Akesson Per, Rasmussen Magnus, Mascini Ellen, von Pawel-Rammingen Ulrich, Janulczyk Robert, Collin Mattias, Olsen Arne, Mattsson Eva, Olsson Martin L, Bjorck Lars, Christensson Bertil
Department of Medical Microbiology, Institute of Laboratory Medicine, Lund University, Lund, Sweden.
J Infect Dis. 2004 Mar 1;189(5):797-804. doi: 10.1086/381982. Epub 2004 Feb 18.
Acute-phase serum samples from 70 patients with group A streptococcal (GAS) invasive disease were analyzed for IgG antibodies against 6 recently characterized GAS virulence factors (SclA, SclB, GRAB, MtsA, EndoS, and IdeS) and SpeB. Antibody levels against the cell wall-attached GAS antigens SclA, SclB, and GRAB were significantly lower in patients with severe invasive disease (streptococcal toxic shock syndrome [STSS] and/or necrotizing fasciitis [NF]; n=35), compared with levels in patients with nonsevere GAS bacteremia (n=35). Among patients with severe invasive disease, significantly lower antibody levels against GRAB were found in patients with STSS (n=10) than in patients with NF (n=17). Antibody levels against SpeB in patients with severe bacteremia were similar to those in patients with nonsevere bacteremia, and levels in patients with STSS were similar to those in patients with NF. The data indicate that immunity to cell wall-attached proteins may play a role in the protection against severe invasive disease and that antibodies against GRAB may be of importance in the pathogenesis of STSS.
对70例A组链球菌（GAS）侵袭性疾病患者的急性期血清样本进行分析，检测其针对6种最近鉴定出的GAS毒力因子（SclA、SclB、GRAB、MtsA、EndoS和IdeS）以及SpeB的IgG抗体。与非重症GAS菌血症患者（n = 35）相比，重症侵袭性疾病患者（链球菌中毒性休克综合征[STSS]和/或坏死性筋膜炎[NF]；n = 35）针对细胞壁附着的GAS抗原SclA、SclB和GRAB的抗体水平显著降低。在重症侵袭性疾病患者中，STSS患者（n = 10）针对GRAB的抗体水平显著低于NF患者（n = 17）。重症菌血症患者针对SpeB的抗体水平与非重症菌血症患者相似，STSS患者的水平与NF患者相似。数据表明，针对细胞壁附着蛋白的免疫可能在预防重症侵袭性疾病中发挥作用，并且针对GRAB的抗体可能在STSS的发病机制中具有重要意义。
