ANTI

STREPTOLYSIN O
(ASO/ASLO)
Presenter :- Rahul Prabhas
Moderator :- Dr. Varsha A Singh
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ANTI
STREPTO
LYSIN
O
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Family Lysin
Toxins

produced by various bacteria.

Chemically

protein in nature

Activated

by Sulphydrl compounds[ It is anorgano sulfur

compoundthat contains a carbon bondedsulfhydryl(CSH
or RSH) group]

Inhibited by Cholesterol and related sterols like ergosterol

(It

is suggested that the inhibition of haemolysis is due to

complex formation between the lysin and the sterol
molecules when the latter are orientated at the interface,
and that the lysis of red cells by streptolysin 0 is dependent
on complex formation between the lysin and the cholesterol
with resultant penetration of the surface film.)
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Streptolysin

Produced by Streptococcus bacteria

lysins
1.

Streptolysin O(SLO)

2.

Streptolysin S (SLS)

Types of streptolysin
SLO

SLS

Produced by group A Streptococci

Produced by Streptococci agalactiae

Oxygen labile.

Oxygen stable.

Antigenic

Nonantigenic - very small size.

Inhibited by cholesterol

Inhibited by serum lipoprotein

Haemolysis only in presence of Oxygen

Haemolysis irrespective to the presence of Oxygen

SLO

Streptococccus pyogens Human pathogen

Cell wall of Streptococcus

pyogenes

Structure of SLO

PARTS OF SLO MOLECULE

Basal portion (base)The

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Action Of SLO

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Mechanism of membrane
damaging by streptolysin O
water soluble toxin molecule bind to cholesterol of target membrane to
assemble into supramolecular rod shaped

This supramolecular rod penetrates into the polar domain of the

membrane bilayer.

Embedment of ring and arc generates trans membrane slit or pores(30

nm).Finally, it leads to damage of the plasma membrane.

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SLO acts on following targets

Cell Membranes of -

1.

Endothelial cells.

2.

Lymphocytes.

3.

Erythrocytes.

4.

Leukocytes.

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Effect of streptolysin O on
different types of cells in body

Endothelial cell- Streptolysin O activates bone

marrow derived mast cells to degranulate & to
rapidly induce or enhance the production of several
cytokines mRNA including TNF alpha. Mast cells derived TNF
alpha plays an important protective role in acute
inflammation.

Leukocytes- It enhances polymorphonuclear binding to gelatin

matrix. It stimulates PMNL- dependent adherence mechanism.

Lymphocyte- It results in decrease lymphokines producton .

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Thus it alters the immune system.

ANTI-STREPTOLYSIN O

ASO/ASLO

Antibodies made against SLO

Todd (1932) developed the assay for ASO antibodies.

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Detection Method

ANTI-STREPTOLYSIN O TEST

1.

Neutralization Method.

2.

Latex Agglutination Method.

3.

ELISA.
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Neutralization
Test
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Neutralization Test
Homologous

Abs - prevents biological effect of toxin.

Infection

with S.pyogens results in Abs against

bacterial haemolysin appearing in serum.

Abs

detected by incubating serum with standard

amounts of active haemolysin when RBCs are added
to mixture.
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Latex Agglutination Slide Test

Polystyrene latex particles are coated with purified and

stabilized SLO(Ag),which reacts with its corresponding
ASO(Ab) resulting in agglutination of latex particles.

Two types:-

1)

Qualitative Slide Test

2)

Semi-Quantitative Slide Test

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1. ASO Latex Reagent

Glass slide

2. Positive Control
Serum
3. Negative Control
Serum

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Latex agglutination test

Principle
Streptolysin antigen + mono specific anti-streptolysin o
Agglutination

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Semiquantitave
Rapid latex slide test

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INTERPRETATION

POSITIVE - Agglutination in 2minutes,

ASO titre >200 IU/ml.

NEGATIVE No agglutination,
ASO titre <200 IU/ml.

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Values
Normal value ranges may vary slightly among
different
laboratories.
Acceptable values, where there is no clinical
feature are as follows:
Adults: less than 200 IU/ml
Children: less than 300 IU/ml
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Easy and simple guidance steps should be

follow when your ASOT blood test show high
values

ASO test < 200 mg/dl - NORMAL LEVEL:

- person has no recent strep infection.
- To confirm - repeat ASO test after 10 15 days because ASO levels
peak at about 4 to 6 weeks after the infection.

ASO test - POSITIVE - >= 400 mg/dl, - recent infection and

should be treated.

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 After

medication

NEGATIVE,
test.

course,

carry

ASO

test

and confirmatory test called

- If negative, then the body is

again

to

be

anti-DNase B

completely cured.

ASO titre test have high accuracy but to be assured of

Streptococcal infection, a throat swab can be tested (cultured),
results come after 2 4 days after culturing the sample.
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CLINICAL SIGNIFICANCE

Raised

or rising levels

Past or present
infection

Historically,

first bacterial markers used for

diagnosis and follow up of rheumatic fever.

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DISEASES IN WHICH ASO IS ELEVATED

SUPPURATIVE

INFECTIONS

Pharyngitis

Pyoderma and streptococcal skin infections

Scarlet fever

NON SUPPURATIVE INFECTION

Rheumatic fever

Highest titre- >200 Todd units

Acute Post-streptococcal Glomerulonephritis

Bacterial Endocarditis

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Pharyngitis

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Pyoderma Erysipelas

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Pyoderma Impetigo

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Scarlet fever

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THANK YOU
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