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The streptococci are classified as beta-hemolytic if complete hemolysis of the blood cells in the agar surrounding the colonies is observed, alpha-hemolytic if a characteristic greenish color is seen, or nonhemolytic if the blood cells are not affected. This chapter mainly focuses on the group A streptococci () that cause a large number of different disease syndromes. The group A streptococci are the causative agents of several serious diseases, such as necrotizing fasciitis, scarlet fever, sepsis, and a recently recognized toxic shock-like syndrome, as well as suppurative infections of the skin and throat , such as impetigo, erysipelas, and pharyngitis ("strepthroat") . A number of surface structures have been implicated as virulence factors of the group A streptococci. M protein is considered t h e major virulence factor of group A streptococci () because it protects the bacteria from phagocytosis by polymorphonuclear leukocytes. Infection by causes production of antibodies that include those that react with M protein. The M protein or a derivative of it is being considered as a possible antistreptococcus vaccine. A greater understanding of the relation of the structure of the M protein to its function should help in the rational design of an antistreptococcal vaccine and should also increase our understanding of the way in which coiled-coil fibrous proteins can act.

Citation: Scott J, Caparon M. 1993. , p 53-63. In Sonenshein A, Hoch J, Losick R (ed), and Other Gram-Positive Bacteria. ASM Press, Washington, DC. doi: 10.1128/9781555818388.ch4

Key Concept Ranking

Bacterial Proteins
M Protein
Protein A
Streptococcus pyogenes
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Figure 1

The M protein of the group A streptococcus. The left half of the figure is a schematic representation of the dimeric coiled-coil M-protein molecules and the streptococcal cell wall. M-protein dimers, cell membrane, cytoplasm, peptidoglycan (cell wall), and group A-specific carbohydrate(s) are shown. The right half of the figure shows the domains of the M6.1 protein, which has served as a prototype for the structures of all M proteins. The brackets between the two halves of the figure indicate the locations of the main structural features of the M molecule. Shown is the cell wall-associated region, which remains after trypsin digestion of streptococcal cells; the helical rod region, which forms the coiled-coil structure; and the nonhelical amino terminus (N), which is the region most distal to the streptococcal cell wall. Specific domains of the M6 molecule are shown, including the five A repeats of 14 amino acids each, the five B repeats of 25 amino acids each, and the two C repeats of 27 amino acids each. Also shown is the anchor domain, which consists of the carboxy-terminal (C) cytoplasmic charged tail, a membrane-spanning hydrophobic region, and a flexible region rich in proline and glycine residues that traverses the cell wall. LPSTGE indicates the location of an amino acid motif conserved among many gram-positive surface proteins that is also found in eukaryotic proteins attached to membranes by a GPI linkage. The arrow at Pepsin indicates the site at which the M molecule is cleaved preferentially by pepsin. Brackets on the far right of the figure show locations of the three major domains of all M-protein molecules: the polymorphic N terminus, the hypervariable coiled-coil domain, and the conserved domain, which is highly similar among the different M proteins that have been studied.

Citation: Scott J, Caparon M. 1993. , p 53-63. In Sonenshein A, Hoch J, Losick R (ed), and Other Gram-Positive Bacteria. ASM Press, Washington, DC. doi: 10.1128/9781555818388.ch4
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Image of Figure 2
Figure 2

Model for the roles of different proteins in the attachment of to epithelial cells. (A) Chains composed of individual streptococcal cells are shown in the process of attaching to an epithelial cell. Both M protein (↓) and protein F (↑), a fibronectin-binding protein, are shown on the surface of the streptococcal cells. Molecules of fibronectin (symbol here) are shown on the surface of the epithelial cell. The streptococcal chain in the center of the figure has adhered to the epithelial cell by a mechanism that involves the binding of protein F to a molecule of fibronectin. (B) Once a chain of streptococci has attached by its protein F to a tonsillar epithelial cell, the M protein of the attached organisms interacts with other streptococci to cause bacterial aggregation. This type of M-protein-mediated interstreptococcal interaction may contribute to colonization of the host.

Citation: Scott J, Caparon M. 1993. , p 53-63. In Sonenshein A, Hoch J, Losick R (ed), and Other Gram-Positive Bacteria. ASM Press, Washington, DC. doi: 10.1128/9781555818388.ch4
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1. Albright, L. M.,, E. Huala,, and F. M. Ausubel. 1989. Prokaryotic signal transduction mediated by sensor and regulator protein pairs. Annu. Rev. Genet. 23:311336.
