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Preclinical safety and immunogenicity of Streptococcus pyogenes (Strep A) peptide vaccines. Sci Rep 2021; 11:127. [PMID: 33420258 PMCID: PMC7794325 DOI: 10.1038/s41598-020-80508-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 12/16/2020] [Indexed: 11/08/2022] Open
Abstract
We have developed two candidate vaccines to protect against multiple strains of Strep A infections. The candidates are combinatorial synthetic peptide vaccines composed of a M protein epitope (J8 or p*17) and a non-M protein epitope (K4S2). To enhance immunogenicity, each peptide is conjugated to the carrier protein CRM197 (CRM) and formulated with aluminium hydroxide adjuvant Alhydrogel (Alum) to make the final vaccines, J8-CRM + K4S2-CRM/Alum and p*17-CRM + K4S2-CRM/Alum. The safety and toxicity of each vaccine was assessed. Sprague Dawley rats were administered three intramuscular doses, over a six-week study with a 4-week recovery period. A control group received CRM only formulated with Alum (CRM/Alum). There was no evidence of systemic toxicity in the rats administered either vaccine. There was an associated increase in white blood cell, lymphocyte and monocyte counts, increased adrenal gland weights, adrenocortical hypertrophy, and increased severity of granulomatous inflammation at the sites of injection and the associated inguinal lymph nodes. These changes were considered non-adverse. All rats administered vaccine developed a robust and sustained immunological response. The absence of clinical toxicity and the development of an immunological response in the rats suggests that the vaccines are safe for use in a phase 1 clinical trial in healthy humans.
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2
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Sekuloski S, Batzloff MR, Griffin P, Parsonage W, Elliott S, Hartas J, O’Rourke P, Marquart L, Pandey M, Rubin FA, Carapetis J, McCarthy J, Good MF. Evaluation of safety and immunogenicity of a group A streptococcus vaccine candidate (MJ8VAX) in a randomized clinical trial. PLoS One 2018; 13:e0198658. [PMID: 29965967 PMCID: PMC6028081 DOI: 10.1371/journal.pone.0198658] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 05/06/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Group A streptococcus (GAS) is a serious human pathogen that affects people of different ages and socio-economic levels. Although vaccination is potentially one of the most effective methods to control GAS infection and its sequelae, few prototype vaccines have been investigated in humans. In this study, we report the safety and immunogenicity of a novel acetylated peptide-protein conjugate vaccine candidate MJ8VAX (J8-DT), when delivered intramuscularly to healthy adults. METHODS A randomized, double-blinded, controlled Phase I clinical trial was conducted in 10 healthy adult participants. Participants were randomized 4:1 to receive the vaccine candidate (N = 8) or placebo (N = 2). A single dose of the vaccine candidate (MJ8VAX), contained 50 μg of peptide conjugate (J8-DT) adsorbed onto aluminium hydroxide and re-suspended in PBS in a total volume of 0.5 mL. Safety of the vaccine candidate was assessed by monitoring local and systemic adverse reactions following intramuscular administration. The immunogenicity of the vaccine was assessed by measuring the levels of peptide (anti-J8) and toxoid carrier (anti-DT)-specific antibodies in serum samples. RESULTS No serious adverse events were reported over 12 months of study. A total of 13 adverse events (AEs) were recorded, two of which were assessed to be associated with the vaccine. Both were mild in severity. No local reactogenicity was recorded in any of the participants. MJ8VAX was shown to be immunogenic, with increase in vaccine-specific antibodies in the participants who received the vaccine. The maximum level of vaccine-specific antibodies was detected at 28 days post immunization. The level of these antibodies decreased with time during follow-up. Participants who received the vaccine also had a corresponding increase in anti-DT serum antibodies. CONCLUSIONS Intramuscular administration of MJ8VAX was demonstrated to be safe and immunogenic. The presence of DT in the vaccine formulation resulted in a boost in the level of anti-DT antibodies. TRIAL REGISTRATION ACTRN12613000030774.
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Affiliation(s)
- Silvana Sekuloski
- Clinical Tropical Medicine Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Michael R. Batzloff
- The Institute for Glycomics, Griffith University, Gold Coast, Queensland, Australia
| | - Paul Griffin
- Clinical Tropical Medicine Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- Q-Pharm Pty Ltd, Brisbane, Australia
- Department of Medicine and Infectious Diseases, Mater Hospital and Mater Medical Research Institute, Brisbane, Australia
- The University of Queensland, Brisbane, Australia
| | - William Parsonage
- Australian Centre for Health Service Innovation, Queensland University of Technology, Brisbane, Australia
| | | | - Jon Hartas
- The Institute for Glycomics, Griffith University, Gold Coast, Queensland, Australia
| | - Peter O’Rourke
- Clinical Tropical Medicine Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Louise Marquart
- Clinical Tropical Medicine Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Manisha Pandey
- The Institute for Glycomics, Griffith University, Gold Coast, Queensland, Australia
| | - Fran A. Rubin
- Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Jonathan Carapetis
- Telethon Kids Institute, University of Western Australia and Perth Children’s Hospital, Perth, Australia
| | - James McCarthy
- Clinical Tropical Medicine Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- The University of Queensland, Brisbane, Australia
| | - Michael F. Good
- The Institute for Glycomics, Griffith University, Gold Coast, Queensland, Australia
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3
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Gandhi GD, Krishnamoorthy N, Motal UMA, Yacoub M. Towards developing a vaccine for rheumatic heart disease. Glob Cardiol Sci Pract 2017; 2017:e201704. [PMID: 28971103 PMCID: PMC5621712 DOI: 10.21542/gcsp.2017.4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Rheumatic heart disease (RHD) is the most serious manifestations of rheumatic fever, which is caused by group A Streptococcus (GAS or Streptococcus pyogenes) infection. RHD is an auto immune sequelae of GAS pharyngitis, rather than the direct bacterial infection of the heart, which leads to chronic heart valve damage. Although antibiotics like penicillin are effective against GAS infection, improper medical care such as poor patient compliance, overcrowding, poverty, and repeated exposure to GAS, leads to acute rheumatic fever and RHD. Thus, efforts have been put forth towards developing a vaccine. However, a potential global vaccine is yet to be identified due to the widespread diversity of S. pyogenes strains and cross reactivity of streptococcal proteins with host tissues. In this review, we discuss the available vaccine targets of S. pyogenes and the significance of in silico approaches in designing a vaccine for RHD.
