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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
"such as m"
symptom
acute rheumatic fever
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