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      Streptococcus pyogenes evades adaptive immunity through specific IgG glycan hydrolysis

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          Abstract

          EndoS from Streptococcus pyogenes hydrolyzes the functionally important glycan on the Fc portion of IgG during infections in humans. In mice with IgG mediated immunity against the M1 protein on the bacteria, EndoS is a virulence factor.

          Abstract

          Streptococcus pyogenes (Group A streptococcus; GAS) is a human pathogen causing diseases from uncomplicated tonsillitis to life-threatening invasive infections. GAS secretes EndoS, an endoglycosidase that specifically cleaves the conserved N-glycan on IgG antibodies. In vitro, removal of this glycan impairs IgG effector functions, but its relevance to GAS infection in vivo is unclear. Using targeted mass spectrometry, we characterized the effects of EndoS on host IgG glycosylation during the course of infections in humans. Substantial IgG glycan hydrolysis occurred at the site of infection and systemically in the severe cases. We demonstrated decreased resistance to phagocytic killing of GAS lacking EndoS in vitro and decreased virulence in a mouse model of invasive infection. This is the first described example of specific bacterial IgG glycan hydrolysis during infection and thereby verifies the hypothesis that EndoS modifies antibodies in vivo. This mechanisms of immune evasion could have implications for treatment of severe GAS infections and for future efforts at vaccine development.

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          Most cited references63

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          The global burden of group A streptococcal diseases.

          The global burden of disease caused by group A streptococcus (GAS) is not known. We review recent population-based data to estimate the burden of GAS diseases and highlight deficiencies in the available data. We estimate that there are at least 517,000 deaths each year due to severe GAS diseases (eg, acute rheumatic fever, rheumatic heart disease, post-streptococcal glomerulonephritis, and invasive infections). The prevalence of severe GAS disease is at least 18.1 million cases, with 1.78 million new cases each year. The greatest burden is due to rheumatic heart disease, with a prevalence of at least 15.6 million cases, with 282,000 new cases and 233,000 deaths each year. The burden of invasive GAS diseases is unexpectedly high, with at least 663,000 new cases and 163,000 deaths each year. In addition, there are more than 111 million prevalent cases of GAS pyoderma, and over 616 million incident cases per year of GAS pharyngitis. Epidemiological data from developing countries for most diseases is poor. On a global scale, GAS is an important cause of morbidity and mortality. These data emphasise the need to reinforce current control strategies, develop new primary prevention strategies, and collect better data from developing countries.
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            Disease manifestations and pathogenic mechanisms of group a Streptococcus.

            Streptococcus pyogenes, also known as group A Streptococcus (GAS), causes mild human infections such as pharyngitis and impetigo and serious infections such as necrotizing fasciitis and streptococcal toxic shock syndrome. Furthermore, repeated GAS infections may trigger autoimmune diseases, including acute poststreptococcal glomerulonephritis, acute rheumatic fever, and rheumatic heart disease. Combined, these diseases account for over half a million deaths per year globally. Genomic and molecular analyses have now characterized a large number of GAS virulence determinants, many of which exhibit overlap and redundancy in the processes of adhesion and colonization, innate immune resistance, and the capacity to facilitate tissue barrier degradation and spread within the human host. This improved understanding of the contribution of individual virulence determinants to the disease process has led to the formulation of models of GAS disease progression, which may lead to better treatment and intervention strategies. While GAS remains sensitive to all penicillins and cephalosporins, rising resistance to other antibiotics used in disease treatment is an increasing worldwide concern. Several GAS vaccine formulations that elicit protective immunity in animal models have shown promise in nonhuman primate and early-stage human trials. The development of a safe and efficacious commercial human vaccine for the prophylaxis of GAS disease remains a high priority.
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              A Functional Role for Antibodies in Tuberculosis.

