A brief review on Group A Streptococcus pathogenesis and vaccine development
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Sowmya Ajay Castro1, Helge C Dorfmueller1
1Division of Molecular Microbiology, School of Life Sciences, University of Dundee, Dow Street, Dundee, DD1 5EH, UK.
Abstract:
Streptococcus pyogenes, also known as Group A Streptococcus (GAS), is a Gram-positive human-exclusive pathogen, responsible for more than 500 000 deaths annually worldwide. Upon infection, GAS commonly triggers mild symptoms such as pharyngitis, pyoderma and fever. However, recurrent infections or prolonged exposure to GAS might lead to life-threatening conditions. Necrotizing fasciitis, streptococcal toxic shock syndrome and post-immune mediated diseases, such as poststreptococcal glomerulonephritis, acute rheumatic fever and rheumatic heart disease, contribute to very high mortality rates in non-industrialized countries. Though an initial reduction in GAS infections was observed in high-income countries, global outbreaks of GAS, causing rheumatic fever and acute poststreptococcal glomerulonephritis, have been reported over the last decade. At the same time, our understanding of GAS pathogenesis and transmission has vastly increased, with detailed insight into the various stages of infection, beginning with adhesion, colonization and evasion of the host immune system. Despite deeper knowledge of the impact of GAS on the human body, the development of a successful vaccine for prophylaxis of GAS remains outstanding. In this review, we discuss the challenges involved in identifying a universal GAS vaccine and describe several potential vaccine candidates that we believe warrant pursuit.
Insights
Group A Streptococcus (GAS) causes severe infections and deaths globally. Developing a universal GAS vaccine faces challenges, but several promising candidates are being explored for future prevention.
Area of Science:
- Microbiology
- Infectious Diseases
- Vaccinology
Background:
- Group A Streptococcus (GAS) is a significant human pathogen causing over 500,000 deaths annually.
- GAS infections range from mild pharyngitis to life-threatening conditions like necrotizing fasciitis and toxic shock syndrome.
- Despite increased understanding of GAS pathogenesis, a universal prophylactic vaccine remains elusive, with recent global outbreaks highlighting the need.
Purpose of the Study:
- To review the challenges in developing a universal Group A Streptococcus vaccine.
- To discuss promising vaccine candidates for GAS prophylaxis.
- To provide insight into GAS pathogenesis and transmission.
Main Methods:
- Literature review of Streptococcus pyogenes (GAS) pathogenesis.
- Analysis of current understanding of GAS infection stages: adhesion, colonization, and immune evasion.
- Evaluation of potential vaccine strategies and candidates.
Main Results:
- GAS infections continue to cause significant mortality, particularly in non-industrialized nations.
- Global outbreaks of GAS-related diseases like rheumatic fever and glomerulonephritis have been reported.
- Advances in understanding GAS biology offer new avenues for vaccine development.
Conclusions:
- Developing a universal GAS vaccine is a complex challenge.
- Several potential vaccine candidates show promise and warrant further investigation.
- Effective GAS prophylaxis is crucial for reducing global mortality and morbidity.
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