2. Alouf, J. E. 1980. Streptococcal toxins (streptolysin O, streptolysin S, erythrogenic toxin). Pharmacol. Ther. 11:661717.
3. Avery, O. T.,, C. M. MacLeod,, and M. McCarty. 1944. Studies on the chemical nature of the substance inducing transformation of pneumococcal types. Induction of transformation by a deoxyribonucleic acid fraction isolated from pneumococcus type III. J. Exp. Med. 79:137159.
4. Balganesh, T. S.,, and S. A. Lacks. 1985. Heteroduplex DNA mismatch repair system of Streptococcus pneumoniae: cloning and expression of the hexA gene. J. Bacteriol. 162:979984.
5. Bartter, T.,, A. Dascal,, K. Carroll,, and F. J. Curley. 1987. "Toxic strep syndrome": a manifestation of group A streptococcal infection. Arch. Intern. Med. 148:14211424.
6. Beachey, E. H.,, and I. Ofek. 1976. Epithelial cell binding of group A streptococci by lipoteichoic acid on fimbriae denuded of M protein. J. Exp. Med. 143:759771.
7. Beachey, E. H.,, and J. M. Seyer. 1986. Protective and non-protective epitopes of chemically synthesized peptides of the amino-terminal region of type 6 streptococcal M protein. J. Immunol. 136:22872291.
8. Beachey, E. H.,, J. M. Seyer,, and A. H. Kang. 1978. Repeating covalent structure of M protein. Proc. Natl. Acad. Sci. USA 75:31633167.
9. Beletskaya, L. V.,, and E. V. Gnezditskaya,. 1982. The effect of streptococcal proteinase on connective tissue, p. 141142. In S. E. Holm, and P. Christensen (ed.), Basic Concepts of Streptococci and Streptococcal Diseases: Proceedings of the VIIIth International Symposium on Streptococci and Streptococcal Diseases, June 1981. Reed-books, Ltd., Chertsey, Surrey, England.
10. Bessen, D.,, K. F. Jones,, and V. A. Fischettl. 1989. Evidence for two distinct classes of streptococcal M protein and their relationship to rheumatic fever. J. Exp. Med. 169:269283.
11. Bessen, D. E.,, and V. A. Fischettl. 1990. Differentiation between two biologically distinct classes of group A streptococci by limited substitutions of amino acids within the shared region of M protein-like molecules. J. Exp. Med. 172:17571764.
12. Bessen, D. E.,, and V. A. Fischetti. 1992. Nucleotide sequences of two adjacent M or M-like protein genes of group A streptococci: different RNA transcript levels and identification of a unique immunoglobulin A-binding protein. Infect. Immun. 60:124135.
13. Bisno, A. L. 1979. Alternate complement pathway activation by group A streptococci: role of M-protein. Infect. Immun. 26:11721176.
14. Bjorck, L.,, P. Akesson,, M. Bonus,, J. Trojnar,, M. Abra-hamson,, I. Olafsson,, and A. Grubb. 1989. Bacterial growth blocked by a synthetic peptide based on the structure of a human proteinase inhibitor. Nature (London) 337:385386.
14a. Borst, P.,, and G. A. M. Cross. 1982. Molecular basis for trypanosome antigenic variation. Cell 29:291303.
15. Bronze, M. S.,, E. H. Beachey,, and J. B. Dale. 1988. Protective and heart-crossreactive epitopes located within the N-terminus of type 19 streptococcal M protein. J. Exp. Med. 167:18491859.
16. Caparon, M. G.,, J. Perez-Casal,, and J. R. Scott. Unpublished data.
17. Caparon, M. G.,, and J. R. Scott. 1987. Identification of a gene that regulates expression of M protein, the major virulence determinant of group A streptococci. Proc. Natl. Acad. Sci. USA 84:86778681.
18. Caparon, M. G.,, and J. R. Scott. 1990. Genetic manipulation of pathogenic streptococci. Methods Enzymol. 204:556586.
19. Caparon, M. G.,, D. S. Stephens,, A. Olsen,, and J. R. Scott. 1991. Role of M protein in adherence of group A streptococci. Infect. Immun. 59:18111817.