              While a third of the world carries the burden of tuberculosis, disease control has been hindered by a lack of tools, including a rapid, point-of-care diagnostic and a protective vaccine. In many infectious diseases, antibodies (Abs) are powerful biomarkers and important immune mediators. However, in Mycobacterium tuberculosis (Mtb) infection, a discriminatory or protective role for humoral immunity remains unclear. Using an unbiased antibody profiling approach, we show that individuals with latent tuberculosis infection (Ltb) and active tuberculosis disease (Atb) have distinct Mtb-specific humoral responses, such that Ltb infection is associated with unique Ab Fc functional profiles, selective binding to FcγRIII, and distinct Ab glycosylation patterns. Moreover, compared to Abs from Atb, Abs from Ltb drove enhanced phagolysosomal maturation, inflammasome activation, and, most importantly, macrophage killing of intracellular Mtb. Combined, these data point to a potential role for Fc-mediated Ab effector functions, tuned via differential glycosylation, in Mtb control.
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                Author and article information

                Journal
                J Exp Med
                J. Exp. Med
                jem
                jem
                The Journal of Experimental Medicine
                Rockefeller University Press
                0022-1007
                1540-9538
                01 July 2019
                15 May 2019
                : 216
                : 7
                : 1615-1629
                Affiliations
                [1]Faculty of Medicine, Department of Clinical Sciences, Division of Infection Medicine, Lund University, Lund, Sweden
                Author notes
                Correspondence to Mattias Collin: mattias.collin@ 123456med.lu.se

                A. Naegeli’s present address is Genovis AB, Lund, Sweden.

                R. Kalluru’s present address is Department of Pathology, Stanford University School of Medicine, Stanford, CA.

                Author information
                http://orcid.org/0000-0002-7099-0092
                http://orcid.org/0000-0002-2889-7169
                http://orcid.org/0000-0002-6166-7410
                Article
                20190293
                10.1084/jem.20190293
                6605743
                31092533
                473936e1-908f-4317-baa4-477e9938bb5a
                © 2019 Naegeli et al.

                This article is distributed under the terms of an Attribution–Noncommercial–Share Alike–No Mirror Sites license for the first six months after the publication date (see http://www.rupress.org/terms/). After six months it is available under a Creative Commons License (Attribution–Noncommercial–Share Alike 4.0 International license, as described at https://creativecommons.org/licenses/by-nc-sa/4.0/).

                History
                : 17 February 2019
                : 15 April 2019
                : 16 April 2019
                Page count
                Pages: 15
                Funding
                Funded by: Swiss National Science Foundation, DOI https://doi.org/10.13039/501100001711;
                Award ID: P2EZP3_155594
                Award ID: P300PA_167754
                Funded by: Royal Physiographic Society in Lund, DOI https://doi.org/10.13039/501100005753;
                Funded by: Sigurd and Elsa Goljes Memorial Foundation
                Funded by: Swedish Research Council, DOI https://doi.org/10.13039/501100004359;
                Award ID: 2012-1875
                Award ID: 2017-02147
                Funded by: Royal Physiographic Society in Lund, DOI https://doi.org/10.13039/501100005753;
                Funded by: Åke Wiberg, DOI https://doi.org/10.13039/100007435;
                Funded by: Alfred Österlund, DOI https://doi.org/10.13039/501100005390;
                Funded by: Gyllenstierna-Krapperup
                Funded by: Torsten Söderberg, DOI https://doi.org/10.13039/100007464;
                Funded by: King Gustaf V`s 80-year Fund, DOI https://doi.org/10.13039/501100007857;
                Funded by: Hansa Medical AB
                Funded by: Knut and Alice Wallenberg Foundation, DOI https://doi.org/10.13039/501100004063;
                Award ID: 2016.0023
                Funded by: European Research Council, DOI https://doi.org/10.13039/100010663;
                Award ID: ERC-2012-StG-309831
                Funded by: Swedish Research Council, DOI https://doi.org/10.13039/501100004359;
                Award ID: 2015-02481
                Funded by: Wallenberg Academy Fellow program KAW
                Award ID: 2012.0178
                Award ID: 2017.0271
                Funded by: Olle Engkvist Byggmästare
                Funded by: Medical Faculty of Lund University, DOI https://doi.org/10.13039/501100004817;
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