Antistreptolysin
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Anti-streptolysin O (ASO or ASLO) is the antibody made against streptolysin O, an immunogenic, oxygen-labile
streptococcal ''Streptococcus'' is a genus of gram-positive ' (plural ) or spherical bacteria that belongs to the family Streptococcaceae, within the order Lactobacillales (lactic acid bacteria), in the phylum Bacillota. Cell division in streptococci occur ...
hemolytic Hemolysis or haemolysis (), also known by several other names, is the rupturing (lysis) of red blood cells (erythrocytes) and the release of their contents (cytoplasm) into surrounding fluid (e.g. blood plasma). Hemolysis may occur in vivo o ...
exotoxin produced by most strains of group A and many strains of groups C and G ''
Streptococcus ''Streptococcus'' is a genus of gram-positive ' (plural ) or spherical bacteria that belongs to the family Streptococcaceae, within the order Lactobacillales (lactic acid bacteria), in the phylum Bacillota. Cell division in streptococci occurs ...
'' bacteria. The "O" in the name stands for ''oxygen-labile''; the other related toxin being oxygen-stable streptolysin-S. The main function of streptolysin O is to cause hemolysis (the breaking open of red blood cells)—in particular,
beta-hemolysis Hemolysis (from Greek αιμόλυση, meaning 'blood breakdown') is the breakdown of red blood cells. The ability of bacterial colonies to induce hemolysis when grown on blood agar is used to classify certain microorganisms. This is particular ...
. Increased levels of ASO titre in the blood could cause damage to the heart and joints. In most cases, penicillin is used to treat patients with increased levels of ASO titre.


Clinical significance

When the body is infected with streptococci, it produces antibodies against the various
antigen In immunology, an antigen (Ag) is a molecule or molecular structure or any foreign particulate matter or a pollen grain that can bind to a specific antibody or T-cell receptor. The presence of antigens in the body may trigger an immune respons ...
s that the streptococci produce. ASO is one such antibody. A raised or rising levels can indicate past or present infection. Historically it was one of the first bacterial markers used for diagnosis and follow up of rheumatic fever or scarlet fever. Its importance in this regard has not diminished. Since these antibodies are produced as a delayed antibody reaction to the above-mentioned bacteria, there is no normal value. The presence of these antibodies indicates an exposure to these bacteria. However, as many people are exposed to these bacteria and remain asymptomatic, the mere presence of ASO does not indicate disease. Acceptable values, where there is no clinical suspicion of rheumatism are as follows: * Adults: less than 200 units * Children: less than 100 units This
titre Titer (American English) or titre (British English) is a way of expressing concentration. Titer testing employs serial dilution to obtain approximate quantitative information from an analytical procedure that inherently only evaluates as positiv ...
has a significance only if it is greatly elevated (> 200), or if a rise in titre can be demonstrated in paired blood samples taken days apart. The antibody levels begin to rise after 1 to 3 weeks of strep infection, peaks in 3 to 5 weeks and falls back to insignificant levels in 6 months. Values need to be correlated with a clinical diagnosis. The aim is to convert it .


Estimation

It is done by
serological Serology is the scientific study of serum and other body fluids. In practice, the term usually refers to the diagnostic identification of antibodies in the serum. Such antibodies are typically formed in response to an infection (against a given mic ...
methods like latex agglutination or slide agglutination.
ELISA The enzyme-linked immunosorbent assay (ELISA) (, ) is a commonly used analytical biochemistry assay, first described by Eva Engvall and Peter Perlmann in 1971. The assay uses a solid-phase type of enzyme immunoassay (EIA) to detect the presen ...
may be performed to detect the exact titre value. To detect the titre value, by a non-ELISA method, one has to perform the above agglutination using a serial dilution technique.


Mechanism of action

These antibodies produced against the bacteria cross-react with human antigens (mainly collagen) and hence attack the
cellular matrix In biology, the extracellular matrix (ECM), also called intercellular matrix, is a three-dimensional network consisting of extracellular macromolecules and minerals, such as collagen, enzymes, glycoproteins and hydroxyapatite that provide str ...
of various organs, mainly the heart, joints, skin, brain, etc.


Antistreptolysin O titre

Antistreptolysin O titre (AS(L)O titer or AS(L)OT) is a measure of the blood plasma levels of antistreptolysin O antibodies used in tests for the diagnosis of a streptococcal infection or indicate a past exposure to streptococci. The ASOT helps direct
antimicrobial An antimicrobial is an agent that kills microorganisms or stops their growth. Antimicrobial medicines can be grouped according to the microorganisms they act primarily against. For example, antibiotics are used against bacteria, and antifungals ar ...
treatment and is used to assist in the diagnosis of scarlet fever, rheumatic fever, and post infectious glomerulonephritis. A positive test usually is > 200 units/mL,Antistreptococcal antibody titres. gpnotebook. URL
http://www.gpnotebook.co.uk/cache/-1630535637.htm
. Accessed on: March 31, 2007.
but normal ranges vary from laboratory to laboratory and by age. The
false negative A false positive is an error in binary classification in which a test result incorrectly indicates the presence of a condition (such as a disease when the disease is not present), while a false negative is the opposite error, where the test resul ...
s rate is 20 to 30%. If a false negative is suspected, then an
anti-DNase B Anti-Deoxyribonuclease B (anti-DNase B) titres are a quantitative measure of the presence of serologic antibodies obtained from patients suspected of having a recent group A (Beta-hemolytic) streptococcus bacteria infection, from ''Streptococcus ...
titre should be sought.
False positive A false positive is an error in binary classification in which a test result incorrectly indicates the presence of a condition (such as a disease when the disease is not present), while a false negative is the opposite error, where the test resul ...
s can result from
liver disease Liver disease, or hepatic disease, is any of many diseases of the liver. If long-lasting it is termed chronic liver disease. Although the diseases differ in detail, liver diseases often have features in common. Signs and symptoms Some of the si ...
and
tuberculosis Tuberculosis (TB) is an infectious disease usually caused by '' Mycobacterium tuberculosis'' (MTB) bacteria. Tuberculosis generally affects the lungs, but it can also affect other parts of the body. Most infections show no symptoms, i ...
.


References


External links


Antistreptococcal antibody titres
- GPnotebook.co.uk.
Antistreptolysin O Titer
- medterms.com.


Streptococcal antibody tests
- healthAtoZ.com {{Infectious blood tests Antibodies Infectious disease blood tests