ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2017
Immune Cross-Opsonization Within emm Clusters Following Group A Streptococcus Skin Infection: Broadening the Scope of Type-Specific Immunity.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
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The trial behind it
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Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Pooled it
- Pooled it
- Subclinical exposure to Streptococcus pyogenes drives the development of long-lived homologous immunity.Nature communications · 2026Article
- Protection acquired upon intraperitoneal group aVirulence · 2025Article
- Early-life serological profiles and the development of natural protective humoral immunity to Streptococcus pyogenes in a high-burden setting.Nature medicine · 2025Article
- Group A Streptococcus among American Indian Persons, White Mountain Apache Tribal Lands, United States, 2016-2019Emerging infectious diseases · 2025Article
- Identification of an immunodominant region on a group AVirulence · 2023Article
- Article
- Genomic Characterization of Skin and Soft Tissue Streptococcus pyogenes Isolates from a Low-Income and a High-Income Setting.mSphere · 2023Article
- Correlates of immunity to Group A Streptococcus: a pathway to vaccine development.NPJ vaccines · 2023Review
- Promiscuous evolution of Group A Streptococcal M and M-like proteins.Microbiology (Reading, England) · 2023Article
- Invasive Streptococcal Infection Can Lead to the Generation of Cross-Strain Opsonic Antibodies.Microbiology spectrum · 2022Article
- Group A Streptococcus Infections: Their Mechanisms, Epidemiology, and Current Scope of Vaccines.Cureus · 2022Review
- Increased Breadth of Group A Streptococcus Antibody Responses in Children With Acute Rheumatic Fever Compared to Precursor Pharyngitis and Skin Infections.The Journal of infectious diseases · 2022Article
- Design of Broadly Cross-Reactive M Protein-Based Group A Streptococcal Vaccines.Journal of immunology (Baltimore, Md. : 1950) · 2021Article
- Site-Specific Conjugation of Cell Wall Polyrhamnose to Protein SpyAD Envisioning a Safe Universal Group A Streptococcal Vaccine.Infectious microbes & diseases · 2021Article
- Article
- Naturally Acquired Protection Against Upper Respiratory Symptoms Involving Group A Streptococcus in a Longitudinal Cohort Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- Longitudinal Analysis of Group A Streptococcus emm Types and emm Clusters in a High-Prevalence Setting: Relationship between Past and Future Infections.The Journal of infectious diseases · 2020Article
- Challenges to Vaccine Development: The Diversity of Group A Streptococcal Strains Among Varied Climates and Global Regions.The Journal of infectious diseases · 2020Article
Corrections and comments
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Authors and funding
10 authors at 6 institutions in 5 countries.
Funding
Abstract
backgroundGroup A Streptococcus (GAS) skin infections are particularly prevalent in developing nations. The GAS M protein, by which strains are differentiated into >220 different emm types, is immunogenic and elicits protective antibodies. A major obstacle for vaccine development has been the traditional understanding that immunity following infection is restricted to a single emm type. However, recent evidence has led to the hypothesis of immune cross-reactivity between emm types.
methodsWe investigated the human serological response to GAS impetigo in Fijian schoolchildren, focusing on 3 major emm clusters (E4, E6, and D4). Pre- and postinfection sera were assayed by enzyme-linked immunosorbent assay with N-terminal M peptides and bactericidal assays using the infecting-type strain, emm cluster-related strains, and nonrelated strains.
resultsTwenty of the 53 paired sera demonstrated a ≥4-fold increase in antibody titer against the infecting type. When tested against all cluster-related M peptides, we found that 9 of 17 (53%) paired sera had a ≥4-fold increase in antibody titer to cluster-related strains as well. When grouped by cluster, the mean change to cluster-related emm types in E4 and E6 was >4-fold (5.9-fold and 19.5-fold, respectively) but for D4 was 3.8-fold. The 17 paired sera were tested in bactericidal assays against selected cluster-related and nonrelated strains. While the responses were highly variable, numerous instances of cross-reactive killing were observed.
conclusionsThese data demonstrate that M type-specific and cross-reactive immune responses occur following skin infection. The cross-reactive immune responses frequently align with emm clusters, raising new opportunities to design multivalent vaccines with broad coverage.
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