-05-08Bibliographically approved
Engström-Laurent, A., Johansson, P., Jacobsson, L., Lohmander, S., Palmér, M., Turesson, C. & Wallensten, R. (2012). [More equal care with new guidelines for musculoskeletal disorders].. Läkartidningen, 109(22), 1102
Open this publication in new window or tab >>[More equal care with new guidelines for musculoskeletal disorders].
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2012 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 109, no 22, p. 1102-Article in journal (Refereed) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-65088 (URN)22808662 (PubMedID)
Available from: 2013-02-05 Created: 2013-02-05 Last updated: 2018-06-08Bibliographically approved
Johansson, B., Holmgren, A., Hedström, M., Engström-Laurent, A. & Engström, K. G. (2011). Evaluation of hyaluronan and calcifications in stenotic and regurgitant aortic valves.. European Journal of Cardio-Thoracic Surgery, 39(1), 27-32
Open this publication in new window or tab >>Evaluation of hyaluronan and calcifications in stenotic and regurgitant aortic valves.
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2011 (English)In: European Journal of Cardio-Thoracic Surgery, ISSN 1010-7940, E-ISSN 1873-734X, Vol. 39, no 1, p. 27-32Article in journal (Refereed) Published
Abstract [en]

Objective: Hyaluronan (HA) is a major component of the interstitium and has been observed in normal heart valves. The function of HA in heart valves is unknown but contribution to biomechanical function has been proposed. The purpose of this investigation was to study the distribution of HA in relation to calcifications in diseased human aortic valves. Methods: Human aortic valves were collected at aortic valve replacement, of whom nine patients had regurgitation and 13 stenotic disease. The valves were decalcified and stained for the visualisation of HA. The specimens were macroscopically evaluated for magnitude of calcification using image analysis. The microscopic amount and distribution of HA and calcifications were semiquantitatively evaluated using histochemistry. Results: The overall HA staining showed an inverse relationship against the magnitude of observed valve calcifications (p<0.001) and type of disease (p=0.014). Multiple-group comparison revealed regionally reduced HA staining in diffuse and heavy calcified regions inside the valve (both p<0.001) compared with normal-structured parts of the valve. HA was concentrated on the ventricular side of the valve (p=0.002). Conclusions: The content of HA was reduced in calcified aortic valves and had a heterogeneous distribution, potentially contributing to poor valve function. HA may also be involved in the pathophysiological process in degenerative aortic stenosis.

Place, publisher, year, edition, pages
Elsevier, 2011
Keywords
Hyaluronan, Aortic stenosis, Human
National Category
Surgery
Research subject
Surgery
Identifiers
urn:nbn:se:umu:diva-35696 (URN)10.1016/j.ejcts.2010.04.024 (DOI)20627752 (PubMedID)
Available from: 2010-08-31 Created: 2010-08-31 Last updated: 2018-06-08Bibliographically approved
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