Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:3.2.1.36 (hyaluronidase)
 4,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Spinal arachnoiditis, a complication of tuberculous meningitis, is not uncommon; it may develop despite specific chemotherapy and steroids, and existing avenues of treatment for it are unsatisfactory. The enzyme hyaluronidase, by virtue of its action of hydrolysing the glucosaminidic bonds of hyaluronic acid and other mucopolysaccharides of the ground substance, offers a promising mode of treatment. Sixty-six patients with spinal arachnoiditis secondary to tuberculous meningitis were seen over an 8-year period. All these patients received antituberculous drugs and steroids; 39 of them (group A), who, in addition, were given intrathecal hyaluronidase, fared better than the remaining 27 (group B), who did not receive this enzyme. This study was non-randomised. The disability and functional deficit score showed a significant decrease from 7.6 to 3.7 in the enzyme-treated group in contrast to a mild change from 8.1 to 6.9 in the untreated group. Further, in group A the mortality was 5.2% whereas in group B it was 25.9%. There was a marked 5-fold decrease in mean CSF protein in group A while in group B there was no significant change. There were no serious side effects due to repeated administration of intrathecal hyaluronidase. Thus this study provides convincing evidence of the therapeutic role of hyaluronidase in the management of tuberculous spinal arachnoiditis and replicates our earlier observation of the safety of hyaluronidase given intrathecally.
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PMID:Hyaluronidase as an adjuvant in the management of tuberculous spinal arachnoiditis. 185 27

The effect of different treatment regimes on intracranial pressure (ICP), degree of hydrocephalus and clinical outcome was evaluated in 81 children with tuberculous meningitis. 24 children underwent CSF shunting, while 57 with communicating hydrocephalus were randomly assigned to three treatment groups: antituberculous drugs only; or additional intrathecal hyaluronidase or oral acetazolamide and furosemide in addition to antituberculous treatment. The addition of acetazolamide and furosemide was significantly more effective in achieving normal ICP than antituberculous drugs alone. No difference was found in mortality or number of disabled survivors between groups. Of those surviving, nearly two-thirds with stage II tuberculous meningitis were mildly disabled and nearly one-half with stage III were severely disabled at follow-up, emphasising the need for early diagnosis of tuberculous meningitis in the young child.
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PMID:Tuberculous hydrocephalus: comparison of different treatments with regard to ICP, ventricular size and clinical outcome. 206 26

Immunoglobulin A1 (IgA1) proteases may be important virulence factors of certain bacteria involved in the pathogenesis of meningitis, gonorrhea, destructive periodontal diseases, and some other infections affecting mucosal membranes. This study evaluated the antigen-binding activity of free Fab alpha fragments released from human myeloma IgA1 by IgA1 protease from Haemophilus influenzae. Six myeloma proteins with antibody activity against streptolysin O, alpha-staphylolysin, or streptococcal hyaluronidase were used. Complete cleavage of the IgA1 myeloma proteins in the hinge region of the heavy chain did not affect their antigen-binding capacity. The titers of neutralizing activity associated with free Fab alpha fragments were not significantly different from those of the intact IgA1 proteins. The retained antigen-binding capacity of cleaved IgA1 is an important factor in the understanding of how IgA1 proteases may interfere with the immune protection of mucosal membranes.
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PMID:Retained antigen-binding activity of Fab alpha fragments of human monoclonal immunoglobulin A1 (IgA1) cleaved by IgA1 protease. 351 53

A preliminary study to evaluate the efficacy of intrathecal hyaluronidase was carried out in nine children suffering from tuberculous meningitis with communicating hydrocephalus. This was followed by a randomized trial in which five cases were treated with intrathecal hyaluronidase, while six cases were treated by the insertion of a ventriculoperitoneal shunt. No untoward reaction of any significance was noted. The results were judged in terms of improvement in the sensorium and mentation, in specific neurological deficit (e.g., visual impairment and hemiparesis), and in overall functional performance. Although most of the patients receiving hyaluronidase showed some improvement in the sensorium, only one of the nine preliminary cases and one of the five cases in the randomized trial showed a total recovery of function. Two of the six shunted patients, however, showed complete recovery. Shunt insertion led to further improvement in two of the nine preliminary cases who had failed to respond to treatment with hyaluronidase. This preliminary study shows that intrathecal hyaluronidase does, in most cases, lead to an improvement in the sensorium but does not offer any particular advantage over shunt insertion in terms of regression of specific neurological deficit or overall functional improvement.
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PMID:Use of intrathecal hyaluronidase in the management of tuberculous meningitis with hydrocephalus. 375 76

A total of 252 strains of group B streptococci were serotyped and examined for their ability to ferment lactose (lac+), to hydrolyze salicin (sal+), and to produce hyaluronidase (hy+). Of these strains, 67 had been isolated from bacteremia and meningitis in infants less than 2 months old. Eighty-one strains were isolated from bacteremia and meningitis in adults, and 104 strains were from various other infections. Type III was the most common in neonatal disease, especially if isolates from cases of bacteremia in infants less than 10 days of age were not included. Only 6% of the strains were lac+. Sal+/hy+ strains were never type III, but 91% of the strains belonging to the other serotypes were sal+/hy/. Results showed that 81% of the sal+/hy- strains and 95% of the sal-/hy+ strains were type III, and sal-/hy+ strains were more than twice as frequent as sal+/hy- strains in serious neonatal infections, in contrast to the other two disease groups, in which the opposite was found to be the case. These reactions may be used as additional markers in epidemiological studies.
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PMID:Serotypes of group B streptococci and their relation to hyaluronidase production and hydrolysis of salicin. 698 61

