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Survey of the bp/tee genes from clinical Group A Streptococcus isolates in New Zealand - implications for vaccine development.
[acute rheumatic fever]
Group
A
Streptococcus
(
GAS
)
is
responsible
for
a
wide
range
of
diseases
ranging
from
superficial
infections
,
such
as
pharyngitis
and
impetigo
to
life-threatening
diseases
like
toxic
shock
syndrome
and
acute
rheumatic
fever
(
ARF
)
.
GAS
pili
are
hair
-like
extensions
protruding
from
the
cell
surface
and
consist
of
highly
immunogenic
structural
proteins
;
the
backbone
pilin
(
BP
)
and
one
or
two
accessory
pilins
(
AP
1
and
AP
2
)
.
The
protease-resistant
BP
builds
the
pilus
shaft
and
has
been
recognised
as
the
T
-
antigen
,
which
forms
the
basis
of
a
major
serological
typing
scheme
that
is
often
used
as
a
supplement
to
M-
typing
.
A
previous
sequence
analysis
of
the
bp
gene
(
tee
gene
)
in
39
GAS
isolates
revealed
15
different
bp
/
tee
types
.
In
this
study
,
we
sequenced
the
bp
/
tee
gene
from
101
GAS
isolates
obtained
from
patients
with
pharyngitis
,
ARF
or
invasive
disease
in
New
Zealand
.
We
found
20
new
bp
/
tee
alleles
and
4
new
bp
/
tee
types
/
subtypes
.
No
association
between
bp
/
tee
type
and
clinical
outcome
was
observed
.
We
confirmed
earlier
reports
that
emm-
type
and
tee-
type
are
strongly
associated
,
but
we
also
found
exceptions
,
where
multiple
tee-
type
can
be
found
in
certain
M
/
emm
type
strains
,
such
as
M
/
emm
89
.
We
also
report
,
for
the
first
time
,
the
existence
of
a
chimeric
bp
/
tee
allele
,
which
was
assigned
into
a
new
subclade
(
bp
/
tee
5
.
1
)
.
A
strong
sequence
conservation
of
the
bp
/
tee
gene
was
observed
within
the
individual
bp
/
tee
types
/
subtypes
(
>
97
%
sequence
identity
)
,
as
well
as
between
historical
and
contemporary
New
Zealand
,
and
international
GAS
strains
.
This
temporal
and
geographical
sequence
stability
provides
further
evidence
for
the
potential
use
of
the
BP
/
T
-
antigen
as
a
vaccine
target
.
Diseases
Validation
Diseases presenting
"fever"
symptom
22q11.2 deletion syndrome
acute rheumatic fever
alexander disease
allergic bronchopulmonary aspergillosis
canavan disease
carcinoma of the gallbladder
child syndrome
congenital toxoplasmosis
cushing syndrome
cystinuria
dracunculiasis
erdheim-chester disease
esophageal adenocarcinoma
esophageal carcinoma
familial mediterranean fever
focal myositis
hodgkin lymphoma, classical
lamellar ichthyosis
legionellosis
locked-in syndrome
malignant atrophic papulosis
neonatal adrenoleukodystrophy
neuralgic amyotrophy
oculocutaneous albinism
papillon-lefèvre syndrome
pyomyositis
pyruvate dehydrogenase deficiency
scrub typhus
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
typhoid
waldenström macroglobulinemia
wolf-hirschhorn syndrome
This symptom has already been validated