20. Claverys, J. P.,, and S. A. Lacks. 1986. Heteroduplex deoxyribonucleic acid base mismatch repair in bacteria. Microbiol. Rev. 50:133165.
21. Clewell, D. 1981. Plasmids, drug resistance, and gene transfer in the genus Streptococcus. Microbiol. Rev. 45:409436.
22. Dale, J. B.,, and E. H. Beachey. 1982. Protective antigenic determinant of streptococcal M protein shared with sarcolemmal membrane protein of human heart. J. Exp. Med. 156:11651176.
23. Dale, J. B.,, and E. H. Beachey. 1984. Unique and common protective epitopes among different serotypes of group A streptococcal M proteins defined with hy-bridoma antibodies. Infect. Immun. 46:267269.
24. Dale, J. B.,, and E. H. Beachey. 1985. Multiple heart-cross-reactive epitopes of streptococcal M proteins. J. Exp. Med. 161:113122.
25. Dale, J. B.,, and E. H. Beachey. 1985. Epitopes of streptococcal M protein shared with cardiac myosin. J. Exp. Med. 162:583591.
26. Dale, J. B.,, and E. H. Beachey. 1986. Localization of protective epitopes of the amino terminus of type 5 streptococcal M protein. J. Exp. Med. 163:1191.
27. Dale, J. B.,, J. M. Seyer,, and E. H. Beachey. 1983. Type specific immunogenicity of a chemically synthesized peptide fragment of type 5 streptococcal M protein. J. Exp. Med. 158:17271732.
28. Dowson, C. G.,, A. Hutchison,, N. Woodford,, A. P. Johnson,, R. C. George,, and B. G. Spratt. 1990. Penicillin-resistant viridans streptococci have obtained altered penicillin-binding protein genes from penicillin-resistant strains of Streptococcus pneumoniae. Proc. Natl. Acad. Sci. USA 87:58585862.
29. Ferretti, J. J.,, R. R. B. Russell,, and M. L. Dao. 1989. Sequence analysis of the wall-associated protein precursor of Streptococcus mutans antigen A. Mol. Microbiol. 3:469478.
30. Fischettl, V. A. 1989. Streptococcal M protein: molecular design and biological behavior. Clinical Microbiol. Rev. 2:285314.
31. Fischettl, V. A. 1991. Streptococcal M protein. Sci. Am. 264:5865.
32. Fischettl, V. A.,, K. F. Jones,, and J. R. Scott. 1985. Size variation of the M protein in group A streptococci. J. Exp. Med. 161:13841401.
33. Fischettl, V. A.,, V. Pancholi,, and O. Schneewind. 1990. Conservation of a hexapeptide sequence in the anchor region of surface proteins from Gram-positive cocci. Mol. Microbiol. 4:16031605.
34. Fischettl, V. A.,, D. A. D. Parry,, B. L. Tras,, S. K. Hollingshead,, J. R. Scott,, and B. N. Manjula. 1988. Conformational characteristics of the complete sequence of group A streptococcal M6 protein. Proteins Struct. Fund. Genet. 3:6069.
35. Frithz, E.,, L.-O. Heden,, and G. Lindahl. 1989. Extensive sequence homology between IgA receptor and M protein in Streptococcus pyogenes. Mol. Microbiol. 3:1111.
36. Gomi, H.,, T. Hozumi,, S. Hattori,, C. Tagawa,, F. Kishi-moto,, and L. Bjorck. 1990. The gene sequence and some properties of protein H. J. Immunol. 144:4046.
37. Guss, B.,, M. Uhlen,, B. Nilsson,, M. Llndberg,, J. Sjoquist,, and J. Sjodaht. 1984. Region X, the cell-wall-attachment part of staphylococcal protein A. Eur. J. Biochem. 138:413420.
38. Haanes, E. J.,, and P. P. Cleary. 1989. Identification of a divergent M protein gene and an M protein-related gene family in Streptococcus pyogenes serotype 49. J. Bacterial. 171:63976408.
39. Haanes-Fritz, E.,, W. Kraus,, V. Burdett,, J. B. Dale,, E. H. Beachey,, and P. P. Cleary. 1988. Comparison of the leader sequences of four group A streptococcal M protein genes. Nucleic Acids Res. 16:46674677.
