title: Anti-streptokinase antibodies and streptokinase resistance in an Aboriginal population in northern Australia.
abstract: BACKGROUND
  Thrombolytic treatment with streptokinase in acute myocardial infarction has proven to be safe and effective in Caucasian populations with relatively low levels of anti-streptokinase IgG and streptokinase resistance. Higher levels of antibodies, as seen in previous recipients of streptokinase therapy, cause more adverse reactions and may result in lower efficacy.
  
  
  OBJECTIVE
  To examine the levels of anti-streptokinase IgG and streptokinase resistance in a population subjected to endemic streptococcal infections.
  
  
  RESULTS
  Thirty Aboriginal adults from a remote community in Northern Australia with endemic streptococcal infections and 15 non-Aboriginal adults from an urban community without endemic infections participated in this study. Aboriginal adults exhibited levels of anti-streptokinase IgG and streptokinase resistance that, respectively, were almost 20 and 15 times greater than the values of non-Aboriginal adults. At least 23% of Aboriginal adults had sufficiently high levels of streptokinase resistance to neutralise a standard 1.5 million unit dose of streptokinase.
  
  
  CONCLUSIONS
  Aboriginal adults from a remote community had dramatically elevated levels of anti-streptokinase IgG and in vitro streptokinase resistance. Prospective studies are needed to assess the clinical relevance of streptokinase resistance in populations from areas with endemic streptococcal infection.
authors.affiliation: Department of Microbiology, University of Minnesota Medical School, Minneapolis, USA.
authors.forename: K B
authors.initials: KB
authors.lastname: Urdahl
authors.forename: J D
authors.initials: JD
authors.lastname: Mathews
authors.forename: B
authors.initials: B
authors.lastname: Currie
mesh_terms: D000328:Adult; D000888:Antibodies, Anti-Idiotypic; D004352:Drug Resistance, Microbial / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology*; D008875:Middle Aged; D015876:Northern Territory; D013290:Streptococcal Infections / Q000188:drug therapy / Q000276:immunology*; D013300:Streptokinase / Q000276:immunology* / Q000627:therapeutic use; D000095283:Australian Aboriginal and Torres Strait Islander Peoples
chemical_list: D000888:Antibodies, Anti-Idiotypic; D007074:Immunoglobulin G; D013300:Streptokinase