Heat-killed Group B Streptococcus Research Articles

Neonatal protection and preterm birth reduction following maternal group B streptococcus vaccination in a mouse model

Purpose: Evaluate effects of maternal immunization in a mouse model of Group B Streptococcus (GBS) vaginal colonization using clinical isolates.Materials and methods: Female pregnant mice were immunized with heat-killed GBS 21 days before pregnancy and were inoculated intravaginally with GBS cultures (5 × 107 CFU twice a day for three days) from the 16th day of pregnancy. Gestation period and mice survival were monitored. Maternal anti-GBS IgG levels have been determined by ELISA analysis in vaccinated, unvaccinated mothers and newborns.Results: Maternal immunization before pregnancy provided protection to newborns for three of the four GBS strains used. Evaluation of the immunogenicity showed that this vaccination induced higher levels of IgG in vaccinated compared to unvaccinated dams and the presence of antibodies in the offspring at embryonic and postnatal age, and a Th1 response and high levels of IgG2a subclass antibody and IFN-γ were detected. A significant reduction of preterm births was observed in vaccinated mothers (p< 0.05).Conclusions: Our finding suggest that vaccinated mothers could protect their progeny from GBS infection and preterm birth through passive immunization. The proposed mouse model may represent a noninvasive and effective tool to investigate pathogenetic mechanisms of GBS ascending infection and for vaccine protection studies.

A streptococcal lipid toxin induces membrane permeabilization and pyroptosis leading to fetal injury.

Group B streptococci (GBS) are Gram-positive bacteria that cause infections in utero and in newborns. We recently showed that the GBS pigment is hemolytic and increased pigment production promotes bacterial penetration of human placenta. However, mechanisms utilized by the hemolytic pigment to induce host cell lysis and the consequence on fetal injury are not known. Here, we show that the GBS pigment induces membrane permeability in artificial lipid bilayers and host cells. Membrane defects induced by the GBS pigment trigger K+ efflux leading to osmotic lysis of red blood cells or pyroptosis in human macrophages. Macrophages lacking the NLRP3 inflammasome recovered from pigment-induced cell damage. In a murine model of in utero infection, hyperpigmented GBS strains induced fetal injury in both an NLRP3 inflammasome-dependent and NLRP3 inflammasome-independent manner. These results demonstrate that the dual mechanism of action of the bacterial pigment/lipid toxin leading to hemolysis or pyroptosis exacerbates fetal injury and suggest that preventing both activities of the hemolytic lipid is likely critical to reduce GBS fetal injury and preterm birth.

Pretreatment with Pancaspase Inhibitor (Z-VAD-FMK) Delays but Does Not Prevent Intraperitoneal Heat-Killed Group B Streptococcus-Induced Preterm Delivery in a Pregnant Mouse Model

Caspases and apoptosis are thought to play a role in infection-associated preterm-delivery. We have shown that in vitro treatment with pancaspase inhibitor Z-VAD-FMK protects trophoblasts from microbial antigen-induced apoptosis. Objective. To examine whether in vivo administration of Z-VAD-FMK would prevent infection-induced preterm-delivery. Methods. We injected 14.5 day-pregnant-mice with heat-killed group B streptococcus (HK-GBS). Apoptosis within placentas and membranes was assessed by TUNEL staining. Calpain expression and caspase-3 activation were assessed by immunohistochemistry. Preterm-delivery was defined as expulsion of a fetus within 48 hours after injection. Results. Intrauterine (i.u.) or intraperitoneal (i.p.) HK-GBS injection led to preterm-delivery and induced apoptosis in placentas and membranes at 14 hours. The expression of calpain, a caspase-independent inducer of apoptosis, was increased in placenta. Treatment with the specific caspase inhibitor Z-VAD-FMK (i.p.) prior to HK-GBS (i.p.) delayed but did not prevent preterm-delivery. Conclusion. Caspase-dependent apoptosis appears to play a role in the timing but not the occurrence of GBS-induced preterm delivery in the mouse.

