Abstract
We tested the ability of pepsin-extracted, highly purified M protein to induce type-specific immunity in experimental animals and humans. M protein was prepared from limited peptic digests of whole group A type 24 streptococci and was purified to chemical homogeneity as judged by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, quantitative amino acid analysis, and Edman degradation. For vaccination, the lyophilized M24 protein preparation (pep M24) was precipitated in aluminum hydroxide. When injected into laboratory animals, alum- precipitated pep M24 produced type-specific protective antibodies and was free of non-type-specific immunoreactivity. In man, skin tests with 1-microgram doses of pep M24 were negative in all 37 adults tested. 12 adult human volunteers received two-four subcutaneous injections of 100- 200 micrograms of alum-precipitated pep M24 at intervals of at least 2 wk. The immune response to pep M24 was measured by a variety of assays designed to detect (a) type-specific humoral antibodies (opsonophagocytic, long chain, and mouse protection tests); (b) total humoral antibodies (complement fixation and enzyme-linked immunosorbent assay); (c) cellular immunity (skin tests); and (d) heart cross- reactive antibodies (immunofluorescence). Type-specific opsonic antibodies developed in 10 of the 12 vaccinees, and positive delayed- type skin tests developed in 11. Immune sera from two of the vaccinees were effective in mouse-protection tests against challenge with M24 but not M6 streptococci. None of the volunteers developed heart-reactive antibodies or antibodies to non-type-specific M protein antigens. Alum- precipitated pep M24 was well-tolerated in man, and no serious local or systemic reactions were observed. Thus, pep M24 induces type-specific, protective antibodies in doses that are well-tolerated in man.
Full Text
The Full Text of this article is available as a PDF (1.2 MB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Askenase P. W., Atwood J. E. Basophils in tuberculin and "Jones-Mote" delayed reactions of humans. J Clin Invest. 1976 Nov;58(5):1145–1154. doi: 10.1172/JCI108567. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Beachey E. H., Alberti H., Stollerman G. H. Delayed hypersensitivity to purified streptococcal m protein in guinea pigs and in man. J Immunol. 1969 Jan;102(1):42–52. [PubMed] [Google Scholar]
- Beachey E. H., Campbell G. L., Ofek I. Peptic digestion of streptococcal M protein. II. Extraction of M antigen from group A streptococci with pepsin. Infect Immun. 1974 May;9(5):891–896. doi: 10.1128/iai.9.5.891-896.1974. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Beachey E. H., Chiang E. Y., Seyer J. M., Kang A. H., Chiang T. M., Stollerman G. H. Separation of the type specific M protein from toxic cross reactive antigens of group A streptococci. Trans Assoc Am Physicians. 1977;90:390–400. [PubMed] [Google Scholar]
- Beachey E. H., Ofek I., Bismo A. L. Studies of antibodies to non-type-specific antigens associated with streptococcal M protein in the sera of patients with rheumatic fever. J Immunol. 1973 Nov;111(5):1361–1366. [PubMed] [Google Scholar]
- Beachey E. H., Seyer J. M., Kang A. H. Repeating covalent structure of streptococcal M protein. Proc Natl Acad Sci U S A. 1978 Jul;75(7):3163–3167. doi: 10.1073/pnas.75.7.3163. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Beachey E. H., Stollerman G. H., Chiang E. Y., Chiang T. M., Seyer J. M., Kang A. H. Purification and properties of M protein extracted from group A streptococci with pepsin: covalent structure of the amino terminal region of type 24 M antigen. J Exp Med. 1977 Jun 1;145(6):1469–1483. doi: 10.1084/jem.145.6.1469. