抗白细胞介素-6 免疫治疗期间 A 组链球菌伺机性侵袭性感染。
Opportunistic Invasive Infection by Group A Streptococcus During Anti-Interleukin-6 Immunotherapy.
机构信息
Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, Georgia, USA.
Wayne State University, Detroit, Michigan, USA.
出版信息
J Infect Dis. 2021 Apr 8;223(7):1260-1264. doi: 10.1093/infdis/jiaa511.
Abstract
Invasive group A Streptococcus (GAS) in immunocompetent individuals is largely linked to hypervirulent strains. Congenital immunodeficiencies and those acquired from chronic disease or immunosuppressant drugs also increase risk of severe illness. We recovered GAS from the blood of a patient receiving a biologic inhibitor of interleukin 6 (IL-6). Growth of this serotype M4 isolate in human blood or a murine bacteremia model was promoted by interleukin 1 or IL-6 inhibition. Hyperinvasive M1T1 GAS was unaffected by IL-6 in both models. These findings based on a natural experiment introduce IL-6 signaling deficiencies as a risk factor for invasive GAS.
摘要
在免疫功能正常的个体中，侵袭性 A 组链球菌（GAS）主要与高毒力菌株有关。先天性免疫缺陷，以及由慢性疾病或免疫抑制剂药物引起的免疫缺陷，也会增加患重病的风险。我们从一名接受白细胞介素 6（IL-6）生物抑制剂治疗的患者的血液中分离出 GAS。这种 M4 血清型分离株在人血液或鼠菌血症模型中的生长受到白细胞介素 1 或 IL-6 抑制的促进。在这两种模型中，高侵袭性 M1T1 GAS 不受 IL-6 的影响。这些基于自然实验的发现提示，IL-6 信号缺陷是侵袭性 GAS 的一个风险因素。
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