Chesney P J, Bergdoll M S, Davis J P, Vergeront J M
Annu Rev Microbiol. 1984;38:315-38. doi: 10.1146/annurev.mi.38.100184.001531.
From this composite picture of the history and recent developments related to TSS, several points are clear. TSS is not a new disease, and TST-producing strains of S. aureus are not new. What is new is the recent dramatic increase of this disease in young women who use tampons during menses and who lack antibody to TST. What is also new is the recognition that the disease commonly recurs but only in menstrually associated cases. What remains to be determined are the precise role of tampons, the factors leading to toxin induction, and the mechanism of action of this potent toxin. In order to better determine what these factors and mechanism of action are, and to determine if the TST marker protein is in fact the critical toxin, a reliable animal model is badly needed. Finally, a reliable laboratory test to confirm the clinical diagnosis is another high-priority need. The further unraveling of the secrets of this complex disease may greatly enhance our understanding of the disease associated with this toxin, of the intricacies of toxin production by other bacteria, and of the role that exogenous cofactors play in disease processes.
从这张与中毒性休克综合征（TSS）相关的历史及近期发展的综合图景中，有几点是明确的。TSS并非一种新疾病，产生中毒性休克毒素（TST）的金黄色葡萄球菌菌株也并非新出现的。新情况是，这种疾病在月经期使用卫生棉条且缺乏TST抗体的年轻女性中近期急剧增加。另一个新情况是认识到该疾病通常会复发，但仅在与月经相关的病例中。有待确定的是卫生棉条的确切作用、导致毒素诱导的因素以及这种强效毒素的作用机制。为了更好地确定这些因素和作用机制是什么，并确定TST标记蛋白是否实际上就是关键毒素，急需一个可靠的动物模型。最后，一种可靠的实验室检测方法以确认临床诊断是另一个高度优先的需求。对这种复杂疾病奥秘的进一步揭示可能会极大地增进我们对与这种毒素相关疾病的理解、对其他细菌毒素产生复杂性的理解，以及对外源辅助因子在疾病过程中所起作用的理解。