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Affiliation(s)
- Geethanjali Devadoss Gandhi
- Division of Cardiovascular Research, Sidra Medical and Research Center, Qatar Foundation, Doha, Qatar.,Division of Experimental Genetics, Sidra Medical and Research Center, Doha, Qatar
| | - Navaneethakrishnan Krishnamoorthy
- Division of Cardiovascular Research, Sidra Medical and Research Center, Qatar Foundation, Doha, Qatar.,Division of Experimental Genetics, Sidra Medical and Research Center, Doha, Qatar.,Heart Science Centre, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Ussama M Abdel Motal
- Division of Cardiovascular Research, Sidra Medical and Research Center, Qatar Foundation, Doha, Qatar
| | - Magdi Yacoub
- Division of Cardiovascular Research, Sidra Medical and Research Center, Qatar Foundation, Doha, Qatar.,Heart Science Centre, National Heart and Lung Institute, Imperial College London, London, United Kingdom
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4
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Differing Efficacies of Lead Group A Streptococcal Vaccine Candidates and Full-Length M Protein in Cutaneous and Invasive Disease Models. mBio 2016; 7:mBio.00618-16. [PMID: 27302756 PMCID: PMC4916377 DOI: 10.1128/mbio.00618-16] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Group A Streptococcus (GAS) is an important human pathogen responsible for both superficial infections and invasive diseases. Autoimmune sequelae may occur upon repeated infection. For this reason, development of a vaccine against GAS represents a major challenge, since certain GAS components may trigger autoimmunity. We formulated three combination vaccines containing the following: (i) streptolysin O (SLO), interleukin 8 (IL-8) protease (Streptococcus pyogenes cell envelope proteinase [SpyCEP]), group A streptococcal C5a peptidase (SCPA), arginine deiminase (ADI), and trigger factor (TF); (ii) the conserved M-protein-derived J8 peptide conjugated to ADI; and (iii) group A carbohydrate lacking the N-acetylglucosamine side chain conjugated to ADI. We compared these combination vaccines to a “gold standard” for immunogenicity, full-length M1 protein. Vaccines were adjuvanted with alum, and mice were immunized on days 0, 21, and 28. On day 42, mice were challenged via cutaneous or subcutaneous routes. High-titer antigen-specific antibody responses with bactericidal activity were detected in mouse serum samples for all vaccine candidates. In comparison with sham-immunized mice, all vaccines afforded protection against cutaneous challenge. However, only full-length M1 protein provided protection in the subcutaneous invasive disease model. This set of experiments demonstrates the inherent variability of mouse models for the characterization of GAS vaccine candidate protective efficacy. Such variability poses an important challenge for GAS vaccine development, as advancement of candidates to human clinical trials requires strong evidence of efficacy. This study highlights the need for an open discussion within the field regarding standardization of animal models for GAS vaccine development.
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5
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Epidemiology of Invasive Group A Streptococcal Disease in Alaska, 2001 to 2013. J Clin Microbiol 2015; 54:134-41. [PMID: 26560536 DOI: 10.1128/jcm.02122-15] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 10/20/2015] [Indexed: 12/14/2022] Open
Abstract
The Arctic Investigations Program (AIP) began surveillance for invasive group A streptococcal (GAS) infections in Alaska in 2000 as part of the invasive bacterial diseases population-based laboratory surveillance program. Between 2001 and 2013, there were 516 cases of GAS infection reported, for an overall annual incidence of 5.8 cases per 100,000 persons with 56 deaths (case fatality rate, 10.7%). Of the 516 confirmed cases of invasive GAS infection, 422 (82%) had isolates available for laboratory analysis. All isolates were susceptible to penicillin, cefotaxime, and levofloxacin. Resistance to tetracycline, erythromycin, and clindamycin was seen in 11% (n = 8), 5.8% (n = 20), and 1.2% (n = 4) of the isolates, respectively. A total of 51 emm types were identified, of which emm1 (11.1%) was the most prevalent, followed by emm82 (8.8%), emm49 (7.8%), emm12 and emm3 (6.6% each), emm89 (6.2%), emm108 (5.5%), emm28 (4.7%), emm92 (4%), and emm41 (3.8%). The five most common emm types accounted for 41% of isolates. The emm types in the proposed 26-valent and 30-valent vaccines accounted for 56% and 78% of all cases, respectively. GAS remains an important cause of invasive bacterial disease in Alaska. Continued surveillance of GAS infections will help improve understanding of the epidemiology of invasive disease, with an impact on disease control, notification of outbreaks, and vaccine development.
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6
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Role for streptococcal collagen-like protein 1 in M1T1 group A Streptococcus resistance to neutrophil extracellular traps. Infect Immun 2014; 82:4011-20. [PMID: 25024366 DOI: 10.1128/iai.01921-14] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Streptococcal collagen-like protein 1 (Scl-1) is one of the most highly expressed proteins in the invasive M1T1 serotype group A Streptococcus (GAS), a globally disseminated clone associated with higher risk of severe invasive infections. Previous studies using recombinant Scl-1 protein suggested a role in cell attachment and binding and inhibition of serum proteins. Here, we studied the contribution of Scl-1 to the virulence of the M1T1 clone in the physiological context of the live bacterium by generating an isogenic strain lacking the scl-1 gene. Upon subcutaneous infection in mice, wild-type bacteria induced larger lesions than the Δscl mutant. However, loss of Scl-1 did not alter bacterial adherence to or invasion of skin keratinocytes. We found instead that Scl-1 plays a critical role in GAS resistance to human and murine phagocytic cells, allowing the bacteria to persist at the site of infection. Phenotypic analyses demonstrated that Scl-1 mediates bacterial survival in neutrophil extracellular traps (NETs) and protects GAS from antimicrobial peptides found within the NETs. Additionally, Scl-1 interferes with myeloperoxidase (MPO) release, a prerequisite for NET production, thereby suppressing NET formation. We conclude that Scl-1 is a virulence determinant in the M1T1 GAS clone, allowing GAS to subvert innate immune functions that are critical in clearing bacterial infections.
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7
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Moreland NJ, Waddington CS, Williamson DA, Sriskandan S, Smeesters PR, Proft T, Steer AC, Walker MJ, Baker EN, Baker MG, Lennon D, Dunbar R, Carapetis J, Fraser JD. Working towards a Group A Streptococcal vaccine: Report of a collaborative Trans-Tasman workshop. Vaccine 2014; 32:3713-20. [DOI: 10.1016/j.vaccine.2014.05.017] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Accepted: 05/01/2014] [Indexed: 11/25/2022]
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8
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Mengeloglu FZ, Aktas E, Otlu B, Cömert F, Külah C, Tas E, Sümbüloglu V. Evaluation of emm gene types, toxin gene profiles and clonal relatedness of group A streptococci. Bosn J Basic Med Sci 2014; 13:163-9. [PMID: 23988167 DOI: 10.17305/bjbms.2013.2356] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this study is to evaluate antibiotic susceptibilities, emm gene types, toxin gene profiles and clonal relatedness of group A streptococci (GAS) isolates obtained from patients and carriers. A total of 79 clinical isolates from patients and 60 isolates from carriers were included in the study. Emm typing, toxin gene detection for speA, speB, speC, speG and smeZ genes and pulsed-field gel electrophoresis (PFGE) was performed. Twenty-one distinct emm types were detected; the most common types were emm12, emm89, emm1, emm77, emm4 and emm3. The detection rates of both emm types and the toxin genes didn't differ significantly between patients and carriers. The presence of speA and smeZ was significantly higher in emm1 and speG was significantly lower in emm4 when compared to the other emm types. The rate of clustering obtained with PFGE wasn't significantly different in patients and carriers. As a result, twelve of the 21 emm types detected in this study were covered by the 26-valent vaccine, constituting 77.7% of the emm typeable isolates; however the emm4 type which is one of the most common types in the present study is not among this coverage.
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Affiliation(s)
- Firat Zafer Mengeloglu
- Department of Medical Microbiology, Faculty of Medicine, Abant Izzet Baysal University, Gölköy, 14280 Bolu, Turkey.
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9
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Georgousakis MM, McMillan DJ, Batzloff MR, Sriprakash KS. Moving forward: a mucosal vaccine against group A streptococcus. Expert Rev Vaccines 2014; 8:747-60. [DOI: 10.1586/erv.09.33] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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10
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Good MF, Batzloff MR, Pandey M. Strategies in the development of vaccines to prevent infections with group A streptococcus. Hum Vaccin Immunother 2013; 9:2393-7. [PMID: 23863455 DOI: 10.4161/hv.25506] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
There has long been interest and demand for the development of a vaccine to prevent infections caused by the Gram-positive organism group A streptococcus. Despite numerous efforts utilizing advanced approaches such as genomics, proteomics and bio-informatics, there is currently no vaccine. Here we review various strategies employed to achieve this goal. We also discuss the approach that we have pursued, a non-host reactive, conformationally constrained minimal B cell epitope from within the C-repeat region of M-protein, and the potential limitations in moving forward.