40. Hanskl, E.,, and M. G. Caparon. 1992. Protein F, a fibronectin-binding protein, is an adhesin of the group A streptococcus. Proc. Natl. Acad. Sci. USA 89:61726176.
41. Harvey, R. C.,, M. M. Farley,, T. Stull,, J. D. Smith,, A. Shuchat,, and D. S. Stephens. 1991. Population-based assessment of Streptococcus agalactiae (group B streptococcus) meningitis and bacteremia in metropolitan adults, abstr. 1059. Program Abstr. 31st Intersci. Conf. Antimicrob. Agents Chemother. 1991.
42. Hauser, A. R.,, and P. M. Schlievert. 1990. Nucleotide sequence of the streptococcal pyrogenic exotoxin type B gene and relationship between the toxin and the streptococcal proteinase precursor. J. Bacteriol. 172:45364542.
43. Hauser, A. R.,, D. L. Stevens,, E. L. Kaplan,, and P. M. Schlievert. 1991. Molecular analysis of pyrogenic exotoxins from Streptococcus pyogenes isolates associated with toxic shock-like syndrome. J. Clin. Microbiol. 29: 15621567.
44. Heath, D. G.,, and P. P. Cleary. 1989. Fc-receptor and M-protein genes of group A streptococci are products of gene duplication. Proc. Natl. Acad. Sci. USA 86:47414745.
45. Hollingshead, S.,, V. Fischetti,, and J. R. Scott. 1987. A highly conserved region present in transcripts encoding heterologous M proteins of group A streptococcus. Infect. Immun. 55:32373239.
46. Hollingshead, S. K.,, V. A. Fischetti,, and J. R. Scott. 1986. Complete nucleotide sequence of type 6 M protein of the group A streptococcus: repetitive structure and membrane anchor. J. Biol. Chem. 261:16771686.
47. Hollingshead, S. K.,, V. A. Fischetti,, and J. R. Scott. 1987. Size variation in group A streptococcal protein is generated by homologous recombination between intragenic repeats. Mol. Gen. Genet. 207:196203.
48. Horstmann, R. D.,, H. J. Sievertsen,, J. Knobloch,, and V. A. Fischetti. 1987. Antiphagocytic activity of streptococcal M protein: selective binding of complement control protein factor H. Proc. Natl. Acad. Sci. USA 85:16571661.
49. Hosein, B.,, M. McCarty,, and V. A. Fischetti. 1979. Amino acid sequence and physicochemical similarities between streptococcal M protein and mammalian tropomyosin. Proc. Natl. Acad. Sci. USA 76:37653768.
50. Johnson, L. P.,, J. J. L'Italien,, and P. M. Schlievert. 1986. Streptococcal pyrogenic exotoxin type A (scarlet fever toxin) is related to Staphylococcus aureus entero-toxin B. Mol. Gen. Genet. 203:354356.
51. Jones, K. F.,, and V. A. Fischetti. 1988. The importance of the location of antibody binding on the M6 protein for opsonization and phagocytosis of group A M6 streptococci. J. Exp. Med. 167:11141123.
52. Jones, K. F.,, S. K. Hollingshead,, J. R. Scott,, and V. A. Fischetti. 1988. Spontaneous M6 protein size mutants of group A streptococci display variation in antigenic and opsonogenic epitopes. Proc. Natl. Acad. Sci. USA 85:82718275.
53. Jones, K. F.,, S. K. Hollingshead,, J. R. Scott,, and V. A. Fischetti. Unpublished data.
54. Kehoe, M. A.,, T. P. Poirier,, E. H. Beachey,, and K. N. Timmis. 1985. Cloning and genetic analysis of serotype 5 M protein determinant of group A streptococci: evidence for multiple copies of the M5 determinant in the Streptococcus pyogenes genome. Infect. Immun. 48:190197.
55. Kelly, C.,, P. Evans,, L. Bergmeier,, S. F. Lee-Fox,, A. Progulske,, A. C. Harris,, A. Aitken,, A. S. Blelweis,, and T. Lerner. 1990. Sequence analysis of a cloned streptococcal surface antigen I/II. FEBS Lett. 258:127132.
56. Kok, J.,, K. J. Leenhouts,, A. J. Haandrikman,, A. M. Ledeboer,, and G. Venema. 1988. Nucleotide sequence of the cell wall proteinase gene of Streptococcus cremoris Wg2. Appl. Environ. Microbiol. 54:231238.
