Decreased serum and pharyngeal antibody levels specific to streptococcal lipoteichoic acid in children with recurrent tonsillitis

Abstract

Objective: Streptococcus (S.) pyogenes is common causes of primary as well as recurrent tonsillitis (RT). Lipoteichoic acid (LTA) has been proposed as a possible candidate for vaccine formulation against streptococcal infections, because LTA is a common constituent of streptococci and the antibody to LTA inhibits bacterial attachment to epithelial cells in vitro. Streptolysin-O and streptococcal whole cell body are highly immunogenic and the antibodies to these antigens are reported to be better parameters for streptococcal infections The objective of the present study is to investigate how systemic and local immune activities against S. pyogenes may be associated with RT. Methods: Sera from 178 children with or without RT aged 1-15 years with a median age of 5 years were investigated for the levels of total immunoglobulins and antibodies specific to streptococcal antigens such as whole cell body, LTA, and streptolysin-O. Pharyngeal secretions from 67 children with or without RT aged 2-14 years with a median age of 6 years were subjects to secretory IgA (SIgA) antibody levels to streptococcal LTA. The antibodies to whole cell body and LTA were measured by enzyme-linked immunosorbent assay. Total immunoglobins and the antistreptolysin-O antibody were assayed by nephelometry. Results: An age-matched comparison revealed that either levels of serum IgG antibody or pharyngeal SIgA antibody to streptococcal LTA at 2-5 years of age were significantly lower in RT children than in non-RT children (1.39 vs. 5.14 µg/ml, p=0.001; 10.6 vs. 29.9 units/ng/ml total SIgA, p=0.015; respectively) and correlated inversely to episodes of tonsillitis (r=-0.242, p=0.024; r=-0.3, p=0.024; respectively). Either serum total immunoglobulin levels of IgG or IgA correlated positively to episodes of tonsillitis in children aged 2-5 years(r=0. 293, p=0.011; r=0.361, p=0.002; respectively). No difference was found on either serum levels of IgG antibody to streptococcal whole cell body or antibody to streptolysin-O between RT and non-RT children in any Yokoyama Y. -3-age-matched comparisons. High serum antibody levels to whole cell body was associated with high antibody levels to streptococcal LTA in non-RT children (r=0.198, p<0.05), but no association was found between these antibody levels in RT children. Conclusions:Selective immunologic failure in systemic and pharyngeal antibody response to streptococcal LTA may be a potential cause of RT in young children.

Intranasal immunization with lipoteichoic acid and cholera toxin evokes specific pharyngeal IgA and systemic IgG responses and inhibits streptococcal adherence to pharyngeal epithelial cells in mice

“…However, this is still preliminary and there is a number of problems to be dissolved. For example, we previously demonstrated decreased pharyngeal IgA antibody levels to streptococcal LTA in children with recurrent tonsillitis [10], suggesting that pharyngeal antibody response to LTA vaccine may be reduced in those children. The CT-B used as an adjuvant in this study is toxic in humans.…”

“…Recently, we demonstrated decreased serum IgG and pharyngeal IgA antibody levels specific to streptococcal LTA in young children with RT [10]. This immunologic failure may be potential cause of RT in childhood.…”

Opsonic Antibodies to Enterococcus faecalis Strain 12030 Are Directed against Lipoteichoic Acid

“…Lipoteichoic acid has been linked to a variety of bacterial cellular functions, such as membrane elasticity and porosity, trafficking of molecules, anchoring of wall proteins, and determination of net charge and surface hydrophobicity (25). Lipoteichoic acids from several gram-positive bacteria have been shown to engage in interactions with Tolllike receptor 2 (12), and LTA is known to participate in attachment to epithelial and endothelial surfaces and to biomaterials (3,9,36) and is also involved in cell invasion (3). Thus, antibodies to LTA could inhibit a variety of bacterial functions or host responses.…”

Immunization with heat‐inactivated Staphylococcus aureus induced an antibody response mediated by IgG1 and IgG2 in patients with recurrent tonsillitis

“…This may explain, at least in part, why these patients have persistent infection. In line with this hypothesis, concentrations of IgG antibodies to streptococcal and staphylococcal lipoteichoic acids are reported significantly lower in the serum of children with RT than in that of those without RT ; the titers of these antibodies correlate inversely with number of episodes of tonsillitis . Furthermore, it has been shown that active infection with S. aureus compromises induction of both humoral and cell‐mediated immunity .…”