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Affiliation(s)
- Michael F Good
- Institute for Glycomics; Griffith University, Gold Coast campus; QLD Australia
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11
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Bensi G, Mora M, Tuscano G, Biagini M, Chiarot E, Bombaci M, Capo S, Falugi F, Manetti AGO, Donato P, Swennen E, Gallotta M, Garibaldi M, Pinto V, Chiappini N, Musser JM, Janulczyk R, Mariani M, Scarselli M, Telford JL, Grifantini R, Norais N, Margarit I, Grandi G. Multi high-throughput approach for highly selective identification of vaccine candidates: the Group A Streptococcus case. Mol Cell Proteomics 2012; 11:M111.015693. [PMID: 22286755 PMCID: PMC3433891 DOI: 10.1074/mcp.m111.015693] [Citation(s) in RCA: 100] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2011] [Revised: 01/05/2012] [Indexed: 11/23/2022] Open
Abstract
We propose an experimental strategy for highly accurate selection of candidates for bacterial vaccines without using in vitro and/or in vivo protection assays. Starting from the observation that efficacious vaccines are constituted by conserved, surface-associated and/or secreted components, the strategy contemplates the parallel application of three high throughput technologies, i.e. mass spectrometry-based proteomics, protein array, and flow-cytometry analysis, to identify this category of proteins, and is based on the assumption that the antigens identified by all three technologies are the protective ones. When we tested this strategy for Group A Streptococcus, we selected a total of 40 proteins, of which only six identified by all three approaches. When the 40 proteins were tested in a mouse model, only six were found to be protective and five of these belonged to the group of antigens in common to the three technologies. Finally, a combination of three protective antigens conferred broad protection against a panel of four different Group A Streptococcus strains. This approach may find general application as an accelerated and highly accurate path to bacterial vaccine discovery.
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Affiliation(s)
- Giuliano Bensi
- From the ‡Novartis Vaccines and Diagnostics, Via Fiorentina 1, 53100, Siena, Italy
| | - Marirosa Mora
- From the ‡Novartis Vaccines and Diagnostics, Via Fiorentina 1, 53100, Siena, Italy
| | - Giovanna Tuscano
- From the ‡Novartis Vaccines and Diagnostics, Via Fiorentina 1, 53100, Siena, Italy
| | - Massimiliano Biagini
- From the ‡Novartis Vaccines and Diagnostics, Via Fiorentina 1, 53100, Siena, Italy
| | - Emiliano Chiarot
- From the ‡Novartis Vaccines and Diagnostics, Via Fiorentina 1, 53100, Siena, Italy
| | - Mauro Bombaci
- From the ‡Novartis Vaccines and Diagnostics, Via Fiorentina 1, 53100, Siena, Italy
| | - Sabrina Capo
- From the ‡Novartis Vaccines and Diagnostics, Via Fiorentina 1, 53100, Siena, Italy
| | - Fabiana Falugi
- From the ‡Novartis Vaccines and Diagnostics, Via Fiorentina 1, 53100, Siena, Italy
| | - Andrea G. O. Manetti
- From the ‡Novartis Vaccines and Diagnostics, Via Fiorentina 1, 53100, Siena, Italy
| | - Paolo Donato
- From the ‡Novartis Vaccines and Diagnostics, Via Fiorentina 1, 53100, Siena, Italy
| | - Erwin Swennen
- From the ‡Novartis Vaccines and Diagnostics, Via Fiorentina 1, 53100, Siena, Italy
| | - Marilena Gallotta
- From the ‡Novartis Vaccines and Diagnostics, Via Fiorentina 1, 53100, Siena, Italy
| | - Manuela Garibaldi
- From the ‡Novartis Vaccines and Diagnostics, Via Fiorentina 1, 53100, Siena, Italy
| | - Vittoria Pinto
- From the ‡Novartis Vaccines and Diagnostics, Via Fiorentina 1, 53100, Siena, Italy
| | - Nico Chiappini
- From the ‡Novartis Vaccines and Diagnostics, Via Fiorentina 1, 53100, Siena, Italy
| | - James M. Musser
- §Center for Molecular and Translational Human Infectious Diseases Research, The Methodist Hospital Research Institute, Houston, Texas 77030
| | - Robert Janulczyk
- From the ‡Novartis Vaccines and Diagnostics, Via Fiorentina 1, 53100, Siena, Italy
| | - Massimo Mariani
- From the ‡Novartis Vaccines and Diagnostics, Via Fiorentina 1, 53100, Siena, Italy
| | - Maria Scarselli
- From the ‡Novartis Vaccines and Diagnostics, Via Fiorentina 1, 53100, Siena, Italy
| | - John L. Telford
- From the ‡Novartis Vaccines and Diagnostics, Via Fiorentina 1, 53100, Siena, Italy
| | - Renata Grifantini
- From the ‡Novartis Vaccines and Diagnostics, Via Fiorentina 1, 53100, Siena, Italy
| | - Nathalie Norais
- From the ‡Novartis Vaccines and Diagnostics, Via Fiorentina 1, 53100, Siena, Italy
| | - Immaculada Margarit
- From the ‡Novartis Vaccines and Diagnostics, Via Fiorentina 1, 53100, Siena, Italy
| | - Guido Grandi
- From the ‡Novartis Vaccines and Diagnostics, Via Fiorentina 1, 53100, Siena, Italy
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12
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Vaccination Against Rheumatic Heart Disease: A Review of Current Research Strategies and Challenges. Curr Infect Dis Rep 2012; 14:381-90. [DOI: 10.1007/s11908-012-0263-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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13
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Shea PR, Ewbank AL, Gonzalez-Lugo JH, Martagon-Rosado AJ, Martinez-Gutierrez JC, Rehman HA, Serrano-Gonzalez M, Fittipaldi N, Beres SB, Flores AR, Low DE, Willey BM, Musser JM. Group A Streptococcus emm gene types in pharyngeal isolates, Ontario, Canada, 2002-2010. Emerg Infect Dis 2012; 17:2010-7. [PMID: 22099088 PMCID: PMC3310556 DOI: 10.3201/eid1711.110159] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Determination of emm variations may help improve vaccine design. Group A Streptococcus (GAS) is a human-adapted pathogen that causes a variety of diseases, including pharyngitis and invasive infections. GAS strains are categorized by variation in the nucleotide sequence of the gene (emm) that encodes the M protein. To identify the emm types of GAS strains causing pharyngitis in Ontario, Canada, we sequenced the hypervariable region of the emm gene in 4,635 pharyngeal GAS isolates collected during 2002–2010. The most prevalent emm types varied little from year to year. In contrast, fine-scale geographic analysis identified inter-site variability in the most common emm types. Additionally, we observed fluctuations in yearly frequency of emm3 strains from pharyngitis patients that coincided with peaks of emm3 invasive infections. We also discovered a striking increase in frequency of emm89 strains among isolates from patients with pharyngitis and invasive disease. These findings about the epidemiology of GAS are potentially useful for vaccine research.
