The British Journal of Rheumatology, Vol 36, 328-332, Copyright © 1997 by British Society for Rheumatology
SP Nair, S Meghji, M Wilson, I Nugent, A Ross, A Ismael, NK Bhudia, M Harris and B Henderson
Staphylococcus aureus is directly implicated in the bone destruction
associated with infected orthopaedic implants and bacterial arthritis. The
Oxford (laboratory) strain of this organism has surface-associated proteins
(SAPs) which have potent osteolytic activity. In this study, we have
examined the osteolytic activity of SAPs from clinical isolates and also
investigated the role of the humoral immune response to such proteins. Nine
patients with infected orthopaedic prostheses or infective arthritis, and
six volunteers not suffering from overt S. aureus infection, were examined.
The sera from 5/9 patients and 4/6 volunteers were able to neutralize the
osteolytic activity of the SAPs. The SAPs were extracted from four clinical
isolates and were found to have osteolytic activity, but with a wide range
of efficacies and potencies. All four patients from whom the clinical
isolates were obtained had serum IgG antibodies to the surface proteins
from their autologous isolates as determined by ELISA. In conclusion,
clinical isolates of S. aureus contain osteolytic SAPs which may be
responsible for bone destruction. Apparently disease-free individuals and
patients have antibodies able to block this activity. However, since the
capacity of patients' sera to neutralize the activity of the SAPs derived
from their own S. aureus isolate was not investigated, it is unclear
whether these findings are of prognostic value.
ORIGINAL PAPERS
Clinical isolates of Staphylococcus aureus have osteolytic surface proteins and a proportion of the population have antibodies that block this activity: is this of prognostic significance?
Maxillofacial Surgery Research Unit, Eastman Dental Institute for Oral Health Care Sciences, University College London.
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