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Numerous post-Streptococcal syndromes (PSS) have been described in the literature.
The role of antibiotic therapy in the management of PSS is best established with acute rheumatic fever.
We present a patient with streptococcus-associated medium vessel vasculitis with multiple flares despite immunosuppressive therapy that achieved a sustained remiss...
Citations
... Here, we found that EGPA patients receiving systemic immunosuppressants had significantly lower levels of Enterobacteriaceae compared to non-immunosuppressed patients. These findings, while suggesting a potential association between these bacteria and the systemic inflammatory state, support also the hypothesis that an appropriate treatment of vasculitis could reshape the microbiota composition towards a healthier profile [41]. ...
... Another distinctive feature of EGPA was the enrichment in Streptococcaceae, particularly in subjects with active disease. Interestingly, this family includes Streptococcus spp., which is responsible for streptococcus-associated medium-vessel vasculitis [41], and that has been found increased in faecal samples of patients with active Kawasaki disease [42], a systemic small-to medium-sized-vessel vasculitis. Nevertheless, the specific mechanisms underlying the association between Streptococcaceae abundance and active EGPA remain unclear. ...
Eosinophilic granulomatosis with polyangiitis (EGPA) is an anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis. A genome-wide association study showed a correlation between ANCA-negative EGPA and variants of genes encoding proteins with intestinal barrier functions, suggesting that modifications of the mucosal layer and consequent gut dysbiosis might be involved in EGPA pathogenesis. Here, we characterized the gut microbiota (GM) composition and the intestinal immune response in a cohort of EGPA patients. Faeces from 29 patients and 9 unrelated healthy cohabitants were collected, and GM and derived metabolites’ composition were compared. Seven intestinal biopsies from EGPA patients with gastrointestinal manifestations were analysed to assess the T-cell distribution and its correlation with GM and EGPA clinical and laboratory features. No significant differences in GM composition, nor in the total amount of faecal metabolites, emerged between patients and controls. Nevertheless, differences in bacterial taxa abundances and compositional GM-derived metabolites profile were observed. Notably, an enrichment of potential pathobionts (Enterobacteriacee and Streptococcaceae) was found in EGPA, particularly in patients with active disease, while lower levels were found in patients on immunosuppression, compared with non-immunosuppressed ones. Significantly lower amounts of hexanoic acid were found in patients, compared to controls. The analysis of the immune response in the gut mucosa revealed a high frequency of IFN-γ/IL-17-producing T lymphocytes, and a positive correlation between EGPA disease activity and intestinal T-cell levels. Our data suggest that an enrichment in potential intestinal pathobionts might drive an imbalanced inflammatory response in EGPA.
... The genus Streptococcus is another major group of common Gram-positive cocci in pyogenic cocci. There are 69 species and subspecies, which are widely distributed in nature and the nasopharynx, gastrointestinal tract of the human body, and most of them belong to normal genus (158). Pathogenic Streptococci can cause a variety of purulent inflammation and hypersensitivity diseases in humans, among which group B Streptococcus (GBS) are the most threatening to infants (159). ...
From early life to adulthood, the microbiota play a crucial role in the health of the infant. The microbiota in early life are not only a key regulator of infant health but also associated with long-term health. Pregnancy to early life is the golden time for the establishment of the infant microbiota, which is affected by both environmental and genetic factors. Recently, there is an explosion of the studies on the role of microbiota in human diseases, but the application to disease or health is relatively limited because many aspects of human microbiota remain controversial, especially about the infant microbiota. Therefore, a critical and conclusive review is necessary to understand fully the relationship between the microbiota and the health of infant. In this article, we introduce in detail the role of microbiota in the infant from pregnancy to early life to long-term health. The main contents of this article include the relationship between the maternal microbiota and adverse pregnancy outcomes, the establishment of the neonatal microbiota during perinatal period and early life, the composition of the infant gut microbiota, the prediction of the microbiota for long-term health, and the future study directions of microbiota.
ANCA-associated vasculitis (AAV) is characterized by granulomatous and neutrophilic tissue inflammation, and is commonly accompanied with the development of antibodies that target neutrophil antigens. The two major antigens targeted by ANCAs are leukocyte proteinase 3 (PR3) and myeloperoxidase (MPO). The development of AAV has been linked to a number of potential risk aspects, including ecological, pharmacological, and microbial exposures. Infectious (microbial) factors are thought towards show a part in many types of vasculitis by causing inflammation of vessel walls as a result of direct or contiguous infection, type II or immune complex-mediated reaction, cell mediated allergic reaction, or inflammation caused by immune dysregulation triggered by bacterial toxin and/or super antigen production. Because immune suppressive medication in the absence of antimicrobial therapy may enhance morbidity while failing to resolve infection-related vascular inflammation, infectious entities should be considered as a potential inciting factor in vasculitis disorders. Therefore, amid these factors, here we contribute new consideration on infectious factors associated vasculitis.