TLR-Independent Type I Interferon Induction in Response to an Extracellular Bacterial Pathogen via Intracellular Recognition of Its DNA

Type I interferon (IFN) is an important host defense cytokine against intracellular pathogens, mainly viruses. In assessing IFN production in response to group B streptococcus (GBS), we find that IFN-beta was produced by macrophages upon stimulation with both heat-killed and live GBS. Exposure of macrophages to heat-killed GBS activated a Toll-like receptor (TLR)-dependent pathway, whereas live GBS activated a TLR/NOD/RIG-like receptor (RLR)-independent pathway. This latter pathway required bacterial phagocytosis, proteolytic bacterial degradation, and phagolysosomal membrane destruction by GBS pore-forming toxins, leading to the release of bacterial DNA into the cytosol. GBS DNA in the cytosol induced IFN-beta production via a pathway dependent on the activation of the serine-threonine kinase TBK1 and phosphorylation of the transcription factor IRF3. Thus, activation of IFN-alpha/-beta production during infection with GBS, commonly considered an extracellular pathogen, appears to result from the interaction of GBS DNA with a putative intracellular DNA sensor or receptor.

Toll-like receptor 2-dependent and -independent activation of macrophages by group B streptococci

Group B streptococcus (GBS), a capsulated gram-positive bacterium, is a major cause of newborn infections. Although the innate immune receptor Toll-like receptor (TLR) 2 has been shown to primarily recognize gram-positive bacterial products, the production of TNF by macrophages treated with heat-killed GBS (HK-GBS) does not depend on TLR2. In this report, we have characterized HK-GBS-induced activation of macrophages derived from wildtype and TLR2-deficient mice. Microarray analysis demonstrated that HK-GBS activation of macrophages induces both TLR2-independent and -dependent signals. While the expression of a major fraction of genes in macrophages induced by HK-GBS does not depend on TLR2, induction of several important molecules involved in host innate immunity such as IL-6, IL-1β, and lipocalin 2 is severely impaired in the absence of TLR2 signaling. Furthermore, we show that HK-GBS utilizes centrifugation sensitive components to induce rapid activation of TLR2 −/− macrophages and that HK-GBS-induced activation of macrophages is not mediated through its genomic DNA. Together, our results demonstrate that HK-GBS induces TLR2-dependent antimicrobial gene activation and provide further understanding of the molecular basis of host innate response to GBS infection.

Immunomodulation by exogenous surfactant: effect on TNF-α secretion and luminol-enhanced chemiluminescence activity by murine macrophages stimulated with group B streptococci

Group B streptococci (GBS) are important pathogens in neonatal sepsis and pneumonia. GBS stimulate alveolar macrophages to produce inflammatory cytokines and free oxygen radicals, which can damage the lungs. In several studies, use of exogenous surfactant in term babies has improved outcome related to sepsis and respiratory failure. The role(s) of exogenous surfactant in modulating the inflammatory response produced by this microbe was examined. Tumor necrosis factor alpha (TNF-α) production and luminol-enhanced chemiluminescence (LCL), a measure of respiratory burst, were investigated. For measuring TNF-α release, RAW 264.7 murine macrophages were pre-incubated with bovine surfactant and stimulated with either lipopolysaccharide, live or heat-killed GBS type Ia. LCL was measured after macrophages were pre-incubated with or without surfactant overnight, then stimulated with GBS or phorbol myristate acetate. Lipopolysaccharide and GBS stimulated TNF-α secretion from macrophages that was suppressed by exogenous surfactant in a dose-dependent fashion. GBS and phorbol myristate acetate also increased LCL from macrophages, which was significantly suppressed by pre-incubation of macrophages with exogenous surfactant. We conclude that GBS type Ia stimulates TNF-α release and LCL from RAW 264.7 cells and that these responses are suppressed by surfactant. Suppression of inflammatory mediators by exogenous surfactant might improve respiratory disease associated with GBS.

Interaction between lung surfactant and nitric oxide production by alveolar macrophages stimulated by group B streptococci.

The major etiologic agent in neonatal pneumonia and meningitis is group B streptococci (GBS). Nitric oxide (NO) production by alveolar macrophages (AM) in response to Gram-positive bacteria such as GBS and the effect of surfactant on this production have received little attention. We studied production of NO by GBS-stimulated AM using the Griess reaction, the effect of lung surfactant on this NO production, and the possible lipid peroxidation (LPO) of surfactant caused by NO. The LPO test was used to measure surfactant peroxidation. Heat-killed and live GBS were found to stimulate NO production by rat alveolar macrophages, and the presence of interferon gamma (IFN-gamma) increased this stimulation in a synergistic manner. Curosurf(R), the natural surfactant used in our study, significantly reduced NO production in various sets of experiments. Lipid peroxidation of surfactant was noted when NO was produced by stimulated AM, a phenomenon that could be suppressed by NG-monomethyl L-arginine (L-NMMA), the inhibitor of NO synthase. In the lung of GBS-infected neonates, nitric oxide produced by AM might contribute to the destruction of surfactant caused by inflammatory cells. Pediatr Pulmonol. 2000; 30:106- 113.

