Immunopathophysiological aspects of an emerging neonatal infectious disease induced by a bacterial superantigen
Naoto Takahashi, … , Hiroshi Nishida, Takehiko Uchiyama
Naoto Takahashi, … , Hiroshi Nishida, Takehiko Uchiyama
Published December 1, 2000
Citation Information: J Clin Invest. 2000;106(11):1409-1415. https://doi.org/10.1172/JCI10396.
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Article

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

Abstract

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 Vβ2+ T cells in NTED patients during the acute and recovery phases and in asymptomatic infants exposed to MRSA. In the acute phase, Vβ2+ 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 Vβ2+ 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 Vβ2+ T-cell activation. Vβ2+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.

Authors

Naoto Takahashi, Hidehito Kato, Ken’ichi Imanishi, Keishi Miwa, Sadao Yamanami, Hiroshi Nishida, Takehiko Uchiyama

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Figure 1

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Expression of T-cell receptor Vβ2 versus CD45RO on CD4+ and CD8+ T cells...
Expression of T-cell receptor Vβ2 versus CD45RO on CD4+ and CD8+ T cells obtained from an NTED patient in the acute and recovery phases, an asymptomatic MRSA carrier, and an MRSA-free neonate. The percentage of Vβ2+ T cells and the expression levels of CD45RO by Vβ2+CD4+ and Vβ2+CD8+ T cells were examined in the preterm NTED patient P2 on postnatal days 4 and 32 (a), in the asymptomatic neonatal MRSA carrier Ca1 on postnatal day 5 (b), and in an MRSA-free neonate on postnatal day 5 (c). The numbers are the percentages of stained cells in each area.