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Pathogenesis of group A streptococcal infections
1Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA.
Clinical Microbiology Reviews
|July 25, 2000
Summary
Group A Streptococcus bacteria cause various infections, including strep throat and rheumatic fever. Recent outbreaks highlight evolving strains, necessitating new vaccine strategies targeting M protein and virulence factors.
Area of Science:
- Microbiology
- Immunology
- Pathogenesis
Background:
- Group A Streptococcus (GAS) is a major extracellular gram-positive pathogen.
- GAS causes pharyngitis, impetigo, rheumatic fever, and acute glomerulonephritis.
- Recent outbreaks show a resurgence of invasive GAS diseases and rheumatic fever.
Purpose of the Study:
- To review recent advances in understanding Group A Streptococcus virulence, epidemiology, and vaccine development.
- To highlight the evolving genetic makeup and serotypes of GAS strains.
- To discuss emerging themes in GAS pathogenesis and host immune response.
Main Methods:
- emm gene sequencing for serotyping.
- Characterization of virulence genes, regulatory networks, and superantigens.
- Identification of adhesins and antiphagocytic molecules.
- Analysis of host-pathogen interactions, including complement evasion and molecular mimicry.
Main Results:
- emm gene sequencing has refined GAS serotyping.
- New virulence factors and regulatory networks have been defined.
- GAS exhibits strain dichotomy between skin and throat infections.
- Mechanisms of immune evasion, including C5a peptidase activity, have been elucidated.
- Molecular mimicry is implicated in rheumatic fever pathogenesis.
Conclusions:
- Understanding GAS virulence and host interactions is crucial for combating invasive diseases.
- New vaccine strategies targeting M protein and C5a peptidase are under investigation.
- Mucosal vaccine delivery systems show promise for GAS prevention.