الفهرس 
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Abstract
Tobacco remains the second major cause of preventable death in the world and fourth most common risk factor for disease worldwide. Increases in hyaluronate concentrations have been noticed during injury and repair processes in lung tissue, suggesting that hyaluronate may be a biochemical marker for lung injury. Objective: To determine the relationship between serum hyaluronate level as a marker of lung injury and passive smoking in asthmatic patients and to compare the results of some pulmonary function tests in asthmatic patients who are exposed to passive smoking and those who are not exposed. Methods: Forty eight asthmatic patients attending chest outpatient clinics in both Suez Canal University hospital and Ismailia chest hospital were subjected to the present study. 24 asthmatic patients with history of passive smoking represented (group 1) and equal number without this history represented (group 2). A third group (group 3) included 6 subjects with a negative history of passive smoking and bronchial asthma was added to serve as control. Spirometric dynamic parameters (% predicted FVC, FEV1, FEV1/ FVC%, FEF 25-75%) , serum hyaluronic acid concentrations and salivary cotinine level were determined for all study subjects. Results: Asthmatic passive smokers had statistically significant reduction in mean % predicted FVC ,% predicted FEV1,% predicted FEV1/FVC% and% predicted FEF 25-75 compared to control group. Salivary cotinine level had statistically significant negative correlation with the previous parameters except % predicted FEV1/FVC%, while Serum hyaluronate had statistically significant negative correlation with all these parameters. Salivary cotinine level had statistically significant negative correlation with the measured spirometric dynamic parameters except % predicted FEV1/FVC% ,while Serum hyaluronate had statistically significant negative correlation with all these parameters) and statistically significant positive correlation with salivary cotinine. Conclusion: serum hyaluronate level is affected by increased cotinine levels more than spirometric dynamic parameters in asthmatic patients, so it can used as a marker of their lung injury.