Girlando Virginia, De Angelis Luisa, D'Egidio Gianluca, Di Ludovico Armando, Breda Luciana
Pediatric Rheumatology Unit, Department of Pediatrics, SS Annunziata Hospital, Via dei Vestini, 66100 Chieti, Italy.
Gabriele D'Annunzio University, Via dei Vestini, 31, 66013 Chieti, Italy.
Microorganisms. 2025 Jun 16;13(6):1398. doi: 10.3390/microorganisms13061398.
Group A β-hemolytic Streptococcus (GAS) is a Gram-positive, coccoid-shaped bacterium that tends to grow in chains; it is a non-spore-forming, facultatively anaerobic, catalase-negative, aerobic bacterium. It is known to cause a wide range of infections in children, ranging from mild upper respiratory tract infections, such as pharyngitis, to severe invasive disease. GAS also notably triggers post-infectious immune sequelae, including acute poststreptococcal glomerulonephritis (APSGN), acute rheumatic fever (ARF), and rheumatic heart disease (RHD), which are major health burdens, especially in low-income countries. In this review, we will present the general characteristics of GAS, highlighting its structural and microbiological features. We will also discuss its pathogenetic mechanisms, especially molecular mimicry, and its ability to cause autoimmune responses. Finally, we will elucidate some of the autoimmune sequelae that mark GAS infections, such as ARF, RHD, APSGN, and guttate psoriasis. Understanding GAS as a model pathogen for infection-induced autoimmunity provides insight into host-pathogen interactions and supports the development of targeted interventions. Emphasis on early diagnosis and antibiotic treatment is essential to reduce the burden of autoimmune complications.
A组β溶血性链球菌(GAS)是一种革兰氏阳性、球状细菌,倾向于呈链状生长;它是一种不形成芽孢、兼性厌氧、过氧化氢酶阴性的需氧细菌。已知它会在儿童中引发多种感染,从轻度上呼吸道感染,如咽炎,到严重的侵袭性疾病。GAS还特别会引发感染后的免疫后遗症,包括急性链球菌感染后肾小球肾炎(APSGN)、急性风湿热(ARF)和风湿性心脏病(RHD),这些都是主要的健康负担,尤其是在低收入国家。在这篇综述中,我们将介绍GAS的一般特征,突出其结构和微生物学特征。我们还将讨论其致病机制,特别是分子模拟,以及它引发自身免疫反应的能力。最后,我们将阐明一些标志着GAS感染的自身免疫后遗症,如ARF、RHD、APSGN和点滴状银屑病。将GAS理解为感染诱导自身免疫的模型病原体有助于深入了解宿主与病原体的相互作用,并支持有针对性干预措施的开发。强调早期诊断和抗生素治疗对于减轻自身免疫并发症的负担至关重要。
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