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Beachey E. H., Stollerman G. H. Mediation of cytotoxic effects of streptococcal M protein by nontype-specific antibody in human sera. J Clin Invest. 1973 Oct;52(10):2563–2570. doi: 10.1172/JCI107448. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Beachey E. H., Stollerman G. H. Toxic effects of streptococcal M protein on platelets and polymorphonuclear leukocytes in human blood. J Exp Med. 1971 Aug 1;134(2):351–365. doi: 10.1084/jem.134.2.351. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cunningham M., Beachey E. H. Immunochemical properties of streptococcal M protein purified by isoelectric focusing. J Immunol. 1975 Oct;115(4):1002–1006. [PubMed] [Google Scholar]
- D'Alessandri R., Plotkin G., Kluge R. M., Wittner M. K., Fox E. N., Dorfman A., Waldman R. H. Protective studies with group A streptococcal M protein vaccine. III. Challenge of volunteers after systemic or intranasal immunization with Type 3 or Type 12 group A Streptococcus. J Infect Dis. 1978 Dec;138(6):712–718. doi: 10.1093/infdis/138.6.712. [DOI] [PubMed] [Google Scholar]
- Engvall E., Perlmann P. Enzyme-linked immunosorbent assay, Elisa. 3. Quantitation of specific antibodies by enzyme-labeled anti-immunoglobulin in antigen-coated tubes. J Immunol. 1972 Jul;109(1):129–135. [PubMed] [Google Scholar]
- Fischetti V. A. Streptococcal M protein extracted by nonionic detergent. II. Analysis of the antibody response to the multiple antigenic determinants of the M-protein molecule. J Exp Med. 1977 Oct 1;146(4):1108–1123. doi: 10.1084/jem.146.4.1108. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fox E. N., Pachman L. M., Wittner M. K., Dorfman A. Primary immunization of infants and children with group A streptococcal M protein. J Infect Dis. 1969 Nov;120(5):598–604. doi: 10.1093/infdis/120.5.598. [DOI] [PubMed] [Google Scholar]
- Fox E. N., Waldman R. H., Wittner M. K., Mauceri A. A., Dorfman A. Protective study with a group A streptococcal M protein vaccine. Infectivity challenge of human volunteers. J Clin Invest. 1973 Aug;52(8):1885–1892. doi: 10.1172/JCI107372. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fox E. N., Wittner M. K., Dorfman A. Antigenicity of the M proteins of group A hemolytic streptococci. 3. Antibody responses and cutaneous hypersensitivity in humans. J Exp Med. 1966 Dec 1;124(6):1135–1151. doi: 10.1084/jem.124.6.1135. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hirst G. K., Lancefield R. C. ANTIGENIC PROPERTIES OF THE TYPE-SPECIFIC SUBSTANCE DERIVED FROM GROUP A HEMOLYTIC STREPTOCOCCI. J Exp Med. 1939 Feb 28;69(3):425–445. doi: 10.1084/jem.69.3.425. [DOI] [PMC free article] [PubMed] [Google Scholar]
- KAPLAN M. H. IMMUNOLOGIC RELATION OF STREPTOCOCCAL AND TISSUE ANTIGENS. I. PROPERTIES OF AN ANTIGEN IN CERTAIN STRAINS OF GROUP A STREPTOCOCCI EXHIBITING AN IMMUNOLOGIC CROSS-REACTION WITH HUMAN HEART TISSUE. J Immunol. 1963 Apr;90:595–606. [PubMed] [Google Scholar]
- Kang A. H. Studies on the location of intermolecular cross-links in collagen. Isolation of a CNBr peptide containing -hydroxylysinonorleucine. Biochemistry. 1972 May 9;11(10):1828–1835. doi: 10.1021/bi00760a015. [DOI] [PubMed] [Google Scholar]
- LANCEFIELD R. C. Current knowledge of type-specific M antigens of group A streptococci. J Immunol. 1962 Sep;89:307–313. [PubMed] [Google Scholar]
- LANCEFIELD R. C., PERLMANN G. E. Preparation and properties of type-specific M antigen isolated from a group A, type 1 hemolytic streptococcus. J Exp Med. 1952 Jul;96(1):71–82. doi: 10.1084/jem.96.1.71. [DOI] [PMC free article] [PubMed] [Google Scholar]
- LOWRY O. H., ROSEBROUGH N. J., FARR A. L., RANDALL R. J. Protein measurement with the Folin phenol reagent. J Biol Chem. 1951 Nov;193(1):265–275. [PubMed] [Google Scholar]