57. Kraus, W.,, E. Hannes-Fritz,, P. P. Cleary,, J. Seyer,, J. Dale,, and E. Beachey. 1987. Sequence and type-specific immunogenicity of the amino-terminal region of type 1 streptococcal M protein. J. Immunol. 139:30843090.
58. Lacks, S. A.,, B. M. Mannarelli,, S. S. Springhorn,, and B. Greenberg. 1986. Genetic basis of the complementary DpnI and DpnII restriction systems of S. pneumoniae: an intercellular cassette mechanism. Cell 46:9931000.
59. Lancefield, R. C. 1933. A serological differentiation of human and other groups of hemolytic streptococci. J. Exp. Med. 57:571595.
60. Lancefield, R. C. 1957. Differentiation of group A streptococci with a common R antigen into three serological types, with special reference to the bactericidal test. J. Exp. Med. 106:525544.
61. Lindahl, G.,, and B. Akerstrom. 1989. Receptor for IgA in group A streptococci: cloning of the gene and characterization of the protein expressed in Escherichia coli. Mol. Microbiol. 3:239247.
62. Malke, H., and J. Ferretti. 1984. Streptokinase: cloning, expression, and excretion by Escherichia coli. Proc. Natl. Acad. Sci. USA 81:35573561.
63. Manjula, B. N. 1988. Molecular aspects of the phagocytosis resistance of group A streptococci. Eur. J. Epidemiol. 4:289300.
64. Manjula, B. N.,, and V. A. Fischetti. 1980. Tropomyosin-like seven residue periodicity in three immunologically distinct streptococcal M proteins and its implications for the antiphagocytic property of the molecule. J. Exp. Med. 151:695708.
65. Martin, B.,, H. Prats,, and J. P. Claverys. 1985. Cloning of the hexA mismatch-repair gene of Streptococcus pneumoniae and identification of the product. Gene 34:293303.
66. McLachlan, A. D.,, and M. Stewart. 1975. Tropomyosin coiled-coil interactions: evidence for an unstaggered structure. J. Mol. Biol. 98:293304.
67. Miller, J. F.,, J. J. Mekalanos,, and S. Falkow. 1989. Coordinate regulation and sensory transduction in the control of bacterial virulence. Science 243:916922.
68. Murray, B. E., 1987. Plasmid-mediated beta-lactamase in Enterococcus faecalis, p. 8386. In J. J. Ferretti, and R. Curtiss (ed.), Streptococcal Genetics. American Society for Microbiology, Washington, D.C.
69. Murray, B. E.,, and B. Mederski-Samoraj. 1983. Transferable beta-lactamase: a new mechanism for in vitro penicillin resistance in Streptococcus faecalis. J. Clin. Invest. 72:11681171.
70. Norgren, M.,, M. G. Caparon,, and J. R. Scott. 1989. A method for allelic replacement that uses the conjugative transposon Tn916: deletion of the emm6.1 allele in Streptococcus pyogenes JRS4. Infect. Immun. 57:38463850.
71. Ofek, I.,, E. H. Beachey,, W. Jefferson,, and G. L. Campbell. 1975. Cell membrane-binding properties of group A streptococcal lipoteichoic acid. J. Exp. Med. 141:9901003.
72. Ofek, I.,, W. A. Simpson,, and E. H. Beachey. 1982. Formation of molecular complexes between a structurally defined M protein and acylated or deacylated lipoteichoic acid of Streptococcus pyogenes. J. Bacteriol. 149:426433.
73. Olsson, A.,, M. Eliasson,, B. Guss,, B. Nilsson,, U. Hellman, M. Lindberg, and M. Uhlen. 1987. Structure and evolution of the repetitive gene encoding streptococcal protein G. Eur. J. Biochem. 168:319324.
74. Pancholi, V.,, and V. Fischettl. 1988. Isolation and characterization of the cell-associated region of group A streptococcal M6 protein. J. Bacteriol. 170:26182624.
75. Pancholi, V.,, and V. A. Fischetti. 1989. Identification of an endogenous membrane anchor-cleaving enzyme for group A streptococcal M protein. J. Exp. Med. 170:21192133.