Protective effect of tyrphostin AG-556 on shock induced by endotoxin or gram positive bacteria.

The effects of tyrphostin AG-556 (TYR), a tyrosine kinase inhibitor, were evaluated on shock induced by lipopolysaccharide (LPS) or group B streptococcus (GBS) in rats. Mortality and mean survival time were monitored. Plasma 6-keto prostaglandin F1alpha (6-keto PGF1alpha) was also measured at four hours after LPS injection. The effects of TYR on the production of 6-keto PGF1alpha thromboxane B2(TXB2) and nitrite (NO) from LPS or GBS stimulated in vitro peritoneal rat macrophage were also examined. Salmonella enteritidis LPS (12 mg/kg, i.v. ) (n=6) produced severe shock (100% mortality). Simultaneous treatment with TYR (n=6) significantly (p < 0.01) extended mean survival time and 33% of rats survived. Plasma 6-keto PGF1alpha concentrations were increased in LPS controls, whereas TYR (5 mg/kg) significantly (p < 0.05) decreased the production. Animals treated with GBS/D-galactosamine (n=9) also exhibited shock with 100% lethality and TYR again prolonged survival time (p < 0.05) with 55% of the animals surviving. To evaluate direct effects of TYR on mediator production induced by LPS or GBS, rat macrophages were stimulated with heat-killed GBS or LPS with or without TYR. Supernatants were collected at 24 h for determination of TXB2, 6-keto PGF1alpha and NO. All mediators measured were significantly increased (p < 0.05) with LPS or GBS. TYR inhibited (p < 0.05) the production of all mediators from macrophages induced by LPS or GBS. The decrease in eicosanoids was associated with a reduction of the content of cyclooxygenase-2 (COX-2) as determined by western blotting. Collectively, these results suggest that TYR ameliorates toxic shock induced by LPS or gram positive bacteria. This protection is associated with suppression of macrophage mediator production.

Cytokine production in an ex vivo whole blood model following induction by group B streptococcal polysaccharides and lipoteichoic acid.

An excessive release of pro-inflammatory cytokines, such as TNF-α and IL-1, during bacterial invasive infections can mediate several pathophysiologic phenomena2, 9, 11. Group B streptococci (GBS) are important causes of neonatal sepsis and invasive infections in adults, which are often rapidly fatal despite appropriate therapy. High TNF-α and IL-6 plasma levels were found in children with GBS sepsis2. Infection with GBS can induce the production of TNF-α, IL-1, IL-6 and interferon γ in neonatal rats10. Moreover, in these animals, by the use of heat-killed isogenic GBS mutant strains devoid of the capsular type-specific polysaccharide it was shown that this polysaccharide would not be the only factor which elicits the release of TNF-α6. Many of the host responses to gram-negative bacteria could be attributed to lipopolysaccharide (LPS), which triggers monocytes to release inflammatory cytokines5. Recent studies indicated that, aside from LPS, peptidoglycan and various polysaccharides, including uronic acid, polyuronic acid, rhamnose-glucose polymers, trigger monocytes to release cytokines1, 7, 8. This led us to investigate whether TNF-α, IL-1β, IL-6 and IL-8 could be induced in human whole blood by the addition of purified surface components of GBS, namely group (CHO-B), type Ia (CHO-Ia) and III (CHO-III) specific polysaccharides or lipoteichoic acid (LTA).

Regulation of cultured human chorion cell chemokine production by group B streptococci and purified bacterial products.

