The absence of evidence of staphylococcal toxin involvement in the pathogenesis of Kawasaki disease

M Terai, K Miwa, T Williams, W Kabat… - Journal of Infectious …, 1995 - academic.oup.com
M Terai, K Miwa, T Williams, W Kabat, M Fukuyama, Y Okajima, H Igarashi, ST Shulman
Journal of Infectious Diseases, 1995academic.oup.com
To detect a causative superantigen and to clarify a possible role for staphylococci in
Kawasaki disease (KD), culture supernatants of individual bacterial isolates from 11 acute-
stage patients were studied. Toxic shock syndrome toxin-1 (TSST-1) and antibody to TSST-1
and enterotoxins A (SEA), B (SEB), and C (SEC) in acute (mean, day 7) and late
convalescent (mean, month 15) sera from 26 patients (12 with coronary artery aneurysms)
and 22 age-matched controls were measured. Only 1 of 60 supernatants was mitogenic for …
Abstract
To detect a causative superantigen and to clarify a possible role for staphylococci in Kawasaki disease (KD), culture supernatants of individual bacterial isolates from 11 acute-stage patients were studied. Toxic shock syndrome toxin-1 (TSST-1) and antibody to TSST-1 and enterotoxins A (SEA), B (SEB), and C (SEC) in acute (mean, day 7) and late convalescent (mean, month 15) sera from 26 patients (12 with coronary artery aneurysms) and 22 age-matched controls were measured. Only 1 of 60 supernatants was mitogenic for human lymphocytes; it was 1 of the 4 Staphylococcus aureus isolates. Mitogenicity was neutralized by sera obtained after administration of intravenous gamma globulin (mean, week 4) but not by late convalescent sera. TSST-1 was detectable in 2 of 26 acute sera and 1 of 22 control sera. No KD but 1 control serum had IgM to TSST-1. IgG seroconversion rates to TSST-1, SEA, SEB, and SEC were 10%, 15%, 21%, and 16%, respectively. These data do not support the involvement of toxin-producing staphylococci in KD.
Oxford University Press