Kaplan E L, Wannamaker L W
J Exp Med. 1976 Sep 1;144(3):754-67. doi: 10.1084/jem.144.3.754.
Lipids extracted from rabbit skin block the hemolytic capacity of SO and also suppress the neutralizing antibody response to this streptococcal extracellular antigen in rabbith immunized intravenosly. The modification in antibody response is specific for SO; the antibody responses to streptococcal DNase B and to streptococcal NADase are not affected. Cholesterol, a lipid present in abundance in skin, has a similar specific effect on the antigenicity of SO and may be the component responsible for the demonstrated effects of these lipid extracts of skin. In vitro experiments indicate that lipid extracts of rabbit skin have a greater capacity to block the hemolytic capacity of SO than do lipid extracts of rabbit heart, kidney, lung, liver, or spleen. These data support the view that the feeble ASO response observed in patients with streptococcal pyoderma is a result of the abundance of a local lipid inhibitor, such as cholesterol, in the skin. They may also bear on the pathogenesis of rheumatic fever, a complication which apparently does not occur following group A streptococcal pyoderma. Two possible explanations for this remarkable epidemiologic observation, both related to the presence of a local inhibitor, are considered: (a) suppression of the ASO response, the magnitude of which has been correlated with the risk of developing rheumatic fever after streptococcal infection of the throat, and (b) inhibition of the toxicity of SO, which has been shown to have a direct toxic effect on the mammalian heart and on isolated beating myocytes.
从兔皮中提取的脂质可阻断链球菌溶血素O（SO）的溶血能力，还可抑制经静脉免疫的兔对这种链球菌细胞外抗原的中和抗体反应。抗体反应的改变对SO具有特异性；对链球菌DNA酶B和链球菌NAD酶的抗体反应不受影响。胆固醇是皮肤中大量存在的一种脂质，对SO的抗原性有类似的特异性作用，可能是这些皮肤脂质提取物所显示作用的 responsible component。体外实验表明，兔皮脂质提取物比兔心、肾、肺、肝或脾的脂质提取物具有更强的阻断SO溶血能力的能力。这些数据支持这样一种观点，即链球菌脓皮病患者中观察到的微弱抗链球菌溶血素O（ASO）反应是皮肤中大量存在局部脂质抑制剂（如胆固醇）的结果。它们也可能与风湿热的发病机制有关，风湿热是一种显然不会在A组链球菌脓皮病后发生的并发症。对于这一显著的流行病学观察结果，考虑了两种与局部抑制剂存在相关的可能解释：（a）抑制ASO反应，其程度与咽喉部链球菌感染后发生风湿热的风险相关；（b）抑制SO的毒性，SO已被证明对哺乳动物心脏和分离的跳动心肌细胞有直接毒性作用。
