Poster Presentation Lancefield International Symposium for Streptococci and Streptococcal Diseases 2025

Streptococcus pyogenes evades antibody recognition through decoration of the Group A Lancefield antigen with glycerol phosphate (#240)

Astrid Hendriks 1 , Robin Temming 1 , Zhen Wang 2 , Jeroen D.C. Codée 2 , Nina M. van Sorge 1 3
  1. Department of Medical Microbiology and Infection Prevention, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
  2. Leiden Institute of Chemistry, Leiden University, Leiden, The Netherlands
  3. Netherlands Reference Laboratory for Bacterial Meningitis, Amsterdam UMC, Amsterdam, The Netherlands

Streptococcus pyogenes (or Group A Streptococcus, GAS) presents a frequent cause of mild to life-threatening infections. The Group A Carbohydrate (GAC) is a conserved surface glycan and the target of GAS rapid-test assays used in clinical diagnostics. GAC exists as three different variants or glycoforms: linear polyrhamnose, polyrhamnose with GlcNAc modifications, and a fully mature glycoform where ~25% of GlcNAc moieties are modified with glycerolphosphate (GroP). Several GAS vaccines currently in clinical development include either the polyrhamnose or GlcNAc-containing variant but not the GroP-modified structure. Since the presence of GroP affects susceptibility to innate host defenses (sPLA2-IIA and Zn2+ toxicity), we aimed to investigate how GroP modifications impacted antibody recognition of GAC. Using a multiplexed bead-based flow cytometric assay, we analyzed systemic antibody responses (IgM, IgG1-3 and IgA) against the three GAC glycoforms in human plasma using fully-defined synthetic structures. We observed the universal presence of GAC-specific IgM and IgG antibodies in plasma of healthy individuals (n=16) and GAS bacteremia patients (n=13). Antibody reactivity was highest for the polyrhamnose-GlcNAc epitope and the presence of GroP significantly decreased IgM and IgG antibody binding to GAC-GlcNAc in both groups. We used the synthetic structures to isolate GAC-specific human B cells and produced recombinant monoclonal antibodies with different epitope specificities as confirmed by binding to fully-defined synthetic structures. Here, we provide insight in the human glycoform-specific antibody repertoire against GAC, an important vaccine antigen. Our findings suggest that the presence of GAC-GroP interferes with antibody recognition, which may affect GAC-related vaccine efficacy.