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Affiliation(s)
- Patrick R Shea
- The Methodist Hospital Research Institute, Houston, Texas 77030, USA
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14
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Lannergård J, Gustafsson MCU, Waldemarsson J, Norrby-Teglund A, Stålhammar-Carlemalm M, Lindahl G. The Hypervariable region of Streptococcus pyogenes M protein escapes antibody attack by antigenic variation and weak immunogenicity. Cell Host Microbe 2011; 10:147-57. [PMID: 21843871 DOI: 10.1016/j.chom.2011.06.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Revised: 03/24/2011] [Accepted: 06/28/2011] [Indexed: 10/17/2022]
Abstract
Sequence variation of antigenic proteins allows pathogens to evade antibody attack. The variable protein commonly includes a hypervariable region (HVR), which represents a key target for antibodies and is therefore predicted to be immunodominant. To understand the mechanism(s) of antibody evasion, we analyzed the clinically important HVR-containing M proteins of the human pathogen Streptococcus pyogenes. Antibodies elicited by M proteins were directed almost exclusively against the C-terminal part and not against the N-terminal HVR. Similar results were obtained for mice and humans with invasive S. pyogenes infection. Nevertheless, only anti-HVR antibodies protected efficiently against infection, as shown by passive immunizations. The HVR fused to an unrelated protein elicited no antibodies, implying that it is inherently weakly immunogenic. These data indicate that the M protein HVR evades antibody attack not only through antigenic variation but also by weak immunogenicity, a paradoxical observation that may apply to other HVR-containing proteins.
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Affiliation(s)
- Jonas Lannergård
- Division of Medical Microbiology, Department of Laboratory Medicine, Lund University, Sweden
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15
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Rantala S, Vähäkuopus S, Siljander T, Vuopio J, Huhtala H, Vuento R, Syrjänen J. Streptococcus pyogenes bacteraemia, emm types and superantigen profiles. Eur J Clin Microbiol Infect Dis 2011; 31:859-65. [PMID: 21877175 DOI: 10.1007/s10096-011-1385-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Accepted: 08/11/2011] [Indexed: 10/17/2022]
Abstract
The aim of this study was to investigate the emm types and superantigen profiles of bacteraemic group A streptococcal (GAS; Streptococcus pyogenes) isolates and to detect possible associations between the molecular characteristics of isolates and the clinical presentations of disease. In this population-based study, 87 bacteraemic GAS isolates from adult patients in Pirkanmaa Health District (HD), Finland, during the period 1995-2004 were emm typed and genotyped for superantigen (SAg) profiles. The epidemiological and clinical data of the patients were analysed with the microbiological characterisation data. Among the 87 isolates, 18 different emm types were found. emm1, emm28 and emm81 were the three most common types, covering 52% of isolates. The prevalence of specific emm types showed high variability during the 10-year study period. We could not find any association between the emm type and clinical features of bacteraemic infection, such as underlying diseases, disease manifestations or case fatality. Of nine superantigen genes examined, speA and speC were identified in 20 and 30% of the strains, respectively. No association was found between disease manifestation and the presence of single superantigen genes. The 26-valent GAS vaccine would have covered only 62% of isolates causing invasive disease in Pirkanmaa HD during the study period.
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Affiliation(s)
- S Rantala
- Department of Internal Medicine, Tampere University Hospital, P.O. Box 2000, 33521, Tampere, Finland.
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16
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Abstract
Pathogenesis of rheumatic heart disease (RHD) remains incompletely understood. Several genes associated with RHD have been described; most of these are involved with immune responses. Single nucleotide polymorphisms in a number of genes affect patients with RHD compared to controls. Molecular mimicry between streptococcal antigens and human proteins, including cardiac myosin epitopes, vimentin and other intracellular proteins is central to the pathogenesis of RHD. Autoreactive T cells migrate from the peripheral blood to the heart and proliferate in the valves in response to stimulation with specific cytokines. The types of cells involved in the inflammation as well as different cytokine profiles in these patients are being investigated. High TNF alpha, interferon gamma, and low IL4 are found in the rheumatic valve suggesting an imbalance between Th1 and Th2 cytokines and probably contributing to the progressive and permanent valve damage. Animal model of ARF in the Lewis rat may further contribute towards understanding the ARF.
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Affiliation(s)
- L Guilherme
- Heart Institute (InCor), School of Medicine, University of São Paulo, São Paulo; Brazil
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Guilherme L, Alba MP, Ferreira FM, Oshiro SE, Higa F, Patarroyo ME, Kalil J. Anti-group A streptococcal vaccine epitope: structure, stability, and its ability to interact with HLA class II molecules. J Biol Chem 2011; 286:6989-98. [PMID: 21169359 PMCID: PMC3044955 DOI: 10.1074/jbc.m110.132118] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2010] [Revised: 09/01/2010] [Indexed: 12/29/2022] Open
Abstract
Streptococcus pyogenes infections remain a health problem in several countries due to poststreptococcal sequelae. We developed a vaccine epitope (StreptInCor) composed of 55 amino acids residues of the C-terminal portion of the M protein that encompasses both T and B cell protective epitopes. The nuclear magnetic resonance (NMR) structure of the StreptInCor peptide showed that the structure was composed of two microdomains linked by an 18-residue α-helix. A chemical stability study of the StreptInCor folding/unfolding process using far-UV circular dichroism showed that the structure was chemically stable with respect to pH and the concentration of urea. The T cell epitope is located in the first microdomain and encompasses 11 out of the 18 α-helix residues, whereas the B cell epitope is in the second microdomain and showed no α-helical structure. The prediction of StreptInCor epitope binding to different HLA class II molecules was evaluated based on an analysis of the 55 residues and the theoretical possibilities for the processed peptides to fit into the P1, P4, P6, and P9 pockets in the groove of several HLA class II molecules. We observed 7 potential sites along the amino acid sequence of StreptInCor that were capable of recognizing HLA class II molecules (DRB1*, DRB3*, DRB4*, and DRB5*). StreptInCor-overlapping peptides induced cellular and humoral immune responses of individuals bearing different HLA class II molecules and could be considered as a universal vaccine epitope.
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Affiliation(s)
- Luiza Guilherme
- Heart Institute (InCor), University of São Paulo, São Paulo 5403-903, Brazil.
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Eison TM, Ault BH, Jones DP, Chesney RW, Wyatt RJ. Post-streptococcal acute glomerulonephritis in children: clinical features and pathogenesis. Pediatr Nephrol 2011; 26:165-80. [PMID: 20652330 DOI: 10.1007/s00467-010-1554-6] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Revised: 04/16/2010] [Accepted: 04/19/2010] [Indexed: 12/15/2022]
Abstract
Post-streptococcal acute glomerulonephritis (PSAGN) is one of the most important and intriguing conditions in the discipline of pediatric nephrology. Although the eventual outcome is excellent in most cases, PSAGN remains an important cause of acute renal failure and hospitalization for children in both developed and underdeveloped areas. The purpose of this review is to describe both the typical and less common clinical features of PSAGN, to outline the changes in the epidemiology of PSAGN over the past 50 years, and to explore studies on the pathogenesis of the condition with an emphasis on the search for the elusive nephritogenic antigen.
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Affiliation(s)
- T Matthew Eison
- Division of Pediatric Nephrology, Department of Pediatrics, University of Tennessee Health Science Center, and Children's Foundation Research Center at Le Bonheur Children's Medical Center, 50 North Dunlap, Memphis, TN 38103, USA
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Ghosh P. The nonideal coiled coil of M protein and its multifarious functions in pathogenesis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2011; 715:197-211. [PMID: 21557065 DOI: 10.1007/978-94-007-0940-9_12] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The M protein is a major virulence factor of Streptococcus pyogenes (group A Streptococcus, GAS). This gram-positive bacterial pathogen is responsible for mild infections, such as pharyngitis, and severe invasive disease, like streptococcal toxic shock syndrome. M protein contributes to GAS virulence in multifarious ways, including blocking deposition of antibodies and complement, helping formation of microcolonies, neutralizing antimicrobial peptides, and triggering a proinflammatory and procoagulatory state. These functions are specified by interactions between M protein and many host components, especially C4BP and fibrinogen. The former interaction is conserved among many antigenically variant M protein types but occurs in a strikingly sequence-independent manner, and the latter is associated in the M1 protein type with severe invasive disease. Remarkably for a protein of such diverse interactions, the M protein has a relatively simple but nonideal α-helical coiled coil sequence. This sequence nonideality is a crucial feature of M protein. Nonideal residues give rise to specific irregularities in its coiled-coil structure, which are essential for interactions with fibrinogen and establishment of a proinflammatory state. In addition, these structural irregularities are reminiscent of those in myosin and tropomyosin, which are targets for crossreactive antibodies in patients suffering from autoimmune sequelae of GAS infection.