76. Perez-Casal, J.,, M. G. Caparon,, and J. R. Scott. 1991. Mry, a trans-acting positive regulator of the M protein gene of Streptococcus pyogenes with similarity to the receptor proteins of two-component regulatory systems. J. Bacteriol. 173:26172624.
77. Perez-Casal, J.,, V. A. Fischettl,, and J. R. Scott. Unpublished data.
78. Peterson, P. K.,, D. Schmeling,, P. P. Cleary,, B. J. Wilkinson,, Y. Kim,, and P. G. Qule. 1979. Inhibition of alternative complement pathway opsonization by group A streptococcal M protein. J. Infect. Dis. 139:575585.
79. Phillips, G. N., Jr.,, P. F. Flicker,, C. Cohen,, B. N. Manjulá,, and V. A. Fischettl. 1981. Streptococcal M protein: alpha-helical coiled-coil structure and arrangement on the cell surface. Proc. Natl. Acad. Sci. USA 78:46894693.
80. Podbielski, A.,, B. Melzer,, and R. Lutticken. 1991. Application of the polymerase chain reaction to study the M protein(-like) gene family in beta-hemolytic streptococci. Med. Microbiol. Immunol. 180:213227.
81. Prats, H.,, B. Martin,, and J. P. Claverys. 1985. The hexB mismatch repair gene of Streptococcus pneumoniae: characterization, cloning, and identification of the product. Mol. Gen. Genet. 200:482489.
82. Radius, B. A.,, D. K. Rhee,, and D. A. Morrison. 1990. Genetic transformation in Streptococcus pneumoniae: nucleotide sequence and predicted amino acid sequence of recP. J. Bacteriol. 172:36693674.
83. Relf, W. A.,, and K. S. Sriprakash. 1990. Limited repertoire of the D-terminal region of the M protein in Streptococcus pyogenes. FEMS Microbiol. Lett. 71:345350.
84. Robbins, J. C.,, J. G. Spanier,, S. J. Jones,, W. J. Simpson,, and P. P. Cleary. 1987. Streptococcus pyogenes type 12 M protein gene regulation by upstream sequences. J. Bacteriol. 169:56335640.
85. Saravani, G. A.,, and D. R. Martin. 1990. Opacity factor from group A streptococci is an apoproteinase. FEMS Microbiol. Lett. 68:3540.
86. Sargent, S. J.,, E. H. Beachey,, C. E. Corbett,, and J. B. Dale. 1987. Sequence of protective epitopes of streptococcal M proteins shared with cardiac sarcolemmal membranes. J. Immunol. 139:12851290.
87. Schleifer, K. H.,, and R. Kilpper-Balz. 1987. Molecular and chemotaxonomic approaches to the classification of streptococci, enterococci and lactococci: a review. Syst. Appl. Microbiol. 10:119.
88. Schlievert, P. M.,, K. M. Bettin,, and D. W. Watson. 1979. Production of pyrogenic exotoxin by groups of streptococci: association with group A. J. Infect. Dis. 140:676.
89. Schneewind, O.,, K. F. Jones,, and V. A. Fischettl. 1990. Sequence and structural characterization of the tryp-sin-resistant T6 surface protein of group A streptococci. J. Bacteriol. 172:33103317.
90. Scott, J. R., 1990. The M protein of group A Streptococcus: evolution and regulation, p. 177203. In B. M. Iglewski, and V. L. Clark (ed.), The Bacteria, vol. XI. Molecular Basis of Bacterial Pathogenesis. Academic Press, Inc., San Diego, Calif.
91. Scott, J. R.,, S. K. Hollingshead,, and V. A. Fischettl,. 1988. The evolution of M proteins of group A streptococci, p. 6375. In F. C. Cabello, and C. Pruzzo (ed.), Bacteria, Complement and the Phagocytic Cell. Springer-Verlag, Berlin.
92. Scott, J. R.,, S. K. Hollingshead,, K. F. Jones,, and V. A. Fischettl,. 1987. Structural and genetic relationships of the family of M protein molecules of group A streptococci, p. 9397. In J. Ferretti, and R. Curtiss (ed.), Streptococcal Genetics. American Society for Microbiology, Washington, D.C.
93. Scott, J. R.,, W. M. Pulltam,, S. K. Hollingshead,, and V. A. Fischettl. 1985. Relationship of M protein genes in group A streptococci. Proc. Natl. Acad. Sci. USA 82:18221826.
