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How does hyaluronic acid affect the ground substance of connective tissue?

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Collagenous fibers — connective tissue Randomly oriented collagenous fibers of varying size in a thin spread of loose areolar connective tissue (magnified about 370 ×).

Hyaluronic acid is a primary constituent of the amorphous ground substance in connective tissue, where it functions as a glycosaminoglycan to influence the material's physical properties.12

Because hyaluronic acid is a viscous substance, it contributes to the ground substance's consistency, which typically exists as a highly hydrated thin gel or a viscous solution. By maintaining this viscosity, it helps regulate the exchange of materials between blood and tissue cells, as all substances must pass through this medium. Furthermore, its physical presence acts as a barrier that limits the spread of particulates within the tissues.1

The structural integrity of the ground substance can be altered by hyaluronidase, an enzyme produced by certain bacteria that breaks down hyaluronic acid into smaller subunits. This degradation reduces the viscosity of the ground substance, which can increase tissue permeability and facilitate the spread of bacterial infections.1