SYNOPSIS Inhibition of streptolysin 0 activity by cholesterol depends on the latter being in free form. The normal esterified and protein-bound cholesterol fractions in serum do not influence streptolysin 0 activity. However, high cholesterol levels in rabbits fed cholesterol with cholic acid were associated with an increased antistreptolysin 0 effect. It is suggested that this occurs when all available protein sites are saturated and where a true 'free' cholesterol fraction is present.Splitting the esterified cholesterol fraction of human sera with raised cholesterol levels, by means of pancreatin, produced an increased antistreptolysin 0 effect, again presumably because of saturation of protein-binding sites. Similarly, removal of non-esterified cholesterol from sera of cholesterolfed rabbits, by means of digitonin, reduced antistreptolysin 0 activity of the sera.Evidence is presented that combination of bovine serum albumin and streptolysin 0 has a steric hindrance effect on attachment of cholesterol to streptolysin 0.The method described for the estimation of free cholesterol is extremely sensitive, being capable of detecting concentrations of less than 1 0 ,ug/ml.Confirmation of group A streptococcal infection by estimation of antistreptolysin activity remains one of the most useful of serological tests in terms of reproducibility, clarity of end-point, high percentage of positive results, and relative absence of nonspecific reactions. Non-specific positive reactions are known to be obtained with sera contaminated with bacteria. Strains of the genus Pseudomonas appear to be especially involved (Watson, Rose, and Kerr, 1971). Additionally it is known that cholesterol can inhibit reduced streptolysin 'O' (SLO) activity (Hewitt and Todd, 1939). The mechanism of the latter has been studied by Alouf and Raynaud (1968), who have shown that cholesterol acts by combining with the reduced SLO and prevents its attachment to cell membranes. Haemolysis by saponins is also inhibited by cholesterol but the mechanism of action appears different.The present investigation was undertaken to determine the effect of variations in serum cholesterol levels on streptolysin 0 activity and also some of the factors influencing cholesterol inhibition of streptolysin 0.Received for publication 17 August 1972.
Materials and Methods
ANTISTREPTOLYSIN ESTIMATIONSThese were done by the standard method of Rantz and Randall (1945). Briefly, heat inactivated serum (560 for 30 minutes) is diluted in phosphate-buffered saline (pH 6 7) from three master dilutions (1/10, 1/100, and 1/500). To each 1I0 ml volume of serum dilution in 3 in. x i in. tubes is added 0 5 ml of reduced streptolysin 0 (containing 1.0 IU