To determine if different strains of group B streptococci (GBS) and purified bacterial products regulate chemokine production by cultured human chorion cells. Primary cultures of human chorion cells were established from placentae isolated from normal women at term gestation having repeat cesarean section. Five different strains of heat-killed GBS were incubated with confluent chorion cells at 10(7) bacteria/ml for 16 hours at 37 degrees C. In separate experiments, lipoteichoic acid and sialic acid at various concentrations were incubated with chorion cells for 16 hours at 37 degrees C. Culture supernatants were collected and then assayed to determine concentrations of interleukin-8 (IL-8) and macrophage inflammatory protein-1 alpha (MIP-1 alpha) by ELISA. We found that GBS stimulated chorion cell production of MIP-1 alpha in a strain-specific fashion. We also found that both lipoteichoic acid and sialic acid stimulated concentration-dependent increases in chorion cell IL-8 production. Chorion cells, however, did not increase MIP-1 alpha production in response to either lipoteichoic acid or sialic acid. Two strains of GBS tested induced concentration-dependent increases in both IL-8 and MIP-1 alpha, but both stimulated IL-8 production to a greater extent. Similarly, IL-1 beta also caused chorion cells to produce more IL-8 than MIP-1 alpha. Our data are the first to show that GBS and purified bacterial products can stimulate chemokine production by fetal gestational tissues. We suggest that chorion cells may produce specific types of chemokines to attract different types of inflammatory cells and thus may participate in the pathophysiology of infection-mediated preterm labor by directing specific inflammatory responses.

Biochemical mediators of meningeal inflammatory response to group B streptococcus in the newborn piglet model.

The meningeal inflammatory response to a heat-killed mutant unencapsulated strain of type III group B Streptococcus (GBS) was studied in a newborn piglet model. GBS (10(9) colony-forming unit equivalents) or saline (control) was inoculated intraventricularly. Serial cerebrospinal fluid measurements were done at baseline and over the course of the next 24 h for cytochemical changes and production of tumor necrosis factor (TNF) and prostaglandins. In separate experiments, we defined the time course of early changes during the first 6 h and dose response relationship over a range of inocula 10(6) to 10(9) colony-forming unit equivalents. The intraventricular inoculation of the heat-killed unencapsulated GBS induced marked leukocytosis and increased protein by 6 h. These changes were preceded by a several hundredfold increase in TNF (maximum at 2 h) and prostaglandins (maximum at 2-4 h). The early and sharp rise in TNF suggests its pivotal role in initiating the inflammatory cascade. The magnitude of the inflammatory response increased with increasing bacterial dose over the range studied. To study the effect of encapsulation of GBS in the induction of meningeal inflammation, we compared the response to the unencapsulated mutant strain with that to the encapsulated parent strain. The encapsulated strain produced much smaller inflammatory changes, and only with high doses of bacteria. The GBS cell wall appeared to be the primary bacterial product triggering inflammation. Intraventricular injection of the heat-killed unencapsulated GBS with exposed cell wall can serve as a valid model for studying neonatal meningitis.

Group B streptococci (GBS) injure lung endothelium in vitro: GBS invasion and GBS-induced eicosanoid production is greater with microvascular than with pulmonary artery cells

Neonatal group B streptococcal (GBS) sepsis and pneumonia cause lung endothelial cell injury. GBS invasion of the lung endothelium may be a mechanism for injury and the release of vasoactive eicosanoids. Pulmonary artery endothelial cells (PAEC) and lung microvascular endothelial cells (LMvEC) were isolated from neonatal piglets and were characterized as endothelial on the basis of morphology, uptake of acyl low-density lipoprotein, factor VIII staining, and formation of tube-like structures on Matrigel. PAEC and LMvEC monolayers were infected with COH-1 (parent GBS strain), isogenic mutants of COH-1 devoid of capsular sialic acid or all capsular polysaccharide, or a noninvasive Escherichia coli strain, DH5 alpha. Intracellular GBS were assayed by plate counting of colony-forming units resistant to incubation with extracellular antibiotics. All GBS strains invaded LMvEC significantly more than PAEC, showing that the site of lung endothelial cell origin influences invasion. DH5 alpha was not invasive in either cell type. Both isogenic mutants invaded PAEC and LMvEC more than COH-1 did, showing that GBS capsular polysaccharide attenuates invasion. Live GBS caused both LMvEC and PAEC injury as assessed by lactate dehydrogenase release; heat-killed GBS and DH5 alpha caused no significant injury. Supernatants from PAEC and LMvEC were assayed by radioimmunoassay for prostaglandin E2 (PGE2), the stable metabolite of prostacyclin (6-keto-PGF1 alpha), and the thromboxane metabolite thromoxane B2. At 4 h, live COH-1 caused no significant increases in eicosanoids from both PAEC and LMvEC. At 16 h, live COH-1, but not heat-killed COH-1, caused a significant increase in 6-keto-PGF1 alpha greater than PGE2 from LMvEC, but not PAEC. We conclude that live GBS injure and invade the lung microvascular endothelium and induce release of prostacyclin and PGE2. We postulate that GBS invasion and injury of the lung microvasculature contribute to the pathogenesis of GBS disease.

