Schlievert Patrick M, Case Laura C, Strandberg Kristi L, Abrams Bea B, Leung Donald Y M
Department of Microbiology, University of Minnesota Medical School, Minneapolis, MN 55455, USA.
Clin Infect Dis. 2008 May 15;46(10):1562-7. doi: 10.1086/586746.
Superantigens induce skin inflammatory responses in atopic dermatitis, which is commonly associated with Staphylococcus aureus infection. T cells activated in vitro by superantigens become steroid resistant. The objective was to assess the superantigen profiles of S. aureus isolates from patients with steroid-resistant atopic dermatitis.
We compared the superantigen-production capability of S. aureus isolates from 78 patients with steroid-resistant atopic dermatitis (group 1) with that of 30 vaginal isolates from healthy women (group 2) and 22 isolates from a general population of patients with atopic dermatitis (group 3). Polymerase chain reaction with primers for superantigens, combined with selected antibody testing, was used to analyze the presence of toxic shock syndrome toxin 1, staphylococcal enterotoxins, and enterotoxin-like superantigens.
S. aureus isolates from group 1 had a statistically significant difference in superantigen profile, compared with the profiles of group 2 and group 3 isolates. Group 2 isolates were similar in profile to group 3 isolates, with 4 and 5 superantigens per isolate, respectively. In contrast, group 1 isolates produced a mean of 8 superantigens each (P<<.001, for comparison with group 2 or group 3). These group 1 isolates were more likely to produce the 3 major toxic shock syndrome-associated superantigens (toxic shock syndrome toxin 1, staphylococcal enterotoxin B, and staphylococcal enterotoxin C) and to produce unusual combinations of superantigens (e.g., toxic shock syndrome toxin 1 and staphylococcal enterotoxin B).
S. aureus isolates from patients with steroid-resistant atopic dermatitis appear to be selected on the basis of greater production of superantigens, compared with that of isolates from control groups. Superantigens may offer selective advantages for colonization of patients.
超抗原可在特应性皮炎中引发皮肤炎症反应，特应性皮炎通常与金黄色葡萄球菌感染相关。超抗原在体外激活的T细胞会产生类固醇抗性。目的是评估类固醇抗性特应性皮炎患者中金黄色葡萄球菌分离株的超抗原谱。
我们比较了78例类固醇抗性特应性皮炎患者（第1组）的金黄色葡萄球菌分离株与30例健康女性阴道分离株（第2组）以及22例普通特应性皮炎患者分离株（第3组）的超抗原产生能力。使用针对超抗原的引物进行聚合酶链反应，并结合选定的抗体检测，以分析毒性休克综合征毒素1、葡萄球菌肠毒素和肠毒素样超抗原的存在情况。
与第2组和第3组分离株的超抗原谱相比，第1组的金黄色葡萄球菌分离株在超抗原谱上存在统计学显著差异。第2组分离株的超抗原谱与第3组分离株相似，每组分离株分别有4种和5种超抗原。相比之下，第1组分离株平均每种产生8种超抗原（与第2组或第3组相比，P<<.001）。这些第1组分离株更有可能产生3种与毒性休克综合征相关的主要超抗原（毒性休克综合征毒素1、葡萄球菌肠毒素B和葡萄球菌肠毒素C），并产生超抗原的异常组合（例如，毒性休克综合征毒素1和葡萄球菌肠毒素B）。
与对照组分离株相比，类固醇抗性特应性皮炎患者的金黄色葡萄球菌分离株似乎是基于更高的超抗原产生量而被选择的。超抗原可能为患者定植提供选择性优势。
