Toxic Cellular Component of Group a Streptococci as a Complex of Group- Specific C Polysaccharide and a Protein* by John H. Schwab, Ph.d.,

Chronic multinodular skin lesions were produced in rabbits injected intradermally at a single site with a sterile extract of sonically disrupted Group A streptococcal cells (1). These lesions, which consisted of separate nodules scattered over areas as large as 12 cm. in diameter, presented several remarkable features. The injury to dermal connective tissue was evident within 48 hours after injection, suggesting that the material had a primary toxic effect. The reaction was observed to continue for as long as 30 days in the first series of experiments (1), and subsequent studies have revealed it to continue for at least 60 days after a single injection. In the gross, the process was characterized by periods of abatement followed by either exacerbation of the subsiding lesions or the development of additional nodules in areas where the lesions have previously completely subsided. The initial nodules and the recurrent nodular lesions were associated with focal necrosis of dermal connective tissue. What appeared to be acute focal necrosis was noted during the first 48 hours after injection and as late as 60 days after the animals were inoculated. As the process evolved, mononuclear and giant cells were found in the tissues along with the areas of acute focal necrosis. The gross and microscopic changes suggested that a single injection of this sterile extract could initiate a mechanism of injury that caused recurrent acute focal damage of connective tissue extending over a period of at least 60 days. Comparative study of extracts of various species of streptococci suggested that this toxic material was a cellular component characteristic of Group A streptococci (2). I t is the purpose of this report to record data associating the toxic activity with a complex macromolecule containing the Group-specific C polysaccharide.