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Affiliation(s)
- Partho Ghosh
- Department of Chemistry and Biochemistry, University of California, San Diego, CA, 92093-0375, USA.
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The structure and function of serum opacity factor: a unique streptococcal virulence determinant that targets high-density lipoproteins. J Biomed Biotechnol 2010; 2010:956071. [PMID: 20671930 PMCID: PMC2910554 DOI: 10.1155/2010/956071] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2010] [Accepted: 05/26/2010] [Indexed: 12/04/2022] Open
Abstract
Serum opacity factor (SOF) is a virulence determinant expressed by a variety of streptococcal and staphylococcal species including both human and animal pathogens. SOF derives its name from its ability to opacify serum where it targets and disrupts the structure of high-density lipoproteins resulting in formation of large lipid vesicles that cause the serum to become cloudy. SOF is a multifunctional protein and in addition to its opacification activity, it binds to a number of host proteins that mediate adhesion of streptococci to host cells, and it plays a role in resistance to phagocytosis in human blood. This article will provide an overview of the structure and function of SOF, its role in the pathogenesis of streptococcal infections, its vaccine potential, its prevalence and distribution in bacteria, and the molecular mechanism whereby SOF opacifies serum and how an understanding of this mechanism may lead to therapies for reducing high-cholesterol concentrations in blood, a major risk factor for cardiovascular disease.
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Takahashi T, Ubukata K, Watanabe H. Invasive infection caused by Streptococcus dysgalactiae subsp. equisimilis: characteristics of strains and clinical features. J Infect Chemother 2010; 17:1-10. [PMID: 20607346 DOI: 10.1007/s10156-010-0084-2] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Indexed: 10/19/2022]
Abstract
Among clinically isolated β-hemolytic streptococci, Streptococcus pyogenes and S. agalactiae were considered the main pathogens in humans until recently. In 1996, S. dysgalactiae subsp. equisimilis (SDSE) was proposed as a novel taxon among human-derived streptococcal isolates. SDSE has Lancefield group C or G antigens, exhibits strong β-hemolysis, and exerts streptokinase activity upon human plasminogen and proteolytic activity upon human fibrin. Similarly to group A streptococci, SDSE possesses virulence factors including M protein, streptolysin O, streptolysin S, streptokinase, hyaluronidase, C5a peptidase, and others. SDSE may exist among the normal flora of the skin, oropharynx, and gastrointestinal and genitourinary tracts. In the twenty-first century, invasive SDSE infection (i.e., cellulitis, urosepsis, and pneumonia) leading to various disseminated diseases is being diagnosed increasingly in Japan, elsewhere in Asia, in Europe, and in America. Particularly, among elderly patients, these invasive diseases are encountered increasingly in Japanese hospital emergency departments. Analysis of the part of the emm gene encoding the amino acid sequence at the N-terminal end of the M protein is used to determine the molecular epidemiology of SDSE. The distribution of emm types from patients with invasive or noninvasive infections differs between surveillance results from different countries. In this review, we summarize the characteristics of phenotypes and virulence factors in SDSE strains; the review also focuses on emerging SDSE infectious disease and future vaccination research.
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Affiliation(s)
- Takashi Takahashi
- Laboratory of Infectious Diseases, Graduate School of Infection Control Sciences, Kitasato University, Tokyo, Japan.
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Penfound TA, Ofek I, Courtney HS, Hasty DL, Dale JB. The NH(2)-terminal region of Streptococcus pyogenes M5 protein confers protection against degradation by proteases and enhances mucosal colonization of mice. J Infect Dis 2010; 201:1580-8. [PMID: 20367460 DOI: 10.1086/652005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The NH(2)-terminal sequence of the M protein from group A streptococci defines the serotype of the organism and contains epitopes that evoke bactericidal antibodies. METHODS To identify additional roles for this region of the M protein, we constructed a mutant of M5 group A streptococci expressing an M protein with a deletion of amino acid residues 3-22 (DeltaNH(2)). RESULTS M5 streptococci and the DeltaNH(2) mutant were resistant to phagocytosis and were similarly virulent in mice. However, DeltaNH(2) was significantly less hydrophobic, contained less lipoteichoic acid on its surface, and demonstrated reduced adherence to epithelial cells. These differences were abolished when organisms were grown in the presence of protease inhibitors. Treatment with cysteine proteases or with human saliva resulted in the release of M protein from the DeltaNH(2) mutant at a significantly greater rate than observed with the wild-type M5 strain. Compared with the parent strain, the DeltaNH(2) strain also showed a significant reduction in its ability to colonize the upper respiratory mucosa of mice. CONCLUSIONS The NH(2) terminus of M5 protein has an important role in protecting the surface protein from proteolytic cleavage, thus preserving its function as an anchor for lipoteichoic acid, which is a primary mediator of adherence to epithelial cells and colonization.
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Affiliation(s)
- Thomas A Penfound
- Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee 38163, USA
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Smeesters PR, McMillan DJ, Sriprakash KS, Georgousakis MM. Differences among group A streptococcus epidemiological landscapes: consequences for M protein-based vaccines? Expert Rev Vaccines 2010; 8:1705-20. [PMID: 19905872 DOI: 10.1586/erv.09.133] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Group A streptococcus (GAS) is a bacterial pathogen responsible for a wide array of disease pathologies in humans. GAS surface M protein plays multiple key roles in pathogenesis, and serves as a target for typing and vaccine development. In this review, we have compiled GAS epidemiological studies from several countries around the world to highlight the consequences on the theoretical efficacy of two different M protein-based vaccine strategies.
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Affiliation(s)
- Pierre R Smeesters
- Bacterial Pathogenesis Laboratory, Queensland Institute of Medical Research, Brisbane, Queensland 4029, Australia.
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A vaccine against S. pyogenes: Design and experimental immune response. Methods 2009; 49:316-21. [DOI: 10.1016/j.ymeth.2009.03.024] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Revised: 03/05/2009] [Accepted: 03/09/2009] [Indexed: 11/17/2022] Open
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Turner CE, Kurupati P, Wiles S, Edwards RJ, Sriskandan S. Impact of immunization against SpyCEP during invasive disease with two streptococcal species: Streptococcus pyogenes and Streptococcus equi. Vaccine 2009; 27:4923-9. [PMID: 19563892 PMCID: PMC2759039 DOI: 10.1016/j.vaccine.2009.06.042] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2008] [Revised: 06/05/2009] [Accepted: 06/09/2009] [Indexed: 11/19/2022]
Abstract
Currently there is no licensed vaccine against the human pathogen Streptococcus pyogenes. The highly conserved IL-8 cleaving S. pyogenes cell envelope proteinase SpyCEP is surface expressed and is a potential vaccine candidate. A recombinant N-terminal part of SpyCEP (CEP) was expressed and purified. AntiCEP antibodies were found to neutralize the IL-8 cleaving activity of SpyCEP. CEP-immunized mice had reduced bacterial dissemination from focal S. pyogenes intramuscular infection and intranasal infection. We also identified a functional SpyCEP-homolog protease SeCEP, expressed by the equine pathogen Streptococcus equi, which was able to cleave both human and equine IL-8. CEP-immunized mice also demonstrated reduced bacterial dissemination from S. equi intramuscular infection. Therefore immunization against SpyCEP may provide protection against other streptococci species with homologous proteases.
