Immunopathophysiological aspects of an emerging infectious disease induced by a bacterial superantigen

Maternal and Perinatal Center, and. Department of Microbiology and Immunology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
Journal of Clinical Investigation (Impact Factor: 13.22). 01/2001; 106(11):1409-15. DOI: 10.1172/JCI10396
Source: PubMed


We recently discovered an emerging neonatal infectious disease, neonatal toxic shock syndrome-like (TSS-like) exanthematous disease (NTED), which is induced by a superantigen, TSS toxin-1 (TSST-1), produced by methicillin-resistant Staphylococcus aureus (MRSA). Here, we analyzed the activation and the response of TSST-1-reactive Vss2(+) T cells in NTED patients during the acute and recovery phases and in asymptomatic infants exposed to MRSA. In the acute phase, Vss2(+) T cells were anergic to stimulation with TSST-1 and underwent marked expansion, but by 2 months after disease onset, their numbers had declined to about 10% of the control level. Although the percentage of Vss2(+) T cells in the ten asymptomatic neonatal MRSA carriers was within the control range, these individuals could be divided into two groups on the basis of Vss2(+) T-cell activation. Vss2(+)CD4(+) T cells from three of these infants (Group 1) highly expressed CD45RO and were anergic to TSST-1, whereas in the other seven asymptomatic neonatal MRSA carriers (Group 2), these cells expressed CD45RO at the control level and were highly responsive to stimulation with TSST-1. The serum anti-TSST-1 IgG Ab titer was negligible in the four NTED patients in the acute phase and the three asymptomatic neonatal MRSA carriers in Group 1, but it was high in the seven asymptomatic carriers in Group 2. We suggest that maternally derived anti-TSST-1 IgGs helps to suppress T-cell activation by TSST-1 and protects infants from developing NTED.

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Available from: Ken'ichi Imanishi, Oct 09, 2015
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    • "NTED has been observed in over 70% of the major neonatal care units in Japan, although the condition has not been described elsewhere except for a single case in France [6] [19] [20]. The condition resolves spontaneously without antibiotic therapy in full-term neonates, but most preterm neonates develop severe symptoms, with two deaths in the latter group reported to date [6] [19]. Treatment involves supportive measures and, in the case of premature neonates, antistaphylococcal antibiotics. "
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