Matsuda Yoshio, Kato Hidehito, Ono Erina, Kikuchi Ken, Muraoka Mitsue, Takagi Koichiro, Imanishi Ken'ichi, Itoh Shun'ichi, Itoh Tatsuo, Ogawa Tetsuya, Nitta Kosaku, Inokuchi Sayaka, Hibi Toshifumi, Ohta Hiroaki, Uchiyama Takehiko
Department of Obstetrics and Gynecology, Tokyo Women's Medical University, Tokyo, Japan.
Microbiol Immunol. 2008 Nov;52(11):513-21. doi: 10.1111/j.1348-0421.2008.00071.x.
Two methods of TSS diagnosis were evaluated: comparison of symptoms with clinical criteria and monitoring for evidence of selective activation of Vbeta2(+) T cells by the causative toxin, TSS toxin-1 (TSST-1). Ten patients with acute and systemic febrile infections caused by Staphylococcus aureus were monitored for increase in TSST-1-reactive Vbeta2(+) T cells during their clinical courses. Nine of the ten patients were diagnosed with TSS based on evidence of selective activation of Vbeta2(+) T cells by TSST-1; however, clinical symptoms met the clinical criteria for TSS in only six of these nine patients. In the remaining patient, clinical symptoms met the clinical criteria, but selective activation of Vbeta2(+) T cells was not observed. Time taken to reach the diagnosis of TSS could be significantly shortened by utilizing the findings from tracing Vbeta2(+) T cells. In vitro studies showed that TSST-1- reactive T cells from TSS patients were anergic in the early phase of their illness. Examining selective activation of Vbeta2(+) T cells could be a useful tool to supplement clinical criteria for early diagnosis of TSS.
对两种中毒性休克综合征（TSS）的诊断方法进行了评估：将症状与临床标准进行比较，以及监测由致病毒素——TSS毒素-1（TSST-1）引起的Vβ2(+) T细胞选择性激活的证据。对10例由金黄色葡萄球菌引起的急性全身性发热感染患者在其临床病程中监测TSST-1反应性Vβ2(+) T细胞的增加情况。10例患者中有9例基于TSST-1对Vβ2(+) T细胞的选择性激活证据被诊断为TSS；然而，这9例患者中只有6例的临床症状符合TSS的临床标准。在其余患者中，临床症状符合临床标准，但未观察到Vβ2(+) T细胞的选择性激活。利用追踪Vβ2(+) T细胞的结果可显著缩短确诊TSS所需的时间。体外研究表明，TSS患者的TSST-1反应性T细胞在疾病早期呈无反应状态。检测Vβ2(+) T细胞的选择性激活可能是补充TSS早期诊断临床标准的有用工具。
