Takahashi Naoto, Hattori Minako, Miwa Keishi, Nishida Hiroshi
Maternal and Perinatal Center, Tokyo Women's Medical University School of Medicine, Japan.
Am J Perinatol. 2006 Oct;23(7):413-9. doi: 10.1055/s-2006-951290. Epub 2006 Sep 26.
A novel neonatal disease and puerperal toxic shock syndrome (TSS) induced by a superantigen, TSS toxin-1 (TSST-1), has spread throughout Japan. It is important to investigate serum titers against exotoxins in new mothers and in their infants' cord blood. We investigated antitoxin antibodies against TSST-1, staphylococcal enterotoxin (SE) A (SEA), SEB, and SEC, including immunoglobulin G (IgG) subclass specificity by enzyme-linked immunosorbent assay, in sera from 221 mothers and 97 cord blood samples. The rate of mothers with negative anti-TSST-1 antibody titer was high (more than 40%). Although antitoxin antibody titers in the sera of cord blood were well correlated with those in the sera of the mothers for every toxin, the tendencies of antibody transmission differed between toxins. Anti-TSST-1 antibody consisted mainly of IgG1 and IgG4 subclasses. Anti-TSST-1 IgG1- and IgG4-specific antibody titers in cord blood were well correlated with those in the sera of the mothers. The low frequency of pregnant women with positive anti-TSST-1 antibody titers could be one reason for the spread of TSS in Japan. Neonates whose mothers have positive IgG titers against TSST-1 should be protected because the antibody is composed of the subclasses transferred well through the placenta.
一种由超抗原中毒性休克综合征毒素-1（TSST-1）引起的新型新生儿疾病及产褥期中毒性休克综合征已在日本蔓延。调查初产妇及其婴儿脐带血中针对外毒素的血清滴度很重要。我们通过酶联免疫吸附测定法，对221名母亲的血清和97份脐带血样本中针对TSST-1、葡萄球菌肠毒素（SE）A（SEA）、SEB和SEC的抗毒素抗体进行了调查，包括免疫球蛋白G（IgG）亚类特异性。抗TSST-1抗体滴度呈阴性的母亲比例很高（超过40%）。尽管脐带血血清中的抗毒素抗体滴度与母亲血清中的抗毒素抗体滴度在每种毒素上都有很好的相关性，但不同毒素之间抗体传递的趋势有所不同。抗TSST-1抗体主要由IgG1和IgG4亚类组成。脐带血中抗TSST-1 IgG1和IgG4特异性抗体滴度与母亲血清中的滴度有很好的相关性。初产妇中抗TSST-1抗体滴度呈阳性的频率较低可能是日本中毒性休克综合征蔓延的一个原因。母亲针对TSST-1的IgG滴度呈阳性的新生儿应受到保护，因为该抗体由能很好地通过胎盘转移的亚类组成。