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Affiliation(s)
- Claire E. Turner
- Department of Infectious Diseases & Immunity, Hammersmith Hospital, Du Cane Road, London, W12 0NN, United Kingdom
| | - Prathiba Kurupati
- Department of Infectious Diseases & Immunity, Hammersmith Hospital, Du Cane Road, London, W12 0NN, United Kingdom
| | - Siouxsie Wiles
- Department of Infectious Diseases & Immunity, Hammersmith Hospital, Du Cane Road, London, W12 0NN, United Kingdom
| | - Robert J. Edwards
- Department of Experimental Medicine & Toxicology, Imperial College London, Hammersmith Hospital, Du Cane Road, London, W12 0NN, United Kingdom
| | - Shiranee Sriskandan
- Department of Infectious Diseases & Immunity, Hammersmith Hospital, Du Cane Road, London, W12 0NN, United Kingdom
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Bessen DE. Population biology of the human restricted pathogen, Streptococcus pyogenes. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2009; 9. [PMID: 19460325 PMCID: PMC2685916 DOI: 10.1016/j.meegid.2009.03.00] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Streptococcus pyogenes, also referred to as beta-hemolytic group A streptococci, are strictly human pathogens with a global distribution and high prevalence of infection. The organisms are characterized by high levels of genetic recombination, extensive strain diversity, and a narrow habitat. This review highlights many key features of the population genetics and molecular epidemiology of this biologically diverse bacterial species, with special emphasis on ecological subdivisions and tissue-specific infections, strain diversity and population dynamics in communities, selection pressures arising from the specific host immune response and antibiotic exposure, and within-host selection during the course of invasive disease.
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Affiliation(s)
- Debra E. Bessen
- Department of Microbiology & Immunology, New York Medical College, Valhalla, NY, USA 10595, , +1-914-594-4193
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Novel strategies for controlling
Streptococcus pyogenes
infection and associated diseases: from potential peptide vaccines to antibody immunotherapy. Immunol Cell Biol 2009; 87:391-9. [DOI: 10.1038/icb.2009.29] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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28
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Bessen DE. Population biology of the human restricted pathogen, Streptococcus pyogenes. INFECTION GENETICS AND EVOLUTION 2009; 9:581-93. [PMID: 19460325 DOI: 10.1016/j.meegid.2009.03.002] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2008] [Revised: 02/24/2009] [Accepted: 03/04/2009] [Indexed: 12/31/2022]
Abstract
Streptococcus pyogenes, also referred to as beta-hemolytic group A streptococci, are strictly human pathogens with a global distribution and high prevalence of infection. The organisms are characterized by high levels of genetic recombination, extensive strain diversity, and a narrow habitat. This review highlights many key features of the population genetics and molecular epidemiology of this biologically diverse bacterial species, with special emphasis on ecological subdivisions and tissue-specific infections, strain diversity and population dynamics in communities, selection pressures arising from the specific host immune response and antibiotic exposure, and within-host selection during the course of invasive disease.
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Affiliation(s)
- Debra E Bessen
- Department of Microbiology & Immunology, New York Medical College, Valhalla, NY 10595, USA.
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29
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Clinical and microbiological characteristics of severe Streptococcus pyogenes disease in Europe. J Clin Microbiol 2009; 47:1155-65. [PMID: 19158266 DOI: 10.1128/jcm.02155-08] [Citation(s) in RCA: 221] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In an attempt to compare the epidemiology of severe Streptococcus pyogenes infection within Europe, prospective data were collected through the Strep-EURO program. Surveillance for severe cases of S. pyogenes infection diagnosed during 2003 and 2004 was undertaken in 11 countries across Europe by using a standardized case definition and questionnaire. Patient data as well as bacterial isolates were collected and characterized by T and M/emm typing, and selected strains were analyzed for the presence of superantigen genes. Data were analyzed to compare the clinical and microbiological patterns of the infections across the participating countries. A total of 4,353 isolates were collected from 5,521 cases with severe S. pyogenes infections who were identified. A wide diversity of M/emm types (n = 104) was found among the S. pyogenes clinical isolates, but the M/emm type distribution varied broadly between participating countries. The 10 most predominant M/emm types were M/emm type 1 (M/emm1), M/emm28, M/emm3, M/emm89, M/emm87, M/emm12, M/emm4, M/emm83, M/emm81, and M/emm5, in descending order. A correlation was found between some specific disease manifestations, the age of the patients, and the emm types. Although streptococcal toxic shock syndrome and necrotizing fasciitis were caused by a large number of types, they were particularly associated with M/emm1 and M/emm3. The emm types included in the 26-valent vaccine under development were generally well represented in the present material; 16 of the vaccine types accounted for 69% of isolates. The Strep-EURO collaborative program has contributed to enhancement of the knowledge of the spread of invasive disease caused by S. pyogenes within Europe and encourages future surveillance by the notification of cases and the characterization of strains, which are important for vaccination strategies and other health care issues.
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Smeesters PR, Mardulyn P, Vergison A, Leplae R, Van Melderen L. Genetic diversity of Group A Streptococcus M protein: Implications for typing and vaccine development. Vaccine 2008; 26:5835-42. [DOI: 10.1016/j.vaccine.2008.08.037] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2008] [Revised: 08/12/2008] [Accepted: 08/18/2008] [Indexed: 10/21/2022]
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Bessen DE, McGregor KF, Whatmore AM. Relationships between emm and multilocus sequence types within a global collection of Streptococcus pyogenes. BMC Microbiol 2008; 8:59. [PMID: 18405369 PMCID: PMC2359762 DOI: 10.1186/1471-2180-8-59] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2007] [Accepted: 04/11/2008] [Indexed: 12/02/2022] Open
Abstract
Background The M type-specific surface protein antigens encoded by the 5' end of emm genes are targets of protective host immunity and attractive vaccine candidates against infection by Streptococcus pyogenes, a global human pathogen. A history of genetic change in emm was evaluated for a worldwide collection of > 500 S. pyogenes isolates that were defined for genetic background by multilocus sequence typing of housekeeping genes. Results Organisms were categorized by genotypes that roughly correspond to throat specialists, skin specialists, and generalists often recovered from infections at either tissue site. Recovery of distant clones sharing the same emm type was ~4-fold higher for skin specialists and generalists, as compared to throat specialists. Importantly, emm type was often a poor marker for clone. Recovery of clones that underwent recombinational replacement with a new emm type was most evident for the throat and skin specialists. The average ratio of nonsynonymous substitutions per nonsynonymous site (Ka) and synonymous substitutions per synonymous site (Ks) was 4.9, 1.5 and 1.3 for emm types of the throat specialist, skin specialist and generalist groups, respectively. Conclusion Data indicate that the relationships between emm type and genetic background differ among the three host tissue-related groups, and that the selection pressures acting on emm appear to be strongest for the throat specialists. Since positive selection is likely due in part to a protective host immune response, the findings may have important implications for vaccine design and vaccination strategies.
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Affiliation(s)
- Debra E Bessen
- Department of Microbiology and Immunology, New York Medical College, Valhalla, NY 10595, USA.
