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Ground Substance in the Nose in Health and Infection.Eugene S. Hopp, M.D., and Helen F. Burn, M.S. (by invitation).
Hopp and Burn present the evidence thus far accumulated by themselves and others relating to the permeability of the ground substance in nasal tissues under varying conditions and the factors which permit certain bacteria to penetrate and spread. Spreading factors, notably hyaluronidase, seem to be more abundant in staphylococci than in most streptococci, which enhances their invasive potentialities. The hyaluronidase posseses the ability to depolymerize the hyaluronic acid in connective tissue, thus favoring the spread of infection. These findings resulted from comparative multiple stain techniques of serially sectioned biopsy specimens of turbinates from normal persons and from patients with infection. The authors conclude that since hyaluronidase is most active in the range of normal, slightly acidic nasal pH, the accepted concept of alteration of nasal pH to the alkaline side
Schenck HP, Maxwell JH, Salinger S. AMERICAN LARYNGOLOGICAL ASSOCIATION. AMA Arch Otolaryngol. 1959;69(2):229–239. doi:10.1001/archotol.1959.00730030235020