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Happonen L, Collin M. Immunomodulating Enzymes from Streptococcus pyogenes-In Pathogenesis, as Biotechnological Tools, and as Biological Drugs. Microorganisms 2024; 12:200. [PMID: 38258026 PMCID: PMC10818452 DOI: 10.3390/microorganisms12010200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/12/2024] [Accepted: 01/16/2024] [Indexed: 01/24/2024] Open
Abstract
Streptococcus pyogenes, or Group A Streptococcus, is an exclusively human pathogen that causes a wide variety of diseases ranging from mild throat and skin infections to severe invasive disease. The pathogenesis of S. pyogenes infection has been extensively studied, but the pathophysiology, especially of the more severe infections, is still somewhat elusive. One key feature of S. pyogenes is the expression of secreted, surface-associated, and intracellular enzymes that directly or indirectly affect both the innate and adaptive host immune systems. Undoubtedly, S. pyogenes is one of the major bacterial sources for immunomodulating enzymes. Major targets for these enzymes are immunoglobulins that are destroyed or modified through proteolysis or glycan hydrolysis. Furthermore, several enzymes degrade components of the complement system and a group of DNAses degrade host DNA in neutrophil extracellular traps. Additional types of enzymes interfere with cellular inflammatory and innate immunity responses. In this review, we attempt to give a broad overview of the functions of these enzymes and their roles in pathogenesis. For those enzymes where experimentally determined structures exist, the structural aspects of the enzymatic activity are further discussed. Lastly, we also discuss the emerging use of some of the enzymes as biotechnological tools as well as biological drugs and vaccines.
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Affiliation(s)
- Lotta Happonen
- Faculty of Medicine, Department of Clinical Sciences, Division of Infection Medicine, Lund University, SE-22184 Lund, Sweden
| | - Mattias Collin
- Faculty of Medicine, Department of Clinical Sciences, Division of Infection Medicine, Lund University, SE-22184 Lund, Sweden
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Milhès J, Marion O, Puissant B, Carlé C, Bouthemy C, Del Bello A, Kamar N, Renaudineau Y, Congy-Jolivet N. Impact of imlifidase treatment on immunoglobulins in an HLA-hypersensitized lupus nephritis patient with anti-SSA/SSB antibodies after kidney transplantation: A case report. J Transl Autoimmun 2023; 7:100223. [PMID: 38162455 PMCID: PMC10755536 DOI: 10.1016/j.jtauto.2023.100223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 11/28/2023] [Indexed: 01/03/2024] Open
Abstract
Bacterial recombinant cysteine protease Ides (imlifidase, Idefirix®, Hansa Biopharma) is used to prevent humoral transplant rejection in highly HLA-sensitized recipients, and to control IgG-mediated autoimmune diseases. We report the case of a 51 years old woman suffering from lupus nephritis with end stage kidney disease, grafted for the second time and pre-treated with imlifidase. The patient was HLA-hypersensitized (calculated Panel Reactive Antibodies [Abs], cPRA>99 %) and has three preformed Donor Specific Antibodies (DSA). Circulating immunoglobulins were monitored at initiation (0, 6, 36, 72 and 96 h), and at Ab recovery one and two months following imlifidase injection. From baseline, the higher depletion was reported after 36h for total IgG (-75 %) and IgG subclasses (-87 % for IgG1, IgG2 and IgG3, -78 % for IgG4), while no significant impact on IgA and IgM was observed. Anti-SSA 60 kDa and anti-SSB auto-Abs quickly decreased after imlifidase injection (-96 % for both after 36 h) as well as post-vaccinal specific IgG (-95 % for tetanus toxoid, -97 % for pneumococcus and -91 % for Haemophilus influenzae Abs after 36 h). At the Ab recovery phase, total IgG and anti-SSA60/SSB Abs reached their initial level at two months. Regarding alloreactive Abs, anti-HLA Abs including the three DSA showed a dramatic decrease after injection with 100 % depletion from baseline after 36 h as assessed by multiplex single bead antigen assay, leading to negative crossmatches using both lymphocytotoxicity (LCT) and flow cell techniques. DSA rebound at recovery was absent and remained under the positivity threshold (MFI = 1000) after 6 months. The findings from this case report are that imlifidase exerts an early depleting effect on all circulating IgG, while IgG recovery may depend in part from imlifidase's capacity to target memory B cells.
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Affiliation(s)
- Jean Milhès
- Immunology Laboratory Department, Institut Fédératif de Biologie, Purpan, Toulouse University Hospital Center, Toulouse, France
| | - Olivier Marion
- Nephrology and Organ Transplantation Department, Rangueil Toulouse University Hospital, Toulouse, France
| | - Benedicte Puissant
- Immunology Laboratory Department, Institut Fédératif de Biologie, Purpan, Toulouse University Hospital Center, Toulouse, France
- INSERM UMR 1291 - CNRS UMR 5051, Toulouse Institute for Infectious and Inflammatory Diseases (INFINITy), University Toulouse III, Toulouse, France
| | - Caroline Carlé
- Immunology Laboratory Department, Institut Fédératif de Biologie, Purpan, Toulouse University Hospital Center, Toulouse, France
- INSERM UMR 1291 - CNRS UMR 5051, Toulouse Institute for Infectious and Inflammatory Diseases (INFINITy), University Toulouse III, Toulouse, France
| | - Charlène Bouthemy
- Immunology Laboratory Department, Institut Fédératif de Biologie, Purpan, Toulouse University Hospital Center, Toulouse, France
| | - Arnaud Del Bello
- Nephrology and Organ Transplantation Department, Rangueil Toulouse University Hospital, Toulouse, France
| | - Nassim Kamar
- Nephrology and Organ Transplantation Department, Rangueil Toulouse University Hospital, Toulouse, France
| | - Yves Renaudineau
- Immunology Laboratory Department, Institut Fédératif de Biologie, Purpan, Toulouse University Hospital Center, Toulouse, France
- INSERM UMR 1291 - CNRS UMR 5051, Toulouse Institute for Infectious and Inflammatory Diseases (INFINITy), University Toulouse III, Toulouse, France
| | - Nicolas Congy-Jolivet
- Immunology Laboratory Department, Institut Fédératif de Biologie, Purpan, Toulouse University Hospital Center, Toulouse, France
- UMR 1037 INSERM Team 20 / Université Toulouse III Paul Sabatier, Toulouse Cancerology Research Center (CRCT), Toulouse, France
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