Toxic Shock Syndrome and Bacterial Superantigens: An Update

DOI Web Site 被引用文献20件
  • John K. McCormick
    Department of Microbiology, University of Minnesota Medical School, Minneapolis, Minnesota 55455;
  • Jeremy M. Yarwood
    Department of Microbiology, University of Minnesota Medical School, Minneapolis, Minnesota 55455;
  • Patrick M. Schlievert
    Department of Microbiology, University of Minnesota Medical School, Minneapolis, Minnesota 55455;

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<jats:p>▪ Abstract  Toxic shock syndrome (TSS) is an acute onset illness characterized by fever, rash formation, and hypotension that can lead to multiple organ failure and lethal shock, as well as desquamation in patients that recover. The disease is caused by bacterial superantigens (SAGs) secreted from Staphylococcus aureus and group A streptococci. SAGs bypass normal antigen presentation by binding to class II major histocompatibility complex molecules on antigen-presenting cells and to specific variable regions on the β-chain of the T-cell antigen receptor. Through this interaction, SAGs activate T cells at orders of magnitude above antigen-specific activation, resulting in massive cytokine release that is believed to be responsible for the most severe features of TSS. This review focuses on clinical and epidemiological aspects of TSS, as well as important developments in the genetics, biochemistry, immunology, and structural biology of SAGs. From the evolutionary relationships between these important toxins, we propose that there are five distinct groups of SAGs.</jats:p>

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