{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T20:30:48Z","timestamp":1758400248774,"version":"3.37.3"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2017,11,1]],"date-time":"2017-11-01T00:00:00Z","timestamp":1509494400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000001","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000001","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"crossref","award":["PZ00P3_136639","310030-130748","310030_146295\/1"],"award-info":[{"award-number":["PZ00P3_136639","310030-130748","310030_146295\/1"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,1,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Necrotizing fasciitis (NF) retains a very high mortality rate despite prompt and adequate antibiotic treatment and surgical debridement. Necrotizing fasciitis has recently been associated withStreptococcus dysgalactiae subspeciesequisimilis (SDSE).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We investigated the causes of a very severe clinical manifestation of SDSE-NF by assessing both host and pathogen factors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We found a lack of streptokinase-function blocking antibodies in the patient resulting in increased streptokinase-mediated fibrinolysis and bacterial spread. At the same time, the clinical SDSE isolate produced very high levels of streptokinase. Exogenous immunoglobulin Gs (ex-IgGs) efficiently blocked streptokinase-mediated fibrinolysis in vitro, indicating a protective role against the action of streptokinase. In vivo, SDSE infection severity was also attenuated by ex-IgGs in a NF mouse model.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>These findings illustrate for the first time that the lack of specific antibodies against streptococcal virulence factors, such as streptokinase, may contribute to NF disease severity. This can be counteracted by ex-IgGs.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jix560","type":"journal-article","created":{"date-parts":[[2017,10,29]],"date-time":"2017-10-29T04:07:01Z","timestamp":1509250021000},"page":"270-279","source":"Crossref","is-referenced-by-count":8,"title":["Immunoglobulin Attenuates Streptokinase-Mediated Virulence inStreptococcus dysgalactiae Subspeciesequisimilis Necrotizing Fasciitis"],"prefix":"10.1093","volume":"217","author":[{"given":"Federica","family":"Andreoni","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Ugolini","sequence":"first","affiliation":[{"name":"Institute of Intensive Care Medicine, University Hospital Zurich, University of Zurich, Switzerland"},{"name":"Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadia","family":"Keller","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrina","family":"Neff","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor","family":"Nizet","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Pharmacology and Drug Discovery, San Diego, California"},{"name":"Skaggs School of Pharmacy and Pharmaceutical Sciences, San Diego, 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