Antibodies to group A streptococcal virulence factors, SIC and DRS, increase predilection to GAS pyoderma

BMC Infectious Diseases

Kadaba S Sriprakash³  Niwrutti K Hase²  Uday Khopkar²  Preeti R Mehta²  Ainslie Cameron¹  Gouri P Hule²  Mohan G Karmarkar² 

[1] Present Address: Griffith University, Gold Coast Campus, Gold Coast, QLD, Australia;KEM Hospital, Mumbai, India;QIMR Berghofer Medical Centre, 300, Herston road, Brisbane 4006, QLD, Australia

关键词: Streptococcal inhibitor of complement;    Pyoderma;    Post streptococcal glomerulonephritis;    Streptococcus pyogenes;   

Others  :  1135643
DOI  :  10.1186/s12879-015-0857-4

 received in 2014-09-03, accepted in 2015-02-20,  发布年份 2015

【 摘 要 】

Background

Streptococcus pyogenes (group A streptococcus; GAS) is an etiological agent for pharyngitis, pyoderma, and invasive infections in humans. Pharyngitis and pyoderma may lead to serious immune sequelae such as rheumatic heart disease and post-streptococcal glomerulonephritis (PSGN). Streptococcal Inhibitor of Complement (SIC) and its orthologue, distantly related to SIC (DRS), are virulence factors expressed by only four of more than 100 M types of GAS. These four types (M1, M57, M12 and M55) are among the M types, which are associated with PSGN. In several populations PSGN has been shown to be a risk factor for chronic kidney disease (CKD) and end-stage renal disease (ESRD). Previous studies showed SIC or DRS antibody-prevalence was associated with PSGN, and seroprevalence of SIC antibodies is significantly high among CKD and ESRD patients in Mumbai.

Methods

Streptococcal isolates recovered from GAS pyoderma cases were typed. Seropositivity for SIC and DRS antibodies in subjects with pyoderma, PSGN pediatric cases, age matched healthy controls and non-GAS pyoderma cases were determined.

Results

We confirm in this study an association between seroprevalence to SIC and DRS antibodies, and PSGN in Mumbai population despite low point prevalence of M1, M12, M55 and M57. In addition we extended the study to GAS-pyoderma and non-GAS pyoderma cases. To our surprise, we found a positive association between the seroprevalence to SIC and DRS antibodies, and GAS-pyoderma owing to infection with diverse M types. The mechanism of increased predisposition to pyoderma owing to infection by diverse GAS among SIC or DRS antibody-positive population is not clear. Nonetheless, our findings could be explained by a phenomenon akin to antibody-dependent enhancement (ADE).

Conclusions

This is the first report showing a small number of GAS M types conferring predisposition to pyoderma by diverse types. Implications of this ADE-like phenomenon are discussed in the light of evolutionary advantage to GAS, vaccine design and control of renal diseases.

【 授权许可】

   
2015 Karmarkar et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

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