Ayoub Elia M, Nelson Beverly, Shulman Stanford T, Barrett Douglas J, Campbell J Douglas, Armstrong George, Lovejoy John, Angoff Gerald H, Rockenmacher Sol
Department of Pediatrics, University of Florida, Gainesville 32610, USA.
Clin Diagn Lab Immunol. 2003 Sep;10(5):886-90. doi: 10.1128/cdli.10.5.886-890.2003.
The levels of streptococcal antibody titers in populations with or without rheumatic fever from an area with a relatively high incidence of rheumatic fever and an area with a low incidence of this disease were compared. Streptococcal antibody titers were determined for two populations, each of which included children without rheumatic fever (nonrheumatic children) and rheumatic fever patients. The two populations were derived from two separate geographic areas, one with a high incidence of rheumatic fever (Grenada) and another with a low incidence of this disease (central Florida). The results revealed an absence of consistent differences in the geometric mean antibody titers between the nonrheumatic subjects and the rheumatic fever patients from Grenada. In the population from Grenada, the mean anti-streptolysin O and anti-DNase B titers were higher in the nonrheumatic controls (P of 0.085 and 0.029, respectively). However, the mean titer of the antibody to the group A streptococcal cell wall carbohydrate was higher in the rheumatic fever patients than in the nonrheumatic controls (P = 0.047). This finding contrasted with the finding that the means of all three streptococcal antibody titers in the patients with rheumatic fever were significantly higher than those in the nonrheumatic subjects from Florida (P = 0.01-<0.001). The reason for this paradoxical finding became evident when the streptococcal antibody titers of the nonrheumatic subjects from Grenada and Florida were compared, revealing significantly higher levels of all three antibodies in the nonrheumatic subjects from Grenada than in the nonrheumatic subjects from Florida (P < 0.001). These results suggest that nonrheumatic individuals in an area with a high incidence of rheumatic fever have inordinately elevated levels of streptococcal antibodies in serum. The presence of elevated streptococcal antibody titers in such a population, which probably reflects a high background prevalence of streptococcal infections, should be taken into consideration when evaluating the role of the group A streptococcus in nonpurulent complications of infections.
对风湿热发病率相对较高地区和该疾病发病率较低地区的有或无风湿热人群的链球菌抗体滴度水平进行了比较。测定了两个人群的链球菌抗体滴度，每个群体都包括无风湿热儿童（非风湿热儿童）和风湿热患者。这两个人群来自两个不同的地理区域，一个是风湿热高发地区（格林纳达），另一个是该疾病低发地区（佛罗里达州中部）。结果显示，格林纳达的非风湿热受试者和风湿热患者之间的几何平均抗体滴度没有一致的差异。在格林纳达人群中，非风湿热对照组的抗链球菌溶血素O和抗脱氧核糖核酸酶B平均滴度较高（P值分别为0.085和0.029）。然而，风湿热患者中抗A组链球菌细胞壁碳水化合物抗体的平均滴度高于非风湿热对照组（P = 0.047）。这一发现与风湿热患者的所有三种链球菌抗体滴度均值显著高于佛罗里达州非风湿热受试者的发现形成对比（P = 0.01 - <0.001）。当比较格林纳达和佛罗里达州非风湿热受试者的链球菌抗体滴度时，这个矛盾发现的原因变得明显，结果显示格林纳达非风湿热受试者的所有三种抗体水平显著高于佛罗里达州非风湿热受试者（P < 0.001）。这些结果表明，在风湿热高发地区的非风湿热个体血清中链球菌抗体水平异常升高。在评估A组链球菌在感染非化脓性并发症中的作用时，应考虑到这类人群中链球菌抗体滴度升高的情况，这可能反映了链球菌感染的高背景患病率。
