Seroprevalence of Streptococcal Inhibitor of Complement (SIC) suggests association of streptococcal infection with chronic kidney disease

BMC Nephrology

Kadaba Srinivasa Sriprakash²  Scott Robert Walter³  Preeti Rajeev Mehta¹  Niwrutti Khandu Hase¹  Gouri Pandharinath Hule¹  Mohan Ganesh Karmarkar¹ 

[1] King Edward Memorial Hospital, Mumbai, India;Bacterial Pathogenesis Laboratory, Queensland Institute of Medical Research, Brisbane, Queensland 4006, Australia;Centre for Health Systems and Safety Research, University of New South Wales, Sydney, Australia

关键词: Streptococcal inhibitor of complement;    Streptococcus pyogenes;    Protein creatinine ratio;    End-stage renal disease;    Chronic kidney disease;    Post streptococcal glomerulonephritis;   

Others  :  1082938
DOI  :  10.1186/1471-2369-14-101

 received in 2012-12-30, accepted in 2013-05-03,  发布年份 2013

【 摘 要 】

Background

Group A streptococcus (GAS) is an etiological agent for the immune mediated sequela post streptococcal glomerulonephritis (PSGN). In some populations PSGN is recognized as a risk factor for chronic kidney disease (CKD) and end-stage renal disease (ESRD). It was found that a significantly greater proportion of subjects with past history of PSGN than without the history exhibited seroreactions to streptococcal antigens called streptococcal inhibitor of complement (SIC) and to distantly related SIC (DRS). These antigens are expressed by major PSGN-associated GAS types. We therefore predicted that in populations such as India, which is endemic for streptococcal diseases and which has high prevalence of CKD and ESRD, greater proportions of CKD and ESRD patients exhibit seroreaction to SIC and DRS than healthy controls.

Methods

To test this we conducted a SIC and DRS seroprevalence study in subjects from Mumbai area. We recruited 100 CKD, 70 ESRD and 70 healthy individuals.

Results

Nineteen and 35.7% of CKD and ESRD subjects respectively were SIC antibody-positive, whereas only 7% of healthy cohort was seropositive to SIC. Furthermore, significantly greater proportion of the ESRD patients than the CKD patients is seropositive to SIC (p=0.02; odds ratio 2.37). No association was found between the renal diseases and DRS-antibody-positivity.

Conclusions

Past infection with SIC-positive GAS is a risk factor for CKD and ESRD in Mumbai population. Furthermore, SIC seropositivity is predictive of poor prognosis of CKD patients.

【 授权许可】

   
2013 Karmarkar et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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