Hyaluronic Acid Utilization by Hemolytic Streptococci in Relation to Possible Hyaluronidase Function in Pathogenesis

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Abstract
Hemolytic streptococcal strains, virulent for chick embryos, can utilize hyaluronic acid for respiration to a greater extent than relatively avirulent strains. The hydrolytic products of the micro-organisms tested, and not hyaluronate itself, are utilized in respiration, such hydrolysis occurring presumably through the agency of hyaluronidase. Potentially pathogenic bacteria (Diplococcus pneumoniae Staphylococcus aureus, Mycobacterium tuberculosis, Corynebacterium diphtheriae, Hemophilus influenzae, H. pertussis) frequently found associated with group A streptococci in vivo had a synergistic relationship with the latter in utilizing hyaluronate as a substrate for energy. The animal body, unlike bacteria, is relatively unable to utilize a most important hydrolytic product of hyaluronic acid, namely, N-acetylglucosamine. A mechanism of pathogenesis by hemolytic streptococci alone and with associated agents of infection is proposed, and certain clinical findings, interpreted as evidence for the existence of such a process, are cited.

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