Russian Journal of Infection and ImmunityRussian Journal of Infection and ImmunityИнфекция и иммунитет2220-76192313-7398SPb RAACI172310.15789/2220-7619-MPF-1723REVIEWSОБЗОРЫMajor pathogenicity factors of Streptococcus pyogenesОсновные факторы патогенности Streptococcus pyogenesBurovaL. A.БуроваЛ. А.
Russian Federation

Larisa A. Burova - PhD, MD (Medicine), Leading Researcher, Department of Molecular Microbiology, Institute of Experimental Medicine.

197376, St. Petersburg, Academic Pavlov str., 12.

Phone: +7 (812) 234-05-42.

Бурова Лариса Александровна – доктор медицинских наук, ведущий научный сотрудник отдела молекулярной микробиологии.

197376, Санкт-Петербург, ул. Академика Павлова, 12.

Тел.: 8 (812) 234-05-42.

lburova@yandex.ruTotolianA. A.ТотолянА. А.
Russian Federation

Artem A. Totolian - RAS Full Member, PhD, MD (Medicine), Head Researcher, Department of Molecular Microbiology, Institute of Experimental Medicine.

197376, St. Petersburg, Academic Pavlov str., 12.

Тотолян Артем А. - академик РАН, доктор медицинских наук, главный научный сотрудник отдела молекулярной микробиологии.

197376, Санкт-Петербург, ул. Академика Павлова, 12.

totolyan@hotmail.comInstitute of Experimental MedicineИнститут экспериментальной медицины1203202212133501604202130102021Copyright ©; 2021, Burova L.A., Totolian A.A.Copyright ©; 2021, Бурова Л.А., Тотолян А.А.2021Burova L.A., Totolian A.A.Бурова Л.А., Тотолян А.А.https://creativecommons.org/licenses/by/4.0https://iimmun.ru/iimm/article/view/1723

Streptococcal diseases and their complications are among the global problems of international health. S. pyogenes (group A streptococci — GAS) is a pathogen that causes significant morbidity in different countries and different age groups of the population, occurring both sporadically and epidemically. Due to ineffective antibacterial therapy or its absence, 3–5% of people who have had streptococcal infection may develop complications such as acute rheumatic fever, rheumatic heart disease, acute post-streptococcal glomerulonephritis and invasive complications: necrotizing fasciitis and myositis, septicemia and toxic shock syndrome, highly lethal due to the rapid development of the process and systemic organ damage. According to recent estimates, at least 517 000 deaths occur annually in the world due to diseases caused by GAS. The diverse arsenal of pathogenic factors of this pathogen is manifested in a combination of joint or sequential reactions in the process of microbial colonization of tissue, formation of the focus of infection and overcoming the host's defense mechanisms. It is an important point in the process of studying the pathogenesis of diseases caused by these microbes. The pathogenic factors of GAS can be divided into extracellular and associated with the microbial cell, predominantly with its cell wall. The spectrum activity of pathogenicity factors can be quite wide (M proteins, pyrogenic exotoxins, superantigens) or limited (serine and cysteine proteinases, streptokinase). Information about the specificity of pathogenicity factors, their properties, relationships, regulation and specific function in pathology is the task of scientific, as well as complex researches, leading to understanding the pathogen-host interaction. An integrated approach to the investigation of GAS pathogenicity factors is needed to study the pathogenicity of streptococci, since pathogenicity factors do not manifest themselves in isolation and are not always independently regulated. In many cases, regulators control the expression of more than one of them. S. pyogenes has been studied for about 150 years, but a number of issues related to their pathogenicity remain unknown to this day. Some factors need more in-depth study: for example, endo-β-N-acetylglucosaminidase, arginine deiminase. Immunoglobulin-degrading enzymes require special attention due to their possible participation in the genesis of immunopathological processes of streptococcal etiology. This review summarizes the literature data about most of the pathogenicity factors of S. pyogenes and their role in the infectious process.

Стрептококковые заболевания и их осложнения являются одной из глобальных проблем международного здравоохранения. S. pyogenes (стрептококк серологической группы А — СГА) — патоген, вызывающий значительную заболеваемость в разных странах и разных возрастных группах населения, возникающую как спорадически, так и эпидемическими вспышками. Из-за неэффективной антибактериальной терапии или ее отсутствия у 3–5% людей, перенесших стрептококковую инфекцию, могут развиться такие осложнения, как острая ревматическая лихорадка, ревматическое поражение сердца, острый постстрептококковый гломерулонефрит, а также инвазивные осложнения: некротизирующий фасциит и миозит, септицемии и синдром токсического шока, высоколетальные из-за быстрого развития процесса и системного поражения органов. По последним оценкам, ежегодно в мире регистрируется по меньшей мере 517 000 смертей из-за заболеваний, вызываемых S. pyogenes. Разнообразный арсенал факторов патогенности этого возбудителя проявляется сочетанными и последовательными реакциями в процессах колонизации микробом тканей, формирования очага инфекции и преодоления защитных механизмов хозяина. Их совокупность определяет патогенетические механизмы заболеваний стрептококковой этиологии. Факторы патогенности СГА можно разделить на ассоциированные с микробной клеткой, преимущественно с ее клеточной стенкой, и на внеклеточные — экстрацеллюлярные. Спектр активности стрептококковых факторов патогенности может быть достаточно широким (М-белки, пирогенные экзотоксины, суперантигены) или узким (сериновая и цистеиновая протеиназы, стрептокиназа). Исследования специфичности факторов патогенности, их свойств, взаимосвязей, регуляторных механизмов и конкретной функции в патологии являются задачей научного поиска, ведущего к пониманию всей сложности функциональной организации возбудителя в его взаимодействии с макроорганизмом. Необходим также комплексный подход в изучении патогенности стрептококков, поскольку факторы патогенности не проявляют себя изолированно и не всегда регулируются независимо. Во многих случаях регуляторы контролируют экспрессию более чем одного из них. Несмотря на то что S. pyogenes изучаются уже около 150 лет, до настоящего времени остается ряд нерешенных вопросов, связанных с их болезнетворностью. Некоторые факторы патогенности СГА нуждаются в более углубленном изучении, например эндо-β-N-ацетилглюкозаминидаза, аргининдеиминаза. Отдельного внимания требуют иммуноглобулин-деградирующие ферменты в связи с их возможным участием в генезе иммунопатологических процессов стрептококковой этиологии. В данном обзоре суммированы литературные данные о большинстве факторов патогенности S. pyogenes и их роли в инфекционном процессе.

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