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Erysipelas Caused by Group A Streptococcus Activates the Contact System and Induces the Release of Heparin-Binding Protein.

Linder, Adam LU ; Johansson, Linda; Thulin, Pontus; Hertzén, Erika; Mörgelin, Matthias LU ; Christensson, Bertil LU ; Björck, Lars LU ; Norrby-Teglund, Anna and Åkesson, Per LU (2010) In Journal of Investigative Dermatology 130. p.1365-1372
Abstract
Bacterial skin infections, such as erysipelas or cellulitis, are characterized by fever and a painful erythematous rash. Despite the high prevalence of these infections, little is known about the underlying pathogenic mechanisms. This is partly due to the fact that a bacterial diagnosis is often difficult to attain. To gain insight into the pathogenesis of erysipelas, we investigated the samples obtained from infected and noninfected areas of skin from 12 patients with erysipelas. Bacterial cultures, detection of specific streptococcal antibodies in convalescent sera, and immunohistochemical analyses of biopsies indicated group A streptococcal etiology in 11 of the 12 patients. Also, electron micrographs of erythematous skin confirmed the... (More)
Bacterial skin infections, such as erysipelas or cellulitis, are characterized by fever and a painful erythematous rash. Despite the high prevalence of these infections, little is known about the underlying pathogenic mechanisms. This is partly due to the fact that a bacterial diagnosis is often difficult to attain. To gain insight into the pathogenesis of erysipelas, we investigated the samples obtained from infected and noninfected areas of skin from 12 patients with erysipelas. Bacterial cultures, detection of specific streptococcal antibodies in convalescent sera, and immunohistochemical analyses of biopsies indicated group A streptococcal etiology in 11 of the 12 patients. Also, electron micrographs of erythematous skin confirmed the presence of group A streptococcal cells and showed a limited solubilization of the surface-attached M protein. Degradation of high-molecular-weight kininogen and upregulation of the bradykinin-1 receptor in inflamed tissues indicated activation of the contact system in 11 patients. Analyses of release of the vasoactive heparin-binding protein (HBP) showed increased levels in the infected as compared with the noninfected areas. The results suggest that group A streptococci induce contact activation and HBP release during skin infection, which likely contribute to the symptoms seen in erysipelas: fever, pain, erythema, and edema.Journal of Investigative Dermatology advance online publication, 28 January 2010; doi:10.1038/jid.2009.437. (Less)
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author
organization
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type
Contribution to journal
publication status
published
subject
in
Journal of Investigative Dermatology
volume
130
pages
1365 - 1372
publisher
Nature Publishing Group
external identifiers
  • wos:000276972300023
  • pmid:20107486
  • scopus:77951090766
ISSN
1523-1747
DOI
10.1038/jid.2009.437
language
English
LU publication?
yes
id
99cf2b6a-247e-4e3c-84bd-5b7ec2b23249 (old id 1540505)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20107486?dopt=Abstract
date added to LUP
2010-02-04 21:13:52
date last changed
2018-05-29 09:56:10
@article{99cf2b6a-247e-4e3c-84bd-5b7ec2b23249,
  abstract     = {Bacterial skin infections, such as erysipelas or cellulitis, are characterized by fever and a painful erythematous rash. Despite the high prevalence of these infections, little is known about the underlying pathogenic mechanisms. This is partly due to the fact that a bacterial diagnosis is often difficult to attain. To gain insight into the pathogenesis of erysipelas, we investigated the samples obtained from infected and noninfected areas of skin from 12 patients with erysipelas. Bacterial cultures, detection of specific streptococcal antibodies in convalescent sera, and immunohistochemical analyses of biopsies indicated group A streptococcal etiology in 11 of the 12 patients. Also, electron micrographs of erythematous skin confirmed the presence of group A streptococcal cells and showed a limited solubilization of the surface-attached M protein. Degradation of high-molecular-weight kininogen and upregulation of the bradykinin-1 receptor in inflamed tissues indicated activation of the contact system in 11 patients. Analyses of release of the vasoactive heparin-binding protein (HBP) showed increased levels in the infected as compared with the noninfected areas. The results suggest that group A streptococci induce contact activation and HBP release during skin infection, which likely contribute to the symptoms seen in erysipelas: fever, pain, erythema, and edema.Journal of Investigative Dermatology advance online publication, 28 January 2010; doi:10.1038/jid.2009.437.},
  author       = {Linder, Adam and Johansson, Linda and Thulin, Pontus and Hertzén, Erika and Mörgelin, Matthias and Christensson, Bertil and Björck, Lars and Norrby-Teglund, Anna and Åkesson, Per},
  issn         = {1523-1747},
  language     = {eng},
  pages        = {1365--1372},
  publisher    = {Nature Publishing Group},
  series       = {Journal of Investigative Dermatology},
  title        = {Erysipelas Caused by Group A Streptococcus Activates the Contact System and Induces the Release of Heparin-Binding Protein.},
  url          = {http://dx.doi.org/10.1038/jid.2009.437},
  volume       = {130},
  year         = {2010},
}