# Defining novel mechanisms of clonal emergence in Group A Streptococcus

> **NIH NIH R21** · UNIVERSITY OF TX MD ANDERSON CAN CTR · 2021 · $254,000

## Abstract

PROJECT SUMMARY
The emergence and spread of closely related strains or clones are characteristic of many bacteria causing
serious disease in humans. The major human pathogen group A Streptococcus (GAS) displays such behavior
and has long been a model organism for studying clonal emergence in bacteria. GAS is divided into emm types
based on variation in the emm gene which encodes for the cell-surface, anti-phagocytic M protein. The present
paradigm is that GAS clonal emergence occurs due to genetic recombination events which either allow for
acquisition of a novel virulence factor or for increased production of existing virulence factors, particularly those
encoded by the nga-slo operon. By sequencing >1,000 emm4 strains from diverse temporal and geographic
sources, we have identified that a new emm4 clone has replaced previously circulating emm4 strains over the
past decade. The “emergent” strains have not undergone significant genetic recombination, do not contain new
virulence factor encoding genes, and have significantly lower transcript levels of the nga-slo operon relative to
the “replaced” strains. However, emergent emm4 GAS are more virulent than replaced emm4 strains in both
animal models and during growth in human blood. Thus, this newly identified clonal emergence does not fit the
current understanding of GAS clonal emergence. It is the goal of this R21 proposal to begin to establish novel
mechanisms underlying the proliferation of emergent emm4 GAS. In specific aim 1, we will determine whether
emergent emm4 strains have increased colonization/transmission capacities relative to replaced strains. This
aim will employ both primary human cells as well as a newly established animal model of GAS transmission. In
specific aim 2, we will leverage our existing transcriptomic data which show that emergent strains have
significantly higher transcript levels of genes encoding proteins putatively involved in cell surface oxidative stress
response and peptidoglycan turnover. We will determine whether the emergent GAS strains have augmented
resistance to oxidative stress and to challenge by human neutrophils, which utilize reactive oxygen species as a
major killing mechanism. Moreover, cell wall differences between emergent and replaced strains will be explored
using complementary imaging techniques and by testing susceptibility to cell-envelope active innate
antimicrobials. The specific role of particular genes in observed phenotypic differences will be assessed using
either an insertional mutagenesis approach or by modifying gene expression when the candidate genes are
essential. These studies have been devised to facilitate the subsequent design and execution of downstream
investigations of the molecular underpinning of bacterial epidemics, a key aspect of pathogenesis for a wide
variety of medically important pathogens.

## Key facts

- **NIH application ID:** 10189994
- **Project number:** 1R21AI159059-01
- **Recipient organization:** UNIVERSITY OF TX MD ANDERSON CAN CTR
- **Principal Investigator:** Anthony Richard Flores
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $254,000
- **Award type:** 1
- **Project period:** 2021-03-08 → 2023-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10189994

## Citation

> US National Institutes of Health, RePORTER application 10189994, Defining novel mechanisms of clonal emergence in Group A Streptococcus (1R21AI159059-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10189994. Licensed CC0.

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