Binding of human plasma proteins to Streptococcus pyogenes M protein determines the location of opsonic and non‐opsonic epitopes

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Abstract
Summary: Antibodies directed against a pathogenic microorganism may recognize either protective or non‐protective epitopes. Because antibodies elicited by a vaccine must be directed against protective epitopes, it is essential to understand the molecular properties that distinguish the two types of epitope. Here we analyse this problem for the antiphagocytic M protein of Streptococcus pyogenes, using the opsonizing capacity of antibodies to estimate their ability to confer protection in vivo. Our studies were focused on the M5 protein, which has three surface‐exposed regions: the amino‐terminal hypervariable region (HVR) and the B‐ and C‐repeat regions. We first analysed the role of different M5 regions in phagocytosis resistance under non‐immune conditions, employing chromosomal mutants expressing M5 proteins with internal deletions, and demonstrate that only the B‐repeat region is essential for phagocytosis resistance. However, only antibodies to the HVR were opsonic. This apparent paradox could be explained by the ability of fibrinogen and albumin to specifically bind to the B‐ and C‐repeats, respectively, causing inhibition of antibody binding under physiological conditions, while antibodies to the HVR could bind and promote deposition of complement. These data indicate that binding of human plasma proteins plays an important role in determining the location of opsonic and non‐opsonic epitopes in streptococcal M protein.