Possible Role of Streptococcus pyogenes in Mucocutaneous Lymph Node Syndrome VI. Heightened Cellular Reactivity to Streptolysin‐O in Mice Infected with S. pyogenes and in MCLS Patients

Abstract

AbstructThe present investigations were performed to determine, by using the macrophage migration inhibition test (MIT), whether cell-mediated hypersensitivity to streptolysin-0 (SLO) was developed in mice infected with Streptococcus pyogenes as well as in patients with mucocutaneous lymph node syndrome (MCLS), with the following results:1 . The splenic lymphocytes from murine hosts infected with B-346 op strain of S. pyogenes, which fails to induce cellular immunity in infected mice, showed a complete lack of responsiveness to SLO. In contrast, the mice infected with streptococci of Sv and S-43 strains, both of which possess an intrinsic activity of eliciting enhanced cellular hypersensitivity in the same species of animals, exhibited positive responses to the hemolysin from streptococcal culture supernatant. 2. Although a considerable number of MCLS patients in the acute phase of the illness failed to respond to SLO, a complete restoration of their responsiveness was observed in parallel with recovery from the acute illness. Conversely, all patients in the subacute phase of the disease reacted well in vitro to SLO, followed by a gradual decline of their responsiveness over a period of 1-2 weeks.Furthermore, the implications of these findings are discussed in association with the possible role of S. pyogenes as an etiological agent for MCLS. Introduction

Possible Role of Streptococcus pyogenes in Mucocutaneous Lymph Node Syndrome. XV. Potential Utility of Streptococcal Pyrogenic Exotoxin Toxoid for the Prophylaxis and Treatment of MCLS

“…Provocation was performed approximately 3 months later with four S.C. infections every other day with streptococci of S-43 strain. These methods were the same as those described circumstantially by us previously [3,9]. 5 I8 (28) Akzyarna et al…”

“…Role of Streptococcus pyogenes in MCLS (Anti-SPE titers of sera as quantified by ELISA in mice sacrificed on day 35 postprovocation with (a) multiple infections with S-43 and (b) multiple inoculations with SPE. (I) and ( 5 ) were tolerance induced by infection/inoculation (no immunization);(2)and(6)were tolerance induced by infection/inoculation and immunized with SPE;(3) and(7)were tolerance induced by infection/inoculation and immunized with toxoid; and (4) and (8) were not tolerance induced or immunized.…”

Possible Role of Streptococcus pyogenes in Mucocutaneous Lymph Node Syndrome VIII. Immunological Tolerance to S. pyogenes‐Associated Antigens Seems Essential to Induction of MCLS

“…Correspondence address: Dr. Takehisa Akiyama, Department of Microbiology, School of Medicine, Kita-sat0 University, 1-15-1, Sagamihara 228, Japan While patients with the mucocutaneous lymph node syndrome (MCLS) show heightened cell-Streptococcus pyogenes and MCLS (99) 463 mediated reactivity, as measured by the macrophage migration inhibition test (MIT) in response to group A beta-hemolytic streptococci and their pyrogenic exotoxin [ 11 , streptolysin-0 (SLO) [2] and several mammalian muscle cell antigens which are related antigenically to the cell wall of Streptococcus pyogenes [3], a lack of antibody formation in these patients to SLO has been a perplexing problem for investigators favoring a streptococcal etiology of the disease.…”