94. Seifert, H. S.,, and M. So. 1988. Genetic mechanisms of bacterial antigenic variation. Microbiol. Rev. 52:327336.
95. Simpson, W. A.,, and E. H. Beachey. 1983. Adherence of group A streptococci to fibronectin on oral epithelial cells. Infect. Immun. 39:275279.
96. Simpson, W. A.,, H. S. Courtney,, and I. Ofek. 1987. Interactions of fibronectin with streptococci: the role of fibronectin as a receptor for Streptococcus pyogenes. Rev. Infect. Dis. 9:S351S359.
97. Simpson, W. J.,, D. LaPenta,, C. Chen,, and P. P. Cleary. 1990. Coregulation of type 12 M protein and streptococcal C5a peptidase genes in group A streptococci: evidence for a virulence regulon controlled by the virR locus. J. Bacteriol. 172:696700.
98. Spanier, J. G.,, S. J. C. Jones,, and P. Cleary. 1984. Small DNA deletions creating avirulence in Streptococcus pyogenes. Science 225:935938.
99. Stevens, D. L.,, M. H. Tanner,, J. Winshlp,, R. Swarts,, K. M. Ries,, P. M. Schlievert,, and E. Kaplan. 1989. Severe group A streptococcal infections associated with a toxic shock-like syndrome and scarlet fever toxin A. N. Engl. J. Med. 321:17.
100. Stock, J. B.,, A. J. Ninfa,, and A. M. Stock. 1989. Protein phosphorylation and regulation of adaptive responses in bacteria. Microbiol. Rev. 53:450490.
101. Svensson, M.,, P. Christensen,, and D. Schalen. 1986. Monoclonal opsonic mouse antibodies specific for streptococcal IgG Fc-receptor. J. Med. Microbiol. 22: 251256.
102. Swanson, J.,, K. C. Hsu,, and E. C. Gotschllch. 1969. Electron microscope studies on streptococci. I. M. Antigen. J. Exp. Med. 130:10631075.
103. Tomasz, A.,, and J. L. Mosser. 1966. On the nature of the pneumococcal activator substance. Proc. Natl. Acad. Sci. USA 55:5866.
104. Tyewska, S. K.,, V. A. Fischettl,, and R. J. Gibbons. 1988. Binding selectivity of Streptococcus pyogenes and M-protein to epithelial cells differs from that of lipoteichoic acid. Curr. Microbiol. 16:209216.
105. Watson, D. W., 1979. Characterisation and pathobiolog-ical properties of group A streptococcal pyrogenic exotoxins, p. 6263. In M. T. Parker (ed.), Pathogenic Streptococci: Proceedings of the Vllth International Symposium on Streptococci and Streptococcal Diseases, September 1978. Reedbooks, Ltd., Chertsey, Surrey, England.
106. Wessels, M. R.,, A. E. Moses,, J. B. Goldberg,, and T. J. DiCesare. 1991. Hyaluronic acid capsule is a virulence factor for mucoid group A streptococci. Proc. Natl. Acad. Sci. USA 88:83178321.
107. Wexler, D. E.,, R. D. Nelson,, and P. P. Cleary. 1983. Human neutrophil chemotactic response to group A streptococci: bacteria-mediated interference with complement-derived factors. Infect. Immun. 39:239246.
108. Whitnack, E.,, A. L. Bisno,, and E. H. Beachey. 1981. Hyaluronate capsule prevents attachment of group A streptococci to mouse peritoneal macrophages. Infect. Immun. 31:985991.
109. Widdowson, J. P., 1980. The M-associated protein antigens of group A streptococci, p. 125147. In S. E. Read, and J. B. Zabriskie (ed.). Streptococcal Diseases and the Immune Response. Academic Press, Inc., New York.
110. Widdowson, J. P.,, W. R. Maxted,, and A. M. Plnney. 1976. Immunological heterogeneity among the M-asso-ciated protein antigens of group A streptococci. J. Med. Microbiol. 9:73.
111. Wilson, A. 1959. The relative importance of the capsule to the M-antigen in determining colony form of group A streptococci. J. Exp. Med. 109:257269.
112. Zighelboim, S.,, and A. Tomasz. 1980. Penicillin-binding proteins of multiply antibiotic resistant South African strains of Streptococcus pneumoniae. Antimicrob. Agents Chemother. 17:433442.

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