bInvasive M1T1 group A Streptococcus (GAS) can have a mutation in the regulatory system CovRS, and this mutation can render strains hypervirulent. Interestingly, via mechanisms that are not well understood, the host innate immune system's neutrophils select spontaneous M1T1 GAS CovRS hypervirulent mutants, thereby enhancing the pathogen's ability to evade immune killing. It has been reported that the DNase Sda1 is critical for the resistance of M1T1 strain 5448 to killing in human blood and provides pressure for in vivo selection of CovRS mutations. We reexamined the role of Sda1 in the selection of CovRS mutations and in GAS innate immune evasion. Deletion of sda1 or all DNase genes in M1T1 strain MGAS2221 did not alter emergence of CovRS mutants during murine infection. Deletion of sda1 in strain 5448 resulted in ⌬sda1 mutants with (5448 ⌬sda1 M؉ strain) and without (5448 ⌬sda1 M؊ strain) M protein production. The 5448 ⌬sda1 M؉ strain accumulated CovRS mutations in vivo and resisted killing in the bloodstream, whereas the 5448 ⌬sda1 M؊ strain lost in vivo selection of CovRS mutations and was sensitive to killing. The deletion of emm and a spontaneous Mga mutation in MGAS2221 reduced and prevented in vivo selection for CovRS mutants, respectively. Thus, in contrast to previous reports, Sda1 is not critical for in vivo selection of invasive M1T1 CovRS mutants and GAS resistance to innate immune killing mechanisms. In contrast, M protein and other Mga-regulated proteins contribute to the in vivo selection of M1T1 GAS CovRS mutants. These findings advance the understanding of the progression of invasive M1T1 GAS infections.
The human pathogen group A Streptococcus (GAS) causes about 700 million cases of relatively mild, noninvasive pharyngitis and superficial skin infections annually. However, severe GAS infections, including severe invasive infections and acute rheumatic fever/rheumatic heart disease, can occur, causing approximately 517,000 deaths in the world each year (1). A globally disseminated M1T1 clone of serotype M1 GAS most frequently is associated with severe invasive infections in the United States (2-4). It is believed that the original M1T1 GAS clone evolved from the acquisitions of DNase Sda1-and superantigen SpeA-encoding prophages and an interserotype exchange of a 36-kb chromosomal region containing the toxin genes encoding NAD ϩ -glycohydrolase (NADase) and streptolysin O (SLO) with serotype M12 GAS (5-7). More recently, hypervirulent M1T1 GAS strains have been isolated, usually having mutations in the two-component regulatory system CovRS (also known as CsrRS) (8-12).CovRS is known to negatively regulate multiple virulence genes in GAS, including the capsule synthetase gene hasA, the interleukin-8 (IL-8)/CXC chemokine peptidase gene spyCEP, and the platelet-activating factor acetylhydrolase gene sse (13-18). Natural CovS mutations of invasive M1T1 isolates usually enhance the expression of these virulence genes and downregulate the production of the protease SpeB (SpeB AϪ , for the lack of the...