Cross-tolerance between bacterial endotoxin and group B Streptococcus in neonatal rats

Although endotoxin tolerance can be induced in newborns, potential cross-tolerance to group B Streptococcus (GBS), a common Gram-positive neonatal pathogen has not been investigated. In the present study we tested the hypothesis that endotoxin or recombinant tumor necrosis factor (rTNFα) can induce tolerance to lethal injection of heat-killed GBS in rat newborn pups and vice versa. The effect of such cross-tolerance on endogenous generation of plasma TNFα was subsequently evaluated. Rat pups (18-24 h old) were pretreated intracardially (i.c.) with either phosphate buffered saline (PBS), Salmonella enteritidis endotoxin (30 μg/kg) or rTNFα (35, 70 or 140 μg/kg). The pups were pretreated for either 4, 24, 48, 96 or 240 h prior to a lethal heat-killed GBS challenge. The susceptibility of the neonates to GBS-induced mortality was dependent on the duration of the pretreatment period. At 4 h of pretreatment with endotoxin or TNF, GBS-induced mortality was augmented relative to the PBS group. However, by 24-48 h the endotoxin and TNF pretreated neonates became more resistant to GBS-induced mortality. In a converse of the above experiment, neonates were pretreated with heat killed GBS (0.7 mg/kg) or rTNFα (70 μg/kg) and sensitivity to endotoxin was determined at 4-240 h after pretreatment. The data were qualitatively similar to endotoxin pretreatment. The 4 h GBS or TNF pretreatment rendered the neonates more susceptible to endotoxin-induced mortality. However, by 24-48 h the pretreatment groups were more resistant (P &lt; 0.05) to endotoxin than the PBS controls. Plasma TNFα levels were increased (P &lt; 0.05) 2 h after challenge i.c. with lethal heat-killed GBS or S. enteritidis endotoxin. In the 4 h pretreatment groups that received either GBS or endotoxin and then challenged with endotoxin or GBS, respectively, the plasma TNFα response was markedly augmented (P &lt; 0.05). By 48 h of pretreatment, however, the plasma TNFα response in these groups to the stimuli was significantly reduced (P &lt; 0.05) compared to the PBS pretreated groups. Therefore, plasma TNFα parallels lethality induced by GBS or endotoxin pretreatment. The ability of GBS and endotoxin to induce cross tolerance suggests that common pathophysiological pathways are involved in these syndromes.

Acute infection of mice with highly virulent group B streptococci as a host resistance model for immunotoxicity assessment.

This report describes a unique model for immunotoxicity evaluation in mice. The model is adapted from previously described mouse models for group B streptococcus (GBS) infections in human neonates. In this disease as well as a number of human diseases caused by highly virulent pathogens, the mechanisms of innate immunity are unable to protect the host, and survival is strictly dependent on acquired immunity. Unlike other host resistance models widely used in immunotoxicity studies, the GBS model utilizes bacteria that are highly virulent for mice (LD50 = 5-17 colony forming units). GBS is not virulent for adult humans and can be safely handled with typical precautions. Acquired immunity in the GBS model is induced during a 2 week period by two injections of heat-killed GBS. The immunizing doses are the minimum which will allow survival of 80-100% of mice in response to challenge with an otherwise lethal dose of live GBS (100 bacteria). Administration of the immunotoxic agents cyclophosphamide, carrageenan, or cobra venom factor during the immunization period and/or shortly before challenge significantly suppressed host resistance. For example, the composite mortality rate for unimmunized mice was 98% and the rate for immunized mice was 8.5%. For all groups treated with cyclophosphamide (one 75 mg/kg dose 48 h before each immunization) the mean mortality was 41 +/- 18%. The consistency of the model was evaluated by repetition of several treatments in independent experiments, and the model's consistency is comparable to that of other host resistance models.(ABSTRACT TRUNCATED AT 250 WORDS)

Role of capsule in pulmonary hypertension induced by group B streptococcus.

