Recruited macrophages control dissemination of group A Streptococcus from infected soft tissues

Inbal Mishalian1, Merav Ordan, Amnon Peled

  • 1Department of Microbiology and Molecular Genetics, Faculty of Medicine, The Institute for Medical Research - Israel-Canada, The Hebrew University, Jerusalem 91120, Israel.

Insights

Group A Streptococcus (GAS) infections, like necrotizing fasciitis, are serious. Macrophages, not neutrophils, are key in limiting GAS spread from tissues, crucial for controlling this pathogen.

Area of Science:

  • Immunology
  • Microbiology
  • Infectious Diseases

Background:

  • Group A Streptococcus (GAS) causes mild to severe human infections, including necrotizing fasciitis (NF).
  • Early leukocyte recruitment is vital for NF outcomes, but macrophage roles are unclear despite established neutrophil functions.
  • Tumor necrosis factor-alpha (TNF-α) influences susceptibility to GAS infections.

Purpose of the Study:

  • To investigate the role of macrophages in host defense against Group A Streptococcus (GAS) during cutaneous infections.
  • To determine if TNF-α's protective effects against GAS are mediated by macrophages/monocytes.
  • To elucidate the contribution of macrophages to limiting bacterial spread in necrotizing fasciitis models.

Main Methods:

  • Utilized a cutaneous murine model of GAS infection that mimics human necrotizing fasciitis.
  • Employed pharmacological and genetic methods to systemically deplete monocytes in C57BL/6 mice.
  • Assessed bacterial dissemination, recruited polymorphonuclear neutrophils (PMNs), and bacterial loads in soft tissues.
  • Administered monocytes or macrophages intravenously or subcutaneously to evaluate rescue effects.

Main Results:

  • Mice deficient in TNF-α exhibited increased susceptibility to GAS, with a notable lack of macrophages but not PMNs.
  • Systemic monocyte depletion led to greater GAS dissemination from soft tissues without altering PMN recruitment or local bacterial loads.
  • The enhanced GAS dissemination resulting from monocyte depletion was reversed by the administration of monocytes or macrophages.
  • Recruited macrophages were shown to limit the spread of GAS from soft tissues.

Conclusions:

  • Recruited macrophages play a critical role in host defense against the extracellular pathogen Group A Streptococcus.
  • Macrophages are essential for limiting the dissemination of GAS from infection sites.
  • These findings highlight macrophages as key players in combating invasive GAS infections, particularly necrotizing fasciitis.