MUCOLYTIC ENZYMES 



rate entities, since the enzyme sijlittincf chondrf)itin sulfate is absent 

 in pneumococcal hyahnonidase preparations. Furthermore, by 

 treatment with acetone, the former may be destroyed in testicular 

 preparations without affecting the hyaluronidase activity. The con- 

 centration of hyaluronidase in testis apparently is far smaller than that 

 found in the leech and probably than that found in some snake venoms. 



Hyaluronidase in the testis or, more specifically, in spermatozoa 

 plays an important role in fertilization, as was shown recently (11,20). 

 The cumulus cells surrounding the ovum are embedded in a jelly 

 which apparently contains hyaluronic acid. This jelly is liquefied by 

 hyaluronidase furnished by a sufficiently large number of spermatozoa. 

 Fertilization then can proceed by a single spermatozoon. 



In the skin — probably the largest store of hyaluronidase in the 

 body — the enzyme, although generally present in an inactive form 

 (27), may be supposed to regulate the velocity of water and metabolite 

 exchange by decreasing the viscosity of the intercellular matrix. 



Clinically, the role of hyaluronic acid and hyaluronidase is yet 

 little explored. Hyaluronic acid concentration appears to be greatly 

 increased in some exudates of the joints. Injection of hyaluronidase 

 into pathological joints lowered the viscosity of the exudates, without 

 permanently improving the pathological condition (37). A dis- 

 appearance of ganglia of the tendon sheaths likewise has been noted on 

 injection of hyaluronidase. Intraperitoneal hyaluronidase injection 

 was used in a case of mesenthelioma of the pleura and peritoneum, 

 to facilitate the removal of a fluid of honeylike consistency: without 

 hyaluronidase injection, paracentesis was incomplete and very difficult; 

 after injection of purified testicular hyaluronidase, a fluid of low 

 viscosity could be completely removed in a short time. The con- 

 tinued injection of large quantities of hyaluronidase apparently had no 

 harmful effects. The continued growth of the malignant tumor 

 finally caused the death of the patient (Stewart and Meyer, unpub- 

 lished experiments). 



Testicular preparations containing hyaluronidase in high 

 concentrations have been shown to lower the high erythrocyte sedi- 

 mentation rate when added to the blood of patients with rheumatic 

 fever and other diseases. This effect, which has all characteristics of 

 an enzymic reaction, does not seem to be due to a proteolytic action 

 on any of the plasma proteins. At present, it is doubtful, however, 



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