The type-specific polysaccharide capsule of group B streptococcus (GBS) is thought to be an important factor in the pathogenesis of disease. We used an acutely instrumented piglet model to assess the hemodynamic effects of rapid infusions of two heat-killed GBS type Ib strains isolated from the spinal fluid of an infant with late-onset meningitis and from the vaginal culture of his mother. These strains expressed different amounts of capsule, as determined by buoyant density centrifugation and electron micrographs, and they produced different hemodynamic effects in the piglets. The mother's strain, which had a smaller capsule, caused significantly higher increases in pulmonary artery pressure and vascular resistance than did the infant's strain, which had a larger capsule. Transposon mutants were then made from the infant's isolate to further study the role of capsule in pulmonary hypertension. Two mutants lacking detectable capsular type-specific polysaccharide were compared with the original isolate and with an isogenic mutant containing transposons but having a large capsule. The nonencapsulated mutants caused significantly higher changes in pulmonary artery pressure and resistance than did the encapsulated strains. Pulmonary hypertension may play a role in the pathophysiology of GBS sepsis, but the presence of a large capsule may partially cloak the hemodynamically active component(s) of the bacteria. The lower initial host response to heavily encapsulated GBS may play a role in pathogenesis by helping the organisms avoid host defense mechanisms.

Thromboxane synthesis inhibition reverses group B Streptococcus-induced pulmonary hypertension.

Group B Streptococcus (GBS) sepsis in humans may cause the persistent pulmonary hypertension syndrome. Infusions of GBS in animals elevate pulmonary artery pressure (PAP) and resistance and are associated with elevated thromboxane levels. We investigated the hemodynamic effects of the specific thromboxane synthesis inhibitor, dazmegrel, in a piglet model of GBS-induced pulmonary hypertension. PAP rose from 22 +/- 6 to 42 +/- 11 (SD) mm Hg during infusion of heat-killed GBS; pulmonary vascular resistance increased from 1440 +/- 400 to 4000 +/- 1040 dyne X sec/cm5. No significant changes in cardiac output, mean arterial pressure, or left atrial pressure were noted. Treatment with 1 mg/kg of dazmegrel resulted in a rapid return of PAP and resistance to control values. No other hemodynamic effects of either bacteria or drug were observed despite continued infusion of GBS.

Stimulation of complement component C3 synthesis in macrophagelike cell lines by group B streptococci.

Complement levels and complement activation are key determinants in streptococcus-induced inflammatory responses. Activation of macrophage functions, such as complement synthesis, by group B streptococci (GBS) was examined as a possible component of GBS-induced chronic inflammation. Using an enzyme-linked immunosorbent assay, secreted C3 from mouse macrophagelike cell lines (PU5-1.8 and J774A.1) was monitored after cultivation with GBS. Whole, heat-killed GBS (1 to 10 CFU per macrophage) of both type Ia and III strains induced 25 to 300% increases in secreted C3 in both cell lines after a 24-h cultivation. GBS-treated cell lines exhibited increases in secreted lysozyme (10%) and in cellular protein (25 to 50%). Inhibition of macrophage phagocytosis by cytochalasin B inhibited GBS stimulation of C3. Purified cell walls of GBS type III strain 603-79 (1 to 10 micrograms/ml) also enhanced C3 synthesis. Local enhancement of macrophage C3 production by ingested streptococci or by persistent cell wall antigens may serve to promote chronic inflammatory responses.

1150 EFFECTS OF INHIBITORS AND ANTIBODY ON THE PULMONARY HYPERTENSIVE EFFECTS OF BOLUS GRP B STREP IN CONSCIOUS PIGS

We have shown that heat-killed Group B Streptococci (GBS) cause dose-related pulmonary artery hypertension in chronically instrumented piglets. These responses are similar to those seen with gram negative bacterial endotoxins. Prostanoids and endorphins have been implicated as mediators of these responses. We tested the effect of a cycloxygenase inhibitor, indomethacin; a thromboxane synthesis inhibitor, dazmegrel (UK-38,185); a leukotreine synthesis inhibitor, BW 540C; and an endorphin antagonist, naloxone on the response to a bolus of 5 × 107 heat-killed GBS Type III (M 732) /kg. We also tested the effect of pre-incubating the GBS with high-titer, type-specific rabbit antibody.Neither leukotriene nor endorphin blockade affected the response. In contrast, both cyolooxygenase and specific thromboxane synthesis inhibition markedly blunted the GBS-induced pulmonary hypertension. This suggests that thromboxane A2 mediates this response. Antibody coated organisms increased the response, suggesting antibody participation in this reaction. Further work will increase our understanding of the response to sepsis.