R. Bunikowski et al., Evidence for a disease-promoting effect of Staphylococcus aureus-derived exotoxins in atopic dermatitis, J ALLERG CL, 105(4), 2000, pp. 814-819
Background: The skin of patients with atopic dermatitis (AD) exhibits a str
iking susceptibility to colonization with Staphylococcus aureus. Some strai
ns of S aureus secrete exotoxins with T-cell superantigen activity (toxigen
ic strains), and abnormal T-cell functions are known to play a critical rol
e in AD.
Objective: Our purpose was to examine the impact of superantigen production
hy skin-colonizing S aureus on disease severity.
Methods: In a cross-sectional study of 74 children with AD, the presence an
d density of toxigenic and nontoxigenic strains of S aureus was correlated
with disease severity. In a subgroup of patients the T-cell receptor V beta
repertoire of peripheral blood and lesional T cells was investigated and c
orrelated with individual superantigen activity of skin-colonizing S aureus
.
Results: Fifty-three percent of children with AD were colonized with toxige
nic strains of S aureus producing staphylococcal enterotoxin C, staphylococ
cal enterotoxin A, toxic shock syndrome toxin-1, staphylococcal enterotoxin
B, and staphylococcal enterotoxin D in decreasing frequency