title: IgG4 subclass-specific responses to Staphylococcus aureus antigens shed new light on host-pathogen interaction.
abstract: IgG4 responses are considered indicative for long-term or repeated exposure to particular antigens. Therefore, studying IgG4-specific antibody responses against Staphylococcus aureus might generate new insights into the respective host-pathogen interactions and the microbial virulence factors involved. Using a bead-based flow cytometry assay, we determined total IgG (IgGt), IgG1, and IgG4 antibody responses to 40 different S. aureus virulence factors in sera from healthy persistent nasal carriers, healthy persistent noncarriers, and patients with various staphylococcal infections from three distinct countries. IgGt responses were detected against all tested antigens. These were mostly IgG1 responses. In contrast, IgG4 antibodies were detected to alpha-toxin, chemotaxis inhibitory protein of S. aureus (CHIPS), exfoliative toxins A and B (ETA and -B), HlgB, IsdA, LukD, -E, -F, and -S, staphylococcal complement inhibitor (SCIN), staphylococcal enterotoxin C (SEC), staphylococcal superantigen-like proteins 1, 3, 5, and 9 (SSL1, -3, -5, and -9), and toxic shock syndrome toxin 1 (TSST-1) only. Large interpatient variability was observed, and the type of infection or geographical location did not reveal conserved patterns of response. As persistent S. aureus carriers trended toward IgG4 responses to a larger number of antigens than persistent noncarriers, we also investigated sera from patients with epidermolysis bullosa (EB), a genetic blistering disease associated with high S. aureus carriage rates. EB patients responded immunologically to significantly more antigens than noncarriers and trended toward even more responses than carriers. Altogether, we conclude that the IgG4 responses against a restricted panel of staphylococcal antigens consisting primarily of immune modulators and particular toxins indicate important roles for these virulence factors in staphylococcal pathogen-host interactions, such as chronicity of colonization and/or (subclinical) infections.
authors.affiliation: Medical Microbiology and Infectious Diseases, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: Jasper
authors.initials: J
authors.lastname: Swierstra
authors.affiliation: Medical Microbiology and Infectious Diseases, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Debets
authors.affiliation: Medical Microbiology and Infectious Diseases, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: Corné
authors.initials: C
authors.lastname: de Vogel
authors.affiliation: Medical Microbiology and Infectious Diseases, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: Nicole
authors.initials: N
authors.lastname: Lemmens-den Toom
authors.affiliation: Medical Microbiology and Infectious Diseases, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: Nelianne
authors.initials: N
authors.lastname: Verkaik
authors.affiliation: Department of Microbiology, University Hospital Mustapha Bacha, Algiers, Algeria.
authors.forename: Nadjia
authors.initials: N
authors.lastname: Ramdani-Bouguessa
authors.affiliation: Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Marcel F
authors.initials: MF
authors.lastname: Jonkman
authors.affiliation: Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Jan Maarten
authors.initials: JM
authors.lastname: van Dijl
authors.affiliation: Department of Surgery, University of Khartoum, Khartoum, Sudan.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Fahal
authors.affiliation: Medical Microbiology and Infectious Diseases, Erasmus Medical Centre, Rotterdam, The Netherlands bioMerieux, La Balme-Les Grottes, France.
authors.forename: Alex
authors.initials: A
authors.lastname: van Belkum
authors.affiliation: Medical Microbiology and Infectious Diseases, Erasmus Medical Centre, Rotterdam, The Netherlands w.vanwamel@erasmusmc.nl.
authors.forename: Willem
authors.initials: W
authors.lastname: van Wamel
mesh_terms: D000907:Antibodies, Bacterial / Q000276:immunology; D000942:Antigens, Bacterial / Q000276:immunology; D016470:Bacteremia / Q000276:immunology / Q000382:microbiology; D001426:Bacterial Proteins / Q000276:immunology; D002353:Carrier State / Q000276:immunology; D004820:Epidermolysis Bullosa / Q000276:immunology / Q000382:microbiology; D054884:Host-Pathogen Interactions / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000145:classification* / Q000276:immunology*; D013203:Staphylococcal Infections / Q000276:immunology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000276:immunology* / Q000472:pathogenicity; D037521:Virulence Factors / Q000276:immunology
chemical_list: D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D007074:Immunoglobulin G; D037521:Virulence Factors