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J Pediatr ; 131(2): 293-9, 1997 Aug.
Article in English | MEDLINE | ID: mdl-9290619

ABSTRACT

OBJECTIVE: To determine the immune responses to the streptococcal M protein in patients with poststreptococcal acute glomerulonephritis (PSAGN). STUDY DESIGN: The gene coding type 12 M protein of group A streptococcus (M12), a known PSAGN-associated serotype, was cloned and expressed in Escherichia coli to investigate the specific immune responses to the M12 protein in patients with PSAGN. Recombinant M proteins for the variable N-terminal half (AB region) and conserved C-terminal half (C region) were produced separately. IgG titers against each region were measured by enzyme-linked immunosorbent assay in patients with PSAGN (n = 51), uncomplicated streptococcal pharyngitis (n = 26), chronic glomerulonephritis (n = 10), and in healthy control subjects (n = 51). Immunodominant domains within the M protein in PSAGN were further investigated by use of overlapping synthetic peptides. RESULTS: IgG titers against the C region, but not the AB region, were markedly higher in the PSAGN group than in other groups (p < 0.01), and these titers were maintained for at least several months after antistreptolysin O or antistreptokinase levels had returned to normal. Studies with overlapping synthetic peptides demonstrated that increased IgG reactivity was observed against the C repeat blocks. CONCLUSION: IgG titers against the C region are significantly elevated in patients with PSAGN, and it may be a diagnostic marker for PSAGN.


Subject(s)
Antibodies, Bacterial/analysis , Antigens, Bacterial/immunology , Antigens, Surface/immunology , Bacterial Outer Membrane Proteins , Bacterial Proteins/immunology , Carrier Proteins , Glomerulonephritis/microbiology , Immunoglobulin G/analysis , Streptococcal Infections/immunology , Streptococcus pyogenes/immunology , Acute Disease , Antigens, Bacterial/genetics , Antigens, Surface/genetics , Antistreptolysin/analysis , Bacterial Proteins/genetics , Biomarkers/analysis , Case-Control Studies , Child , Chronic Disease , Enzyme-Linked Immunosorbent Assay , Escherichia coli/genetics , Female , Gene Expression , Glomerulonephritis/immunology , Humans , Immunodominant Epitopes/genetics , Immunodominant Epitopes/immunology , Male , Peptides , Pharyngitis/immunology , Pharyngitis/microbiology , Polymerase Chain Reaction , Recombinant Proteins , Repetitive Sequences, Nucleic Acid , Sequence Analysis, DNA , Streptococcus pyogenes/genetics , Streptokinase/analysis
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