Streptococcus pyogenes（S. pyogenes ） has been recognised as an important human pathogen since early days of modern microbiology.Clinical manifestations, such as pneumonia, septic arthritis, necrotizing fasciitis and genital tract sepsis, attributable to this organism are perhaps the most diverse of other human pathogen. Although major overall reductions of S.pyogenes infection rates in the modern era, mainly as a result of widespread improvements in socioeconomic environment, S. pyogenes still remains the top ten causes of global morbidity and mortality from infectious diseases. In order to find out how S. pyogenes cause necrotizing fasciitis and surviving from immune system, author respectively mutates S. pyogenes and blocks the nociceptor specific function. In recently research we know the nervous system, the immune system and microbial pathogens are closely interactive at barrier tissues. Finally, author finds out that S. pyogenes, the leading cause of necrotizing fasciitis, secretes streptolysin S (SLS) to directly activate nociceptor neurons and produce pain during invasion. SLS is one kind of pore-forming toxin and is most common bacterial cytotoxic proteins. Trpv1 is a nonselective cation channel provides a sensation of heat and pain on nociceptors. It releases the neuropeptide calcitonin gene-related peptide (CGRP) into infected tissues, which inhibits the recruitment of neutrophils and promotes bacterial survival. After Making sure the mechanis, author uses botulinum neurotoxin A (BoNT/A) and CGRP antagonism to block neuron-mediated suppression of host defense, thereby preventing and curing S. pyogenes infection. Author concludes that targeting the peripheral nervous system and blocking neuro-immune communication is a promising strategy to treat highly invasive bacterial infections.
These encompass invasive GAS infections, with high mortality rates despite effective antimicrobials, toxin-mediated diseases including scarlet fever and streptococcal toxic shock syndrome, the autoimmune sequelae of rheumatic fever and glomerulonephritis with potential for long-term disability, and nuisance manifestations of superficial skin and pharyngeal infection, which continue to consume a sizable proportion of healthcare resources. Although an historical perspective indicates major overall reductions in GAS infection rates in the modern era, chiefly as a result of widespread improvements in socioeconomic circumstances, this pathogen remains as a leading infectious cause of global morbidity and mortality. More than 18 million people globally are estimated to suffer from serious GAS disease. This burden disproportionally affects least affluent populations, and is a major cause of illness and death among children and young adults, including pregnant women, in low-resource settings. We review GAS transmission characteristics and prevention strategies, historical and geographical trends and report on the estimated global burden disease attributable to GAS. The lack of systematic reporting makes accurate estimation of rates difficult. This highlights the need to support improved surveillance and epidemiological research in low-resource settings, in order to enable better assessment of national and global disease burdens, target control strategies appropriately and assess the success of control interventio
