Radcliff Fiona J, Clow Fiona, Mahadevan Murali, Johnston James, Proft Thomas, Douglas Richard G, Fraser John D
Department of Molecular Medicine and Pathology, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
Paediatric Otolaryngology Service, Starship Children's Hospital, Auckland, New Zealand.
Med Microbiol Immunol. 2017 Aug;206(4):337-346. doi: 10.1007/s00430-017-0510-5. Epub 2017 May 4.
The TCR Vβ repertoire from patients with recurrent tonsillitis and/or tonsillar hyperplasia was examined to determine whether the TCR Vβ composition is suggestive of local superantigen activity and if so, whether it is associated with the presence of superantigen producing bacteria. Tonsil specimens were cultured aerobically to allow identification and isolation of the bacterial pathogens Staphylococcus aureus and Group A Streptococcus. TCR Vβ subset analysis of tonsil leucocytes was performed by flow cytometry. The superantigenic potential of tonsil S. aureus isolates was determined by multiplex PCR and a T-cell mitogenicity assay. Tonsils were collected from 40 patients who were predominantly pre-school-aged children undergoing surgery for either recurrent tonsillitis or tonsillar hyperplasia causing obstructive sleep apnoea. S. aureus was cultured from 23/40 and Group A Streptococcus from 5/40 patients. Both CD4 and CD8 TCR Vβ populations were skewed in 17/40 patients. Twelve of these had recurrent tonsillitis of whom 9 also harboured S. aureus. Characterisation of tonsillar S. aureus isolates revealed that many contained genes for one or more potent superantigens and detection of these genes was associated with in vitro mitogenic activity. Skewing of the tonsillar TCR Vβ repertoire was observed at high frequency and was most commonly associated with the presence of S. aureus. Many S. aureus isolates were mitogenic suggesting that they have a potential for local impact on the function of tonsil T cell populations. These results suggest the possibility that anti-staphylococcal antibiotics may be an effective treatment option for some patients.
对复发性扁桃体炎和/或扁桃体增生患者的TCR Vβ库进行检测，以确定TCR Vβ组成是否提示局部超抗原活性，若如此，其是否与产生超抗原的细菌的存在相关。扁桃体标本进行需氧培养，以鉴定和分离细菌病原体金黄色葡萄球菌和A组链球菌。通过流式细胞术对扁桃体白细胞进行TCR Vβ亚群分析。通过多重PCR和T细胞促有丝分裂活性测定法确定扁桃体金黄色葡萄球菌分离株的超抗原潜力。从40名患者收集扁桃体，这些患者主要是学龄前儿童，因复发性扁桃体炎或导致阻塞性睡眠呼吸暂停的扁桃体增生而接受手术。23/40患者培养出金黄色葡萄球菌，5/40患者培养出A组链球菌。17/40患者的CD4和CD8 TCR Vβ群体均出现偏态。其中12例患有复发性扁桃体炎，9例还携带金黄色葡萄球菌。扁桃体金黄色葡萄球菌分离株的特征表明，许多分离株含有一种或多种强效超抗原的基因，这些基因的检测与体外促有丝分裂活性相关。扁桃体TCR Vβ库的偏态在高频率下被观察到，并且最常与金黄色葡萄球菌的存在相关。许多金黄色葡萄球菌分离株具有促有丝分裂活性，表明它们可能对扁桃体T细胞群体的功能产生局部影响。这些结果提示，抗葡萄球菌抗生素可能是某些患者的有效治疗选择。