- Lancefield R. C. THE ANTIGENIC COMPLEX OF STREPTOCOCCUS HAEMOLYTICUS : II. CHEMICAL AND IMMUNOLOGICAL PROPERTIES OF THE PROTEIN FRACTIONS. J Exp Med. 1928 Feb 29;47(3):469–480. doi: 10.1084/jem.47.3.469. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Massell B. F., Michael J. G., Amezcua J., Siner M. Secondary and apparent primary antibody responses after group A streptococcal vaccination of 21 children. Appl Microbiol. 1968 Mar;16(3):509–518. doi: 10.1128/am.16.3.509-518.1968. [DOI] [PMC free article] [PubMed] [Google Scholar]
- POTTER E. V., STOLLERMAN G. H., SIEGEL A. C. Recall of type specific antibodies in man by injections of streptococcal cell walls. J Clin Invest. 1962 Feb;41:301–310. doi: 10.1172/JCI104483. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Russell H., Facklam R. R., Edwards L. R. Enzyme-linked immunosorbent assay for streptococcal M protein antibodies. J Clin Microbiol. 1976 May;3(5):501–505. doi: 10.1128/jcm.3.5.501-505.1976. [DOI] [PMC free article] [PubMed] [Google Scholar]
- SCHMIDT W. C. Type-specific antibody formation in man following injection of streptococcal M protein. J Infect Dis. 1960 May-Jun;106:250–255. doi: 10.1093/infdis/106.3.250. [DOI] [PubMed] [Google Scholar]
- STOLLERMAN G. H., SIEGEL A. C., JOHNSON E. E. Evaluation of the "long chain reaction" as a means for detecting type-specific antibody to group a streptococci in human sera. J Exp Med. 1959 Dec 1;110:887–897. doi: 10.1084/jem.110.6.887. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stollerman G. H. Prospects for a vaccine against group A streptococci: the problem of the immunology of M proteins. Arthritis Rheum. 1967 Jun;10(3):245–255. doi: 10.1002/art.1780100311. [DOI] [PubMed] [Google Scholar]
- Stollerman G. H. The relative rheumatogenicity of strains of group A streptococci. Mod Concepts Cardiovasc Dis. 1975 Jul;44(7):35–40. [PubMed] [Google Scholar]
- Taranta A. Factors influencing recurrent rheumatic fever. Annu Rev Med. 1967;18:159–172. doi: 10.1146/annurev.me.18.020167.001111. [DOI] [PubMed] [Google Scholar]
- Vosti K. L. Characterization of a non-type-specific antigen(s) associated with group A streptococcal type 12 M protein. Infect Immun. 1975 Jun;11(6):1300–1306. doi: 10.1128/iai.11.6.1300-1305.1975. [DOI] [PMC free article] [PubMed] [Google Scholar]
- WOLFE C. K., Jr, HAYASHI J. A., WALSH G., BARKULIS S. S. Type-specific antibody response in man to injections of cell walls and M protein from group A, type 14 streptococci. J Lab Clin Med. 1963 Mar;61:459–468. [PubMed] [Google Scholar]
- Wannamaker L. W. The chain that links the heart to the throat. Circulation. 1973 Jul;48(1):9–18. doi: 10.1161/01.cir.48.1.9. [DOI] [PubMed] [Google Scholar]
- Weber K., Osborn M. The reliability of molecular weight determinations by dodecyl sulfate-polyacrylamide gel electrophoresis. J Biol Chem. 1969 Aug 25;244(16):4406–4412. [PubMed] [Google Scholar]
- Widdowson J. P., Maxted W. R., Pinney A. M. An M-associated protein antigen (MAP) of group A streptococci. J Hyg (Lond) 1971 Dec;69(4):553–564. doi: 10.1017/s0022172400021823. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Zabriskie J. B., Freimer E. H. An immunological relationship between the group. A streptococcus and mammalian muscle. J Exp Med. 1966 Oct 1;124(4):661–678. doi: 10.1084/jem.124.4.661. [DOI] [PMC free article] [PubMed] [Google Scholar]
- van de Rijn I., Zabriskie J. B., McCarty M. Group A streptococcal antigens cross-reactive with myocardium. Purification of heart-reactive antibody and isolation and characterization of the streptococcal antigen. J Exp Med. 1977 Aug 1;146(2):579–599. doi: 10.1084/jem.146.2.579. [DOI] [PMC free article] [PubMed] [Google Scholar]