Detection of serum antibody by the antimitogen assay against streptococcal erythrogenic toxins. Age distribution in children and the relation to Kawasaki disease.
We describe a new method to measure human serum antibody against streptococcal erythrogenic toxins that uses inhibition of lymphocyte mitogenicity of the toxins as the indicator. Sera from 53% of 53 Kawasaki disease patients contained specific inhibitory activity against A toxin, whereas only 15% had serum inhibitory activity against B toxin. The specific anti-A toxin serum inhibitor was found in 10% of 118 age-matched control patients suffering from various infections and allergic diseases (p = 0.001, compared to Kawasaki disease patients). Serum inhibitory activity was detected in a small number of patients with beta-hemolytic streptococcal infection (3/19) and in none of the age-matched healthy children (0/17). However, four of seven cord blood sera samples and five of 13 sera samples from healthy neonates contained the inhibitor, a result suggesting passive transfer from mothers. Most of the antimitogen-positive sera were also positive by ELISA of IgG antibody against A toxin, and IgG fractions of the positive sera remained positive in both assays. Thus, it is possible that the specific serum inhibitor detected by the antimitogen assay represents anti-A toxin antibody. The role of toxin-producing bacteria in the pathogenesis of Kawasaki disease remains to be investigated.
Abe
Y
Y
Department of Pathology, Teikyo University School of Medicine, Japan.
Nakano
S
S
Nakahara
T
T
Kamezawa
Y
Y
Kato
I
I
Ushijima
H
H
Yoshino
K
K
Ito
S
S
Noma
S
S
Okitsu
S
S
D000907:Antibodies, Bacterial / Q000032:analysis*; D001426:Bacterial Proteins; D001427:Bacterial Toxins / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005098:Exotoxins / Q000276:immunology*; D006801:Humans; D008565:Membrane Proteins; D008934:Mitogens / Q000032:analysis*; D009080:Mucocutaneous Lymph Node Syndrome / Q000209:etiology / Q000276:immunology* / Q000382:microbiology; D013297:Streptococcus pyogenes / Q000276:immunology*
D000907:Antibodies, Bacterial; D001426:Bacterial Proteins; D001427:Bacterial Toxins; D005098:Exotoxins; D008565:Membrane Proteins; D008934:Mitogens; C117980:SpeA protein, Streptococcus pyogenes; C027951:erythrogenic toxin