Emerging treatments
M-type specific peptide group A streptococcus (GAS) vaccine
While no vaccine has yet been approved to prevent GAS infection, several have been developed over the past 2 decades. One active phase 1/2 clinical trial is evaluating the safety and immunogenicity of 2 different GAS conjugated recombinant peptide vaccines.[54] These vaccines contain one of two M protein epitopes (J8 or p*17), combined with one non-M protein epitope, and are conjugated to CRM 197 (a synthetic diphtheria toxin) and adjuvanted with aluminium hydroxide.[55] Preclinical studies demonstrated a robust immune response with evidence of clinical protection from skin infection with GAS, as well as no concerns for toxicity or autoantibody development or cross reaction with myocardial peptide sequences (as a surrogate for potential risk of development of acute rheumatic fever), which has been the major hypothetical safety concern historically for GAS vaccines.[56][57]
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