{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T06:25:21Z","timestamp":1778135121234,"version":"3.51.4"},"reference-count":48,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000066","name":"National Institute of Environmental Health Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000066","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Low molecular\u2010weight hyaluronic acid (LMW\u2010HA) is produced by the degradation of high\u2010molecular\u2010weight hyaluronic acid at the pulmonary interstitium and alveolar epithelium by reactive intermediates following lung injury. We aimed to investigate the role of bronchoalveolar lavage (BAL) LMW\u2010HA as a biomarker of pediatric chronic pulmonary aspiration (CPA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Single\u2010center prospective comparison of LMW\u2010HA presence in BAL in pediatric Aerodigestive patients with and without CPA undergoing clinically indicated bronchoscopy. Pediatric pulmonologists diagnosed CPA based on video\u2010fluoroscopic swallowing evaluation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifteen children (mean age 6.1 years, male predominance at 73%, and 53% with CPA) were enrolled. Children with CPA have comparable baseline characteristics (age, sex, and race), but their BAL had higher white blood cell count, higher neutrophil percentages, higher bacterial culture positivity rates, and lower macrophage percentages than those without CPA. The two groups were comparable in sex, BAL lymphocyte percentages, eosinophil percentages, red blood cell counts, and lipid\u2010laden macrophage positivity. Detection of BAL LMW\u2010HA in the BAL had a 100% specificity and 88% sensitivity for CPA diagnosis. BAL protein levels were higher in the CPA group and in participants with positive LMW\u2010HA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We suggest BAL LMW\u2010HA as a potential novel biomarker of pediatric CPA with high specificity and sensitivity. BAL LMW\u2010HA is not detectable in subjects without CPA and is associated with increased BAL protein levels.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.71070","type":"journal-article","created":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T20:44:36Z","timestamp":1743367476000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Pediatric Chronic Pulmonary Aspiration Is Associated With Low Molecular Weight Hyaluronic Acid in the Bronchoalveolar Lavage"],"prefix":"10.1002","volume":"60","author":[{"given":"Ammar Saadoon","family":"Alishlash","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Heersink School of Medicine University of Alabama at Birmingham Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhihong","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, Heersink School of Medicine 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