Abstract
Group A Streptococcus [GAS, Streptococcus pyogenes (S. pyogenes)] is one of the pathogenes which most commonly affect humans. GAS causes acute suppurative diseases such as pharyngitis, tonsillitis, impetigo, cellulitis, or pneumonia, and toxic diseases such as erysipelas or scarlet fever. GAS also elicites two, nonsupprative sequels: acute rheumatic fever and acute glomerulonephritis. In addition, GAS induces severe invasive infections, including necrotizing fasciitis and toxic shock like syndrome (TSLS), which are associated with high mortality. These diseases have increased in number during the last few years. GAS secretes many extracellular products (Fig. 1), and the surface structures allow hyaluronic acid capsule, a family of M proteins, and adherence factors such as fibronectin-binding proteins. These substances possess various biological and immunological activities, and the pathogenic roles of a number of virulent factors of GAS have been described. The streptococcal pyrogenic exotoxins belong to a family of bacterial superantigens associated with severe invasive infections. An extracellular cysteine protease known as streptococcal pyrogenic exotoxin B (SpeB)
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