Gray E D, Wannamaker L W, Ayoub E M, el Kholy A, Abdin Z H
J Clin Invest. 1981 Sep;68(3):665-71. doi: 10.1172/jci110301.
The lymphocyte transformation responses to purified preparations of two extracellular products of group A streptococci (blastogen A and nuclease B), to phytohemagglutinin, and to Candida albicans antigen were measured in tonsillar and peripheral blood lymphocytes from patients with rheumatic heart disease (RHD) and suitably matched nonrheumatic (control) subjects. The mean phytohemagglutinin dose responses of tonsillar and peripheral lymphocytes from RHD patients were essentially indistinguishable from those of controls. In contrast, the responses of tonsillar and peripheral blood lymphocytes to the two extracellular products of group A streptococci were significantly lower in RHD patients than in nonrheumatic control subjects. Candida antigen produced very little stimulation of lymphocytes in any of the subjects. The geometric means of antibody levels against streptolysin O, nuclease B, and nicotinamide adenine dinucleotidase showed no consistent differences between the control group and the group of RHD subjects. Group A streptococci were isolated from the tonsils of approximately 25% of both groups of subjects. The RHD patients clearly had a depressed cellular immune response to the two purified streptococcal extracellular antigens. The equal frequency in recovery of group A streptococci from tonsils and the absence of consistent difference in titers of humoral antibodies to streptococcal extracellular antigens, particularly nuclease B, suggest that this differential response is not due to a lower level of stimulation by repeated exposure to group A streptococcal products.
在风湿性心脏病（RHD）患者以及匹配良好的非风湿性（对照）受试者的扁桃体和外周血淋巴细胞中，检测了对A组链球菌两种细胞外产物（致有丝分裂原A和核酸酶B）的纯化制剂、植物血凝素以及白色念珠菌抗原的淋巴细胞转化反应。RHD患者扁桃体和外周淋巴细胞对植物血凝素的平均剂量反应与对照组基本无差异。相比之下，RHD患者扁桃体和外周血淋巴细胞对A组链球菌两种细胞外产物的反应明显低于非风湿性对照受试者。白色念珠菌抗原在任何受试者中对淋巴细胞的刺激都很小。抗链球菌溶血素O、核酸酶B和烟酰胺腺嘌呤二核苷酸酶的抗体水平几何平均值在对照组和RHD受试者组之间未显示出一致差异。两组受试者中约25%的扁桃体分离出A组链球菌。RHD患者对两种纯化的链球菌细胞外抗原的细胞免疫反应明显降低。从扁桃体中回收A组链球菌的频率相同，并且针对链球菌细胞外抗原，特别是核酸酶B的体液抗体滴度没有一致差异，这表明这种差异反应并非由于反复接触A组链球菌产物导致的刺激水平较低所致。
