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Brouwer S, Rivera-Hernandez T, Curren BF, Harbison-Price N, De Oliveira DMP, Jespersen MG, Davies MR, Walker MJ. Pathogenesis, epidemiology and control of Group A Streptococcus infection. Nat Rev Microbiol 2023; 21:431-447. [PMID: 36894668 PMCID: PMC9998027 DOI: 10.1038/s41579-023-00865-7] [Citation(s) in RCA: 56] [Impact Index Per Article: 56.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2023] [Indexed: 03/11/2023]
Abstract
Streptococcus pyogenes (Group A Streptococcus; GAS) is exquisitely adapted to the human host, resulting in asymptomatic infection, pharyngitis, pyoderma, scarlet fever or invasive diseases, with potential for triggering post-infection immune sequelae. GAS deploys a range of virulence determinants to allow colonization, dissemination within the host and transmission, disrupting both innate and adaptive immune responses to infection. Fluctuating global GAS epidemiology is characterized by the emergence of new GAS clones, often associated with the acquisition of new virulence or antimicrobial determinants that are better adapted to the infection niche or averting host immunity. The recent identification of clinical GAS isolates with reduced penicillin sensitivity and increasing macrolide resistance threatens both frontline and penicillin-adjunctive antibiotic treatment. The World Health Organization (WHO) has developed a GAS research and technology road map and has outlined preferred vaccine characteristics, stimulating renewed interest in the development of safe and effective GAS vaccines.
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Affiliation(s)
- Stephan Brouwer
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
- Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Queensland, Australia
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia
| | | | - Bodie F Curren
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
- Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Nichaela Harbison-Price
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
- Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Queensland, Australia
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia
| | - David M P De Oliveira
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
- Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Queensland, Australia
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia
| | - Magnus G Jespersen
- Department of Microbiology and Immunology, The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Mark R Davies
- Department of Microbiology and Immunology, The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Mark J Walker
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia.
- Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Queensland, Australia.
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia.
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Haliloglu Y, Ozcan A, Erdem S, Azizoglu ZB, Bicer A, Ozarslan OY, Kilic O, Okus FZ, Demir F, Canatan H, Karakukcu M, Uludag SZ, Kutuk MS, Unal E, Eken A. Characterization of cord blood CD3 + TCRVα7.2 + CD161 high T and innate lymphoid cells in the pregnancies with gestational diabetes, morbidly adherent placenta, and pregnancy hypertension diseases. Am J Reprod Immunol 2022; 88:e13555. [PMID: 35452164 DOI: 10.1111/aji.13555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 03/07/2022] [Accepted: 04/12/2022] [Indexed: 11/28/2022] Open
Abstract
PROBLEM Although pregnant women with gestational diabetes (GD), morbidly adherent placenta (MAP), and pregnancy hypertension (pHT) diseases lead to intrauterine growth restriction (IUGR), little is known about their effect on mucosal-associated invariant T (MAIT) and innate lymphoid cells (ILC) in the umbilical cord. This study aimed to quantify and characterize MAIT cells and ILCs in the cord blood of pregnant women with GD, MAP, and pHT diseases. METHOD OF STUDY Cord blood mononuclear cells (CBMCs) were isolated by Ficoll-Paque gradient. CD3+ TCRVα7.2+ CD161high cells and ILC subsets were quantified by flow cytometry. CBMCs were stimulated with PMA/Ionomycin and Golgi Plug for 4 h and stained for IFN-γ, TNF-α, and granzyme B. The stained cells were analyzed on FACS ARIA III. RESULTS Compared with healthy pregnancies, in the cord blood of the pHT group, elevated number of lymphocytes was observed. Moreover, the absolute number of IFN-γ producing CD4+ or CD4- subsets of CD3+ TCRVα7.2+ CD161high cells as well as those producing granzyme B were significantly elevated in the pHT group compared to healthy controls suggesting increased MAIT cell activity in the pHT cord blood. Similarly, in the MAP group, the absolute number of total CD3+ TCRVα7.2+ CD161high cells, but not individual CD4+ or negative subsets, were significantly increased compared with healthy controls' cord blood. Absolute numbers of total CD3+ TCRVα7.2+ CD161high cells and their subsets were comparable in the cord blood of the GD group compared with healthy controls. Finally, the absolute number of total ILCs and ILC3 subset were significantly elevated in only pHT cord blood compared with healthy controls. Our data also reveal that IFN-γ+ or granzyme B+ cell numbers negatively correlated with fetal birth weight. CONCLUSIONS CD3+ TCRVα7.2+ CD161high cells and ILCs show unique expansion and activity in the cord blood of pregnant women with distinct diseases causing IUGR and may play roles in fetal growth restriction.
