Noorbakhsh Samileh, Ashouri Sarvenaz, Moradkhani Masoumeh
Pediatric Infectious Diseases Department, Iran University of Medical Sciences, Tehran, Iran.
ENT and Head and Neck Research Center and Department, Iran University of Medical Sciences, Tehran, Iran.
Infect Disord Drug Targets. 2022;22(7):76-80. doi: 10.2174/1871526522666220530141031.
Superantigens (Sags) are a part of some viral or bacterial proteins that stimulate T cells and antigen-presenting cells leading to systemic immune repose and inflammation. SAgs might have a possible role in various inflammatory childhood diseases (e.g., Kawasaki disease, atopic dermatitis, and chronic rhinosinusitis). Worldwide studies have been conducted to determine the role of staphylococcal SAgs (TSST-1) in various inflammatory diseases. The SAgs (TSST-1) not only induce sepsis and septic shock (even in negative blood culture for S. aureus), but may also have a significant role in various childhood inflammatory diseases (e.g., KD, OMS, Polyp, dermatitis, psoriasis). In proven Sags-induced inflammatory diseases, the inhibition of the cell-destructive process by SAgs suppressants might be helpful. In toxic shock or sepsis-like presentation and even in cases with negative blood cultures, immediate use of anti staphylococcal drugs is required. Occasionally, the clinical presentation of some human viruses (e.g., coronavirus and adenovirus) mimics KD. In addition, coinfection with adenovirus, coronavirus, and para-influenza virus type 3 has also been observed with KD. It has been observed that in developed KD, bacterial sags induced an increase in acute-phase reactants and in the number of white blood cells, and neutrophil counts. Multisystem inflammatory syndrome in children (MISC) and KS were observed during the recent COVID-19 pandemic. This study summarized the relationship between viral and bacterial SAgs and childhood inflammatory diseases.
超抗原（Sags）是某些病毒或细菌蛋白质的一部分，可刺激T细胞和抗原呈递细胞，导致全身免疫反应和炎症。Sags可能在各种儿童炎性疾病（如川崎病、特应性皮炎和慢性鼻窦炎）中发挥作用。世界各地已开展研究以确定葡萄球菌超抗原（TSST-1）在各种炎性疾病中的作用。超抗原（TSST-1）不仅可诱发败血症和感染性休克（即使金黄色葡萄球菌血培养为阴性），还可能在各种儿童炎性疾病（如川崎病、中耳炎、息肉、皮炎、银屑病）中起重要作用。在已证实由超抗原引起的炎性疾病中，使用超抗原抑制剂抑制细胞破坏过程可能会有帮助。在中毒性休克或败血症样表现中，甚至在血培养阴性的病例中，需要立即使用抗葡萄球菌药物。偶尔，一些人类病毒（如冠状病毒和腺病毒）的临床表现会模仿川崎病。此外，也观察到川崎病患者合并腺病毒、冠状病毒和3型副流感病毒感染。据观察，在典型的川崎病中，细菌超抗原会导致急性期反应物增加、白细胞数量和中性粒细胞计数增加。在最近的新冠疫情期间观察到了儿童多系统炎症综合征（MISC）和川崎病。本研究总结了病毒和细菌超抗原与儿童炎性疾病之间的关系。
