Immunological Studies on a C Polysaccharide Complex of Group a Streptococci Having a Direct Toxic Effect on Connective Tissue

A macromolecular complex of C polysaccharide and peptide derived from Group A streptococcal cells produces a multinodular, remittent, and intermittent lesion of dermal connective tissue following a single intradermal injection. This lesion is greatly modified, both in the gross and microscopically, in rabbits hyperimmunized with a Group A streptococcal vaccine. The immune serum, absorbed to yield only antibodies against C polysaccharide as indicated by agar diffusion techniques, will precipitate and neutralize the toxic material. This neutralization and in vitro precipitation can be inhibited with formamide-isolated C polysaccharide hapten and with N-acetylglucosamine, the primary directive group of this antigen. This clearly demonstrates that antibodies against the group-specific C polysaccharide are responsible for resistance to this toxic material. The immunological and other properties of the toxic C polysaccharide complex, the fact that it is a product of Group A streptococci, the gross and microscopic features of the experimental lesion produced with this substance, and the observations on the chronic course of the experimental lesion, indicate that this toxic material should be investigated as a possible factor in the pathogenesis of the non-suppurative sequelae associated with Group A streptococci.