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Anti-streptolysin O (ASO or ASLO) is the antibody made against streptolysin O, an immunogenic, oxygen-labile streptococcal hemolytic exotoxin produced by most strains of group A and many strains of groups C and G Streptococcus bacteria. The "O" in the name stands for oxygen-labile; the other related toxin being oxygen-stable streptolysin-S.
Post-streptococcus glomerulonephritis is more often associated with group A strep skin infection than it is with strep pharyngitis, so in a patient with suspected post-strep glomerulonephritis with a negative ASO titer, one can then obtain anti-DNase-B titers which are more sensitive for group A strep and for its various strains.
The antibody or antigen is only detectable in the blood when there is substantially more of one than the other. Standard techniques require a high enough concentration of antibody or antigen to detect the amount of antibody or antigen; therefore, they cannot detect the small amount that is not bound during seroconversion. [10]
Titers of 1:4 or higher is considered critical for Kell (compared to 1:16 for most other antibodies) and is considered to confer a high risk of fetal anemia. [17] Such high titers may be managed by weekly follow-up by obstetric ultrasound , assessing the peak systolic velocity of the fetal middle cerebral arterial (MCA), amniotic fluid volume ...
Antisense therapy is a form of treatment that uses antisense oligonucleotides (ASOs) to target messenger RNA (mRNA). ASOs are capable of altering mRNA expression through a variety of mechanisms, including ribonuclease H mediated decay of the pre-mRNA, direct steric blockage, and exon content modulation through splicing site binding on pre-mRNA. [1]
The treatment of choice is penicillin, and the duration of treatment is around 10 days. [23] Antibiotic therapy (using injected penicillin) has been shown to reduce the risk of acute rheumatic fever. [24] In individuals with a penicillin allergy, erythromycin, other macrolides, and cephalosporins have been shown to be effective treatments. [25]
Each ASO is fully complementary to its target sequence (and will bind strongly), but has a single mismatch against its non-target allele (leading to weaker interaction). The first diagram shows how the "S" probe is fully complementary to the "S" target (top), but is partially mismatched against the "A" target (bottom).
Thus, if the initial titer is 1:4 and stable but increases at 26 weeks' gestation to 1:8, assessment with MCA Doppler velocity at that point is reasonable. However, if the patient presents in the first trimester with a 1:8 titer that remains stable at 1:8 throughout the second trimester, continued serial antibody titers are appropriate.