Anti-streptolysin O

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Anti-streptolysin O (ASO or ASLO) is the antibody made against streptolysin O, an immunogenic, oxygen-labile streptococcal hemolytic exotoxin produced by most strains of group A and many strains of groups C and G Streptococcus bacteria. The "O" in the name stands for oxygen-labile; the other related toxin being oxygen-stable streptolysin-S. The main function of streptolysin O is to cause hemolysis (the breaking open of red blood cells)—in particular, beta-hemolysis.

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Increased levels of ASO titre in the blood could cause damage to the heart and joints. In most cases, penicillin is used to treat patients with increased levels of ASO titre.

Clinical significance

When the body is infected with streptococci, it produces antibodies against the various antigens that the streptococci produce. ASO is one such antibody. A raised or rising levels can indicate past or present infection. Historically it was one of the first bacterial markers used for diagnosis and follow up of rheumatic fever or scarlet fever. Its importance in this regard has not diminished.[ citation needed ]

Since these antibodies are produced as a delayed antibody reaction to the above-mentioned bacteria, there is no normal value. The presence of these antibodies indicates an exposure to these bacteria. However, as many people are exposed to these bacteria and remain asymptomatic, the mere presence of ASO does not indicate disease.

A titre has significance only if it is greatly elevated (> 200), but a rise in titre demonstrated in paired blood samples taken days apart is more informative for diagnosis. The antibody levels begin to rise after 1 to 3 weeks of strep infection, peaks in 3 to 5 weeks and falls back to insignificant levels in 6 months. Values need to be correlated with a clinical diagnosis.[ citation needed ] The aim is to convert it .

Estimation

It is done by serological methods like latex agglutination or slide agglutination. ELISA may be performed to detect the exact titre value. To detect the titre value, by a non-ELISA method, one has to perform the above agglutination using a serial dilution technique.[ citation needed ]

Mechanism of action

These antibodies produced against the bacteria cross-react with human antigens (mainly collagen) and hence attack the cellular matrix of various organs, mainly the heart, joints, skin, brain, etc.[ citation needed ]

Antistreptolysin O titre

Antistreptolysin O titre (AS(L)O titer or AS(L)OT) is a measure of the blood plasma levels of antistreptolysin O antibodies used in tests for the diagnosis of a streptococcal infection or indicate a past exposure to streptococci. The ASOT helps direct antimicrobial treatment and is used to assist in the diagnosis of scarlet fever, rheumatic fever, and post infectious glomerulonephritis.[ citation needed ]

A positive test usually is > 200 units/mL, [1] but normal ranges vary from laboratory to laboratory and by age. [2]

The false negatives rate is 20 to 30%. [1] If a false negative is suspected, then an anti-DNase B titre should be sought. False positives can result from liver disease and tuberculosis. [1]

Related Research Articles

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Streptococcus is a genus of gram-positive coccus or spherical bacteria that belongs to the family Streptococcaceae, within the order Lactobacillales, in the phylum Bacillota. Cell division in streptococci occurs along a single axis, so as they grow, they tend to form pairs or chains that may appear bent or twisted. This differs from staphylococci, which divide along multiple axes, thereby generating irregular, grape-like clusters of cells. Most streptococci are oxidase-negative and catalase-negative, and many are facultative anaerobes.

<span class="mw-page-title-main">Group A streptococcal infection</span> Medical condition

Group A streptococcal infections are a number of infections with Streptococcus pyogenes, a group A streptococcus (GAS). S. pyogenes is a species of beta-hemolytic Gram-positive bacteria that is responsible for a wide range of infections that are mostly common and fairly mild. If the bacteria enter the bloodstream an infection can become severe and life-threatening, and is called an invasive GAS (iGAS).

<i>Streptococcus pyogenes</i> Species of bacterium

Streptococcus pyogenes is a species of Gram-positive, aerotolerant bacteria in the genus Streptococcus. These bacteria are extracellular, and made up of non-motile and non-sporing cocci that tend to link in chains. They are clinically important for humans, as they are an infrequent, but usually pathogenic, part of the skin microbiota that can cause Group A streptococcal infection. S. pyogenes is the predominant species harboring the Lancefield group A antigen, and is often called group A Streptococcus (GAS). However, both Streptococcus dysgalactiae and the Streptococcus anginosus group can possess group A antigen as well. Group A streptococci, when grown on blood agar, typically produce small (2–3 mm) zones of beta-hemolysis, a complete destruction of red blood cells. The name group A (beta-hemolytic) Streptococcus is thus also used.

<span class="mw-page-title-main">Scarlet fever</span> Infectious disease caused by Streptococcus pyogenes

Scarlet fever, also known as scarlatina, is an infectious disease caused by Streptococcus pyogenes, a Group A streptococcus (GAS). It most commonly affects children between five and 15 years of age. The signs and symptoms include a sore throat, fever, headache, swollen lymph nodes, and a characteristic rash. The face is flushed and the rash is red and blanching. It typically feels like sandpaper and the tongue may be red and bumpy. The rash occurs as a result of capillary damage by exotoxins produced by S.pyogenes. On darker-pigmented skin the rash may be hard to discern.