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O'Grady KAF, Kelpie L, Andrews RM, Curtis N, Nolan TM, Selvaraj G, Passmore JW, Oppedisano F, Carnie JA, Carapetis JR. The epidemiology of invasive group A streptococcal disease in Victoria, Australia. Med J Aust 2007; 186:565-9. [PMID: 17547544 DOI: 10.5694/j.1326-5377.2007.tb01054.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2006] [Accepted: 03/14/2007] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To estimate the incidence and severity of invasive group A streptococcal infection in Victoria, Australia. DESIGN Prospective active surveillance study. SETTING Public and private laboratories, hospitals and general practitioners throughout Victoria. PATIENTS People in Victoria diagnosed with group A streptococcal disease notified to the surveillance system between 1 March 2002 and 31 August 2004. MAIN OUTCOME MEASURE Confirmed invasive group A streptococcal disease. RESULTS We identified 333 confirmed cases: an average annual incidence rate of 2.7 (95% CI, 2.3-3.2) per 100,000 population per year. Rates were highest in people aged 65 years and older and those younger than 5 years. The case-fatality rate was 7.8%. Streptococcal toxic shock syndrome occurred in 48 patients (14.4%), with a case-fatality rate of 23%. Thirty cases of necrotising fasciitis were reported; five (17%) of these patients died. Type 1 (23%) was the most frequently identified emm sequence type in all age groups. All tested isolates were susceptible to penicillin and clindamycin. Two isolates (4%) were resistant to erythromycin. CONCLUSION The incidence of invasive group A streptococcal disease in temperate Australia is greater than previously appreciated and warrants greater public health attention, including its designation as a notifiable disease.
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Affiliation(s)
- Kerry-Ann F O'Grady
- School of Population Health, Department of Paediatrics, University of Melbourne, Melbourne, VIC.
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Liu M, Zhu H, Zhang J, Lei B. Active and passive immunizations with the streptococcal esterase Sse protect mice against subcutaneous infection with group A streptococci. Infect Immun 2007; 75:3651-7. [PMID: 17502395 PMCID: PMC1932925 DOI: 10.1128/iai.00038-07] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The human pathogen group A Streptococcus (GAS) produces many secreted proteins that play important roles in GAS pathogenesis, including hydrolases that degrade proteins and nucleic acids. This study targets another kind of hydrolase, carboxylic esterase, with the objectives of identifying GAS esterase and determining whether it is a protective antigen. The putative esterase gene SPy1718 was cloned, and the recombinant protein (Sse) was prepared. Sse was detected in GAS culture supernatant, and patients with streptococcal pharyngitis seroconverted to Sse, indicating that Sse was produced in vivo and in vitro. Sse hydrolyzes p-nitrophenyl butyrate, and the residue (178)Ser is critical for this esterase activity. There are two Sse variant complexes according to the available genome databases, consistent with the previous finding of two antigenic Sse variants. Complex I includes serotypes M1, M2, M3, M5, M6, M12, and M18, whereas M4, M28, and M49 belong to complex II. Sse variants share >98% identity in amino acid sequence within each complex but have about 37% variation between the two groups. Active immunization with M1 Sse significantly protects mice against lethal subcutaneous infection with virulent M1 and M3 strains and inhibits GAS invasion of mouse skin tissue. Passive immunization with anti-Sse antiserum also significantly protects mice against subcutaneous GAS infection, indicating that the protection is mediated by Sse-specific antibodies. The results suggest that Sse plays an important role in tissue invasion and is an antigen protective in subcutaneous infection against GAS strains of more than one serotype.
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Affiliation(s)
- Mengyao Liu
- Department of Veterinary Molecular Biology, Montana State University, Bozeman, MT 59717, USA
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Earnhart CG, Marconi RT. Construction and analysis of variants of a polyvalent Lyme disease vaccine: approaches for improving the immune response to chimeric vaccinogens. Vaccine 2007; 25:3419-27. [PMID: 17239505 PMCID: PMC2696934 DOI: 10.1016/j.vaccine.2006.12.051] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2006] [Revised: 12/13/2006] [Accepted: 12/20/2006] [Indexed: 10/23/2022]
Abstract
There is currently no Lyme disease vaccine commercially available for use in humans. Outer surface protein C (OspC) of the Borrelia has been widely investigated as a potential vaccinogen. At least 38 OspC types have been defined. While the antibody response to OspC is protective, the range of protection is narrow due to the localization of protective epitopes within OspC type-specific domains. To develop a broadly protective vaccine, we previously constructed a tetravalent chimeric vaccinogen containing epitopes from OspC types A, B, K, and D. While this construct elicited bactericidal antibody against strains bearing each of the four OspC types, its solubility was low, and decreasing IgG titer to epitopes near the C-terminus of the construct was observed. In this report, construct solubility and immunogenicity were increased by dialysis against an Arg/Glu buffer. We also demonstrate the immunogenicity of the construct in alum. To further optimize epitope-specific immune responses, several constructs were generated with differing epitope organization or with putative C-terminal protective motifs. Analyses of murine antibody titers and isotype profiles induced by these constructs revealed that while the C-terminal tags did not enhance antibody titer, specific epitope reorganization and reiteration did. These analyses provide important information that can be exploited in the development of chimeric vaccinogens in general.
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Affiliation(s)
- Christopher G Earnhart
- Department of Microbiology and Immunology, Medical College of Virginia at Virginia Commonwealth University, Richmond, VA 23298-0678, USA
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35
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Batzloff MR, Pandey M, Olive C, Good MF. Advances in potential M-protein peptide-based vaccines for preventing rheumatic fever and rheumatic heart disease. Immunol Res 2007; 35:233-48. [PMID: 17172649 DOI: 10.1385/ir:35:3:233] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/1999] [Revised: 11/30/1999] [Accepted: 11/30/1999] [Indexed: 11/11/2022]
Abstract
Rheumatic fever (RF) and rheumatic heart disease (RHD) are postinfectious complications of an infection (or repeated infection) with the Gram-positive bacterium, Streptococcus pyogenes (also known as group A streptococcus, GAS). RF and RHD are global problems and affect many indigenous populations of developed countries and many developing countries. However, RF and RHD are only part of a larger spectrum of diseases caused by this organism. The development of a vaccine against GAS has primarily targeted the abundant cell-surface protein called the M-protein. This review focuses on different M-protein-based-subunit vaccine approaches and the different delivery technologies used to administer these vaccine candidates in preclinical studies.
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Affiliation(s)
- Michael R Batzloff
- The Cooperative Research Centre for Vaccine Technology and the Australian Centre for International Tropical Health and Nutrition, The Queensland Institute of Medical Research, Post Office Royal Brisbane Hospital, Brisbane 4029, Australia
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Hutcheon CJ, Becker JO, Russell BA, Bariola PA, Peterson GJ, Stroop SD. Physiochemical and functional characterization of antigen proteins eluted from aluminum hydroxide adjuvant. Vaccine 2006; 24:7214-25. [PMID: 16860908 DOI: 10.1016/j.vaccine.2006.06.043] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2006] [Revised: 05/18/2006] [Accepted: 06/20/2006] [Indexed: 11/16/2022]
Abstract
We have characterized protein antigens after quantitative dissociation from aluminum hydroxide adjuvant. Bovine serum albumin (BSA) and a multi-antigen vaccine for Group A Streptococcus (GrAS Vaccine) were formulated on aluminum hydroxide, stored for > or =10 days then eluted with a 48-h treatment at 4 degrees C with 0.85% H(3)PO(4) plus 4M guanidine HCl (GnHCl). BSA is recovered from adjuvant at 92+/-2%. GrAS antigens are equally recovered from GrAS Vaccine (95+/-11% of total protein expected using multiple lots stored for up to 12 months). Recovery after elution is similar when determined by RP-HPLC, SEC-HPLC, UV absorbance, or Bradford methods. Eluted antigens are structurally and functionally intact as judged relative to both treated and untreated antigen controls by SDS-PAGE, RP-HPLC, SEC-HPLC, and after desalting by circular dichroism, bis-ANS binding, and antigenicity determined by ELISA. When formulated and stored for a few weeks, BSA has more dimer (31+/-5%) relative to the elution control (9% dimer) as detected by SEC-HPLC, suggesting that BSA microaggregation is promoted on aluminum. Antigens eluted from very aged GrAS Vaccine (>12 months) show marked changes by RP-HPLC. Structural changes in the antigens under elution conditions were evaluated using bis-ANS, a fluorescent probe of protein structure. Binding of bis-ANS increases fluorescence approximately 100-fold and is significantly diminished with increasing GnHCl concentrations indicating a progressive denaturing of the proteins. At 4M GnHCl (with or without 0.85% H(3)PO(4)) the GrAS antigens are fully denatured and BSA is partially denatured. Interestingly, the addition of 0.85% H(3)PO(4) increases bis-ANS binding on GrAS antigens and reduces the denaturing of GrAS antigens and BSA by chaotropes. Desalting or diluting the eluted antigens results in renaturing of the proteins as judged by bis-ANS fluorescence, circular dichroism and antigenicity testing. The elution method provides a novel approach for high recovery and characterization of GrAS Vaccine antigens and may be applicable to the study of many aluminum hydroxide-bound vaccines.
