Clinical Applications of Hyaluronidase

  • Gregor Cornelius Weber
  • Bettina Alexandra Buhren
  • Holger Schrumpf
  • Johannes Wohlrab
  • Peter Arne GerberEmail author
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 1148)


Hyaluronidases are enzymes that degrade hyaluronic acid, which constitutes an essential part of the extracellular matrix. Initially discovered in bacteria, hyaluronidases are known to be widely distributed in nature and have been found in many classes including insects, snakes, fish and mammals. In the human, six different hyaluronidases, HYAL1-4, HYAL-P1 and PH-20, have been identified. PH-20 exerts the strongest biologic activity, is found in high concentrations in the testicles and can be localized on the head and the acrosome of human spermatozoa. Today, animal-derived bovine or ovine testicular hyaluronidases as well as synthetic hyaluronidases are clinically applied as adjuncts to increase the bioavailability of drugs, for the therapy of extravasations, or for the management of complications associated with the aesthetic injection of hyaluronic acid-based fillers. Further applications in the fields of surgery, aesthetic medicine, immunology, oncology, and many others can be expected for years to come. Here, we give an overview over the molecular and cellular mode of action of hyaluronidase and the hyaluronic acid metabolism, as well as over current and potential future clinical applications of hyaluronidase.


Hylase Hyaluronic acid Hyaluronan Filler Spreading factor Extravasation Bioavailability 





Bovine testicular hyaluronidase


Chinese hamster ovary


Cohesive polydensified matrix




Extracellular matrix




Food and Drug Administration






Hyaluronan synthase






Subcutaneous immunoglobulins


International units








Local anesthetic


Monoclonal antibody






Ovine testicular hyaluronidase


PEGylated recombinant human hyaluronidase






Recombinant human hyaluronidase

S. aureus

Staphylococcus aureus


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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Gregor Cornelius Weber
    • 1
  • Bettina Alexandra Buhren
    • 1
  • Holger Schrumpf
    • 1
  • Johannes Wohlrab
    • 2
    • 3
  • Peter Arne Gerber
    • 1
    Email author
  1. 1.Department of Dermatology, Medical FacultyHeinrich Heine University DüsseldorfDüsseldorfGermany
  2. 2.Department of Dermatology and VenereologyMartin Luther University Halle-WittenbergHalle (Saale)Germany
  3. 3.Institute of Applied DermatopharmacyMartin Luther University Halle-WittenbergHalle (Saale)Germany

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