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Affiliation(s)
- Yesim Haliloglu
- Department of Medical Biology, School of Medicine, Erciyes University, Kayseri, Turkey.,Betül-Ziya Eren Genome and Stem Cell Center (GENKOK), Kayseri, Turkey
| | - Alper Ozcan
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, School of Medicine, Erciyes University, Kayseri, Turkey
| | - Serife Erdem
- Department of Medical Biology, School of Medicine, Erciyes University, Kayseri, Turkey.,Betül-Ziya Eren Genome and Stem Cell Center (GENKOK), Kayseri, Turkey
| | - Zehra Busra Azizoglu
- Department of Medical Biology, School of Medicine, Erciyes University, Kayseri, Turkey.,Betül-Ziya Eren Genome and Stem Cell Center (GENKOK), Kayseri, Turkey
| | - Ayten Bicer
- Department of Medical Biology, School of Medicine, Erciyes University, Kayseri, Turkey.,Betül-Ziya Eren Genome and Stem Cell Center (GENKOK), Kayseri, Turkey
| | - Ozcan Yeniay Ozarslan
- Department of Medical Biology, School of Medicine, Erciyes University, Kayseri, Turkey.,Betül-Ziya Eren Genome and Stem Cell Center (GENKOK), Kayseri, Turkey
| | - Omer Kilic
- Department of Medical Biology, School of Medicine, Erciyes University, Kayseri, Turkey.,Betül-Ziya Eren Genome and Stem Cell Center (GENKOK), Kayseri, Turkey
| | - Fatma Zehra Okus
- Department of Medical Biology, School of Medicine, Erciyes University, Kayseri, Turkey.,Betül-Ziya Eren Genome and Stem Cell Center (GENKOK), Kayseri, Turkey
| | - Fatma Demir
- Department of Medical Biology, School of Medicine, Erciyes University, Kayseri, Turkey.,Betül-Ziya Eren Genome and Stem Cell Center (GENKOK), Kayseri, Turkey
| | - Halit Canatan
- Department of Medical Biology, School of Medicine, Erciyes University, Kayseri, Turkey.,Betül-Ziya Eren Genome and Stem Cell Center (GENKOK), Kayseri, Turkey
| | - Musa Karakukcu
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, School of Medicine, Erciyes University, Kayseri, Turkey
| | - Semih Zeki Uludag
- Department of Obstetrics and Gynecology, School of Medicine, Erciyes University, Kayseri, Turkey
| | - M Serdar Kutuk
- Department of Obstetrics and Gynecology, School of Medicine, Bezmi Alem University, Istanbul, Turkey
| | - Ekrem Unal
- Betül-Ziya Eren Genome and Stem Cell Center (GENKOK), Kayseri, Turkey.,Department of Pediatrics, Division of Pediatric Hematology and Oncology, School of Medicine, Erciyes University, Kayseri, Turkey.,Department of Blood Banking and Transfusion Medicine, Health Science Institution, Erciyes University, Kayseri, Turkey
| | - Ahmet Eken
- Department of Medical Biology, School of Medicine, Erciyes University, Kayseri, Turkey.,Betül-Ziya Eren Genome and Stem Cell Center (GENKOK), Kayseri, Turkey
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Anderson J, Imran S, Frost HR, Azzopardi KI, Jalali S, Novakovic B, Osowicki J, Steer AC, Licciardi PV, Pellicci DG. Immune signature of acute pharyngitis in a Streptococcus pyogenes human challenge trial. Nat Commun 2022; 13:769. [PMID: 35140232 PMCID: PMC8828729 DOI: 10.1038/s41467-022-28335-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 01/18/2022] [Indexed: 01/27/2023] Open
Abstract
Streptococcus pyogenes causes at least 750 million infections and more than 500,000 deaths each year. No vaccine is currently available for S. pyogenes and the use of human challenge models offer unique and exciting opportunities to interrogate the immune response to infectious diseases. Here, we use high-dimensional flow cytometric analysis and multiplex cytokine and chemokine assays to study serial blood and saliva samples collected during the early immune response in human participants following challenge with S. pyogenes. We find an immune signature of experimental human pharyngitis characterised by: 1) elevation of serum IL-1Ra, IL-6, IFN-γ, IP-10 and IL-18; 2) increases in peripheral blood innate dendritic cell and monocyte populations; 3) reduced circulation of B cells and CD4+ T cell subsets (Th1, Th17, Treg, TFH) during the acute phase; and 4) activation of unconventional T cell subsets, γδTCR + Vδ2+ T cells and MAIT cells. These findings demonstrate that S. pyogenes infection generates a robust early immune response, which may be important for host protection. Together, these data will help advance research to establish correlates of immune protection and focus the evaluation of vaccines.
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Affiliation(s)
- Jeremy Anderson
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Samira Imran
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Hannah R Frost
- Murdoch Children's Research Institute, Melbourne, Australia
| | | | - Sedigheh Jalali
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Boris Novakovic
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Joshua Osowicki
- Murdoch Children's Research Institute, Melbourne, Australia.
- Department of Paediatrics, University of Melbourne, Melbourne, Australia.
- Infectious Diseases Unit, Department of General Medicine, The Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia.
| | - Andrew C Steer
- Murdoch Children's Research Institute, Melbourne, Australia.
- Department of Paediatrics, University of Melbourne, Melbourne, Australia.
- Infectious Diseases Unit, Department of General Medicine, The Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia.
| | - Paul V Licciardi
- Murdoch Children's Research Institute, Melbourne, Australia.
- Department of Paediatrics, University of Melbourne, Melbourne, Australia.
| | - Daniel G Pellicci
- Murdoch Children's Research Institute, Melbourne, Australia.
- Department of Paediatrics, University of Melbourne, Melbourne, Australia.
- Department of Microbiology and Immunology, University of Melbourne, Melbourne, Australia.
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