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MESH Headings
- Adjuvants, Immunologic/chemistry
- Aluminum Hydroxide/chemistry
- Antigens, Bacterial/chemistry
- Antigens, Bacterial/immunology
- Chemical Phenomena
- Chemistry, Pharmaceutical
- Chemistry, Physical
- Chromatography, Gel
- Chromatography, High Pressure Liquid
- Circular Dichroism
- Drug Stability
- Electrophoresis, Polyacrylamide Gel
- Enzyme-Linked Immunosorbent Assay
- Fluorescent Dyes
- Protein Denaturation
- Recombinant Proteins/immunology
- Serum Albumin, Bovine/chemistry
- Spectrophotometry, Ultraviolet
- Streptococcus pyogenes/immunology
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Affiliation(s)
- Carolyn J Hutcheon
- GlaxoSmithKline Biologicals North America, 19204 North Creek Parkway, Bothell, WA 98011, USA
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Earnhart CG, Buckles EL, Marconi RT. Development of an OspC-based tetravalent, recombinant, chimeric vaccinogen that elicits bactericidal antibody against diverse Lyme disease spirochete strains. Vaccine 2006; 25:466-80. [PMID: 16996663 DOI: 10.1016/j.vaccine.2006.07.052] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2006] [Revised: 07/18/2006] [Accepted: 07/25/2006] [Indexed: 11/16/2022]
Abstract
Lyme disease is the most common arthropod-borne disease in North America and Europe. At present, there is no commercially available vaccine for use in humans. Outer surface protein C (OspC) has antigenic and expression characteristics that make it an attractive vaccine candidate; however, sequence heterogeneity has impeded its use as a vaccinogen. Sequence analyses have identified 21 well defined OspC phyletic groups or "types" (designated A-U). In this report we have mapped the linear epitopes presented by OspC types B, K, and D during human and murine infection and exploited these epitopes (along with the previously identified type A OspC linear epitopes) in the development of a recombinant, tetravalent, chimeric vaccinogen. The construct was found to be highly immunogenic in mice and the induced antibodies surface labeled in vitro cultivated spirochetes. Importantly, vaccination induced complement-dependent bactericidal antibodies against strains expressing each of the OspC types that were incorporated into the construct. These results suggest that an effective and broadly protective polyvalent OspC-based Lyme disease vaccine can be produced as a recombinant, chimeric protein.
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Affiliation(s)
- Christopher G Earnhart
- Department of Microbiology and Immunology, Medical College of Virginia at Virginia Commonwealth University, Richmond, VA 23298-0678, USA
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Sakota V, Fry AM, Lietman TM, Facklam RR, Li Z, Beall B. Genetically diverse group A streptococci from children in far-western Nepal share high genetic relatedness with isolates from other countries. J Clin Microbiol 2006; 44:2160-6. [PMID: 16757615 PMCID: PMC1489425 DOI: 10.1128/jcm.02456-05] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The genetic diversity of group A streptococci (GAS) throughout much of the world has not been adequately explored. To assess genetic variation among GAS in western Nepal, 120 noninvasive GAS, collected from eight different villages, were genetically characterized using emm typing, sof sequencing, and multilocus sequence typing (MLST). A high level of genetic diversity was observed among these isolates, with 51 genotypes based upon 51 multilocus sequence types (STs), 45 emm sequence types, and 28 sof sequence types. On the basis of shared ST-emm and sof-emm associations, 40 of the 51 genotypes were identical or highly related to genotypes characterized from locations outside of Nepal, even though most of the emm sequence and clonal types are rare among GAS within the United States. When analyzing all known STs highly related to Nepal STs, only one example of similar STs shared between a sof PCR-positive strain and a sof PCR-negative strain was observed. Since previous data indicate free exchange of MLST loci between sof-positive and sof-negative strains, there is possibly selection against the expansion of subclones resulting from horizontal transfers of sof or emm genes between sof-positive and sof-negative strains. All 45 emm types encountered in Nepal have also been documented from other countries. These data, together with data encompassing the past decade of emm type surveillance, support the possibility that most existing GAS emm types have been discovered. Similarly, since most (40/51) strain types were highly related to strains found elsewhere, it is likely that a major fraction of the existing GAS clonal complexes have been discovered.
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Affiliation(s)
- Varja Sakota
- Division of Bacterial and Myotic Diseases, Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
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39
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Eisner A, Leitner E, Feierl G, Kessler HH, Marth E. Prevalence of emm types and antibiotic resistance of group A streptococci in Austria. Diagn Microbiol Infect Dis 2006; 55:347-50. [PMID: 16725301 DOI: 10.1016/j.diagmicrobio.2006.01.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2005] [Revised: 01/13/2006] [Accepted: 01/13/2006] [Indexed: 11/13/2022]
Abstract
The prevalence of emm types and the antibiotic resistance patterns of consecutive isolates of Streptococcus pyogenes from South-East Australian patients collected in 1996 and 2003 were determined. Emm 1, emm 4, emm 12, and emm 28 were found to be the predominant types. A remarkable decrease of macrolide resistance from 1996 (19%) to 2003 (3%) was observed.
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Affiliation(s)
- Alexandra Eisner
- Institute of Hygiene, Medical University of Graz, A-8010 Graz, Austria
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40
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Bisno AL, Rubin FA, Cleary PP, Dale JB. Prospects for a group A streptococcal vaccine: rationale, feasibility, and obstacles--report of a National Institute of Allergy and Infectious Diseases workshop. Clin Infect Dis 2005; 41:1150-6. [PMID: 16163634 DOI: 10.1086/444505] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2005] [Accepted: 06/22/2005] [Indexed: 11/03/2022] Open
Abstract
Infections due to group A streptococci (GAS) represent a public health problem of major proportions in both developing and developed countries. Currently available methods of prevention are either inadequate or ineffective, as attested to by the morbidity and mortality associated with this ubiquitous pathogen worldwide. Advances in molecular biology have shed new light on the pathogenesis of GAS infections and have identified a number of virulence factors as potential vaccine targets. Therefore, the National Institute of Allergy and Infectious Diseases convened an expert workshop in March 2004 to review the available data and to explore the microbiologic, immunologic, epidemiologic, and economic issues involved in development and implementation of a safe and effective GAS vaccine. Participants included scientists and clinicians involved in GAS research, as well as representatives of United States federal agencies (Centers for Disease Control and Prevention, Food and Drug Administration, Department of Defense, and National Institute of Allergy and Infectious Diseases), the World Health Organization, and the pharmaceutical industry. This report summarizes the deliberations of the workshop.
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Affiliation(s)
- Alan L Bisno
- University of Miami Miller School of Medicine, Miami, Florida 33125, USA.
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