<span class="mw-page-title-main">Streptococcal pharyngitis</span> Medical condition

Streptococcal pharyngitis, also known as streptococcal sore throat, is pharyngitis caused by Streptococcus pyogenes, a gram-positive, group A streptococcus. Common symptoms include fever, sore throat, red tonsils, and enlarged lymph nodes in the front of the neck. A headache and nausea or vomiting may also occur. Some develop a sandpaper-like rash which is known as scarlet fever. Symptoms typically begin one to three days after exposure and last seven to ten days.

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<span class="mw-page-title-main">Rheumatic fever</span> Post-streptococcal inflammatory disease

Rheumatic fever (RF) is an inflammatory disease that can involve the heart, joints, skin, and brain. The disease typically develops two to four weeks after a streptococcal throat infection. Signs and symptoms include fever, multiple painful joints, involuntary muscle movements, and occasionally a characteristic non-itchy rash known as erythema marginatum. The heart is involved in about half of the cases. Damage to the heart valves, known as rheumatic heart disease (RHD), usually occurs after repeated attacks but can sometimes occur after one. The damaged valves may result in heart failure, atrial fibrillation and infection of the valves.

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Serology is the scientific study of serum and other body fluids. In practice, the term usually refers to the diagnostic identification of antibodies in the serum. Such antibodies are typically formed in response to an infection, against other foreign proteins, or to one's own proteins. In either case, the procedure is simple.

Sydenham's chorea, also known as rheumatic chorea, is a disorder characterized by rapid, uncoordinated jerking movements primarily affecting the face, hands and feet. Sydenham's chorea is an autoimmune disease that results from childhood infection with Group A beta-haemolytic Streptococcus. It is reported to occur in 20–30% of people with acute rheumatic fever and is one of the major criteria for it, although it sometimes occurs in isolation. The disease occurs typically a few weeks, but up to 6 months, after the acute infection, which may have been a simple sore throat (pharyngitis).

<span class="mw-page-title-main">Widal test</span> Presumptive serological test for enteric fever or undulant fever

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<span class="mw-page-title-main">Hemolysis (microbiology)</span> Breakdown of red blood cells

Hemolysis is the breakdown of red blood cells. The ability of bacterial colonies to induce hemolysis when grown on blood agar is used to classify certain microorganisms. This is particularly useful in classifying streptococcal species. A substance that causes hemolysis is a hemolysin.

The Weil–Felix test is an agglutination test for the diagnosis of rickettsial infections. It was first described in 1916. By virtue of its long history and of its simplicity, it has been one of the most widely employed tests for rickettsia on a global scale, despite being superseded in many settings by more sensitive and specific diagnostic tests. The Weil-Felix antibody was recently found to target rickettsia LPS O-antigen.

<span class="mw-page-title-main">Acute proliferative glomerulonephritis</span> Medical condition

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Perianal cellulitis, also known as perianitis or perianal streptococcal dermatitis, is a bacterial infection affecting the lower layers of the skin (cellulitis) around the anus. It presents as bright redness in the skin and can be accompanied by pain, difficulty defecating, itching, and bleeding. This disease is considered a complicated skin and soft tissue infection (cSSTI) because of the involvement of the deeper soft tissues.

Anti-Deoxyribonuclease B titres are a quantitative measure of the presence of serologic antibodies obtained from patients suspected of having a recent group A (Beta-hemolytic) streptococcus bacteria infection, from Streptococcus pyogenes.

Streptococcosis is a set of diseases varying from mild to fatal side effects of the infection which originate from the bacterial group streptococcus, particularly in animals. Some of the areas of infection include wounds, body tissue, and respiratory areas. Research within horses, dogs, cats, wound injuries and swine infections have been done to document specific side effects from streptococcosis. Streptococcosis can occur to both humans and animals, the most common including horses, guinea pigs, dogs, cats and fish; while uncommon animals infected include monkeys, cattle, sheep, goats, ferrets and poultry. The wide range of diseases is due to the variability of streptococcus strains which thus creates multiple species for the diseases to occur.

References

  1. 1 2 3 Antistreptococcal antibody titres. gpnotebook. URL: http://www.gpnotebook.co.uk/cache/-1630535637.htm Archived January 26, 2007, at the Wayback Machine . Accessed on: March 31, 2007.
  2. Danchin M, Carlin J, Devenish W, Nolan T, Carapetis J (2005). "New normal ranges of antistreptolysin O and antideoxyribonuclease B titres for Australian children". J Paediatr Child Health. 41 (11): 583–6. doi:10.1111/j.1440-1754.2005.00726.x. PMID   16398843. S2CID   9111180.