Use of subarachnoid/intraventricular administration of hyaluronidase in the treatment of 15 cases of cranial arachnoiditis which occurred as a complication of tuberculous meningitis is reported. Eleven of these cases had communicating hydrocephalus and four had optochiasmatic arachnoiditis. An average of 4.5 injections were administered at weekly to fortnightly intervals. These patients had been followed-up for a mean period of 6.1 months per patient. Serious side effects such as flare-up of the underlying meningitis process, miliary spread of tuberculosis, convulsions or allergic reactions were not observed. Improvement of sensorium and/or neurological deficit was observed in 14 of the 15 cases. A clinically comparable group of 15 cases subjected to shunt surgery (14) and ventricular drainage (1) were considered as "control". This medical method of treatment appears to be superior to shunt surgery and offers a simpler alternative line of management of cranial arachnoiditis/hydrocephalus complicating tuberculous meningitis.
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PMID:Hyaluronidase as an adjuvant in the treatment of cranial arachnoiditis (hydrocephalus and optochiasmatic arachnoiditis) complicating tuberculous meningitis. 746 56

Pneumococcal meningitis in St. Petersburg in the period 1985-1991 occurred in 1.7-2.3 children per 100,000 annually. The most common serotypes among pneumococcal strains isolated from patients with meningitis were 19, 1, 6, 15, and 2, whereas, among the capsulated strains isolated from carriers, type 3 predominated. Only one third of strains from cases of meningitis were highly virulent for mice (types 1, 2, 3). Hyaluronidase was produced by all the 39 studied strains, 22 (84.6 +/- 7.1%) out of 26 strains from patients with otitis media, and only by 15 (11.5 +/- 2.8%) out of 130 strains isolated from carriers. Non-capsulated strains lacked this enzyme. Results of intranasal inoculation of pneumococcal strains with different hyaluronidase activity and addition of exogenous hyaluronidase to strains which did not produce the enzyme confirm the hypothesis that this enzyme plays an important role in bacterial dissemination and breaching of the blood brain barrier by pneumococci. It was concluded that high hyaluronidase activity, presence of capsule, and pneumolysin or serotype (1, 2, and 19) despite hyaluronidase titer, are the most important factors contributing to the development of pneumococcal meningitis. The role of the mouse toxic factor is unclear.
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PMID:A study of pathogenic factors of Streptococcus pneumoniae strains causing meningitis. 771 81

The hyaluronidase activity of pneumococcal strains isolated from 39 patients with purulent meningitis, 26 patients with acute internal otitis and 130 healthy carriers was studied. All strains isolated from patients with purulent meningitis and meningoencephalitis and 84.6% of strains isolated in cases of otitis were found to have hyaluronidase, while in healthy children hyaluronidase-synthesizing strains were detected only in 11.5% of cases. Hyaluronidase titers in pneumococcal strains isolated from patients with meningitis and meningoencephalitis were significantly higher than in strains causing purulent otitis. At the same time strains with high hyaluronidase titers were also isolated from 7% of healthy carriers. Noncapsular pneumococcal strains had no hyaluronidase. The average value of the reverse correlation between hyaluronidase activity and the virulence of strains for mice was established. Hyaluronidase activity did not correlate with different serotypes of pneumococcal strains. The intranasal administration of hyaluronidase in high titers (> or = 1:8) to mice and rats led to the penetration of the infective agent through the hematoencephalic barrier of the animals and to their death from generalized pneumococcal infection. The role of hyaluronidase as the invasiveness factor of pneumococci was confirmed in experiments on the intranasal infection of mice with low active strains mixed with the preparation of exogenous hyaluronidase.
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PMID:[The role of hyaluronidase in the occurrence of a generalized pneumococcal infection]. 785 38

The adhesive capacity of 425 S.pneumoniae strains (S- and R-forms) isolated from children with various clinical forms of pneumococcal infection was studied with the use of the epithelium of oral cavity as a model. The strains isolated from patients with meningitis and otitis appeared to be less adhesive than the strains isolated from mucous membrane of respiratory tracts. In all clinical forms of infections the adhesive capacity of S.pneumoniae S-forms was significantly lower than that of R-forms. The hyaluronidase activity and the adhesive capacity of S.pneumoniae strains were found to be inversely related.
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PMID:[Streptococcus pneumoniae adhesion]. 852 25

Pneumococcal meningitis was registered in St. Petersburg in 1985-1991, morbidity rate being 1.7-2.3 cases per 100,000 children, including 7.4-19.8 cases among children under 1 year. Two thirds of the pneumococcal strains isolated in cases of meningitis belonged to serovars 19, 1, 6, 15 and 2. The comparative study of pneumococcal strains revealed that the presence of capsules, pneumolysin, high hyaluronidase activity or belonging to serovars 1 and 2 (irrespective of their hyaluronidase titers) were the most important factors contributing to the development of generalized infection. The role of such a factor as virulence for mice is not yet clear.
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PMID:[The pathogenicity factors of Streptococcus pneumoniae strains causing meningitis]. 877 29


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