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as well as being a hyaluronidase, and signalling from the matrix via CD44 modulates cellular
activity. 28 Also, hyaluronic acid can itself modulate signalling by growth factors such as
TGF b . 29 It is therefore possible that loss of the molecule due to bacterial hyaluronidase causes
condensation because of effect on signalling rather than by purely mechanical means. The
simple mechanism depicted in Figure 14.7 , though attractive, should therefore be viewed
with appropriate caution.
It must be stressed that the mechanisms of adhesion and of elimination of interstitial
matrix are not mutually exclusive and both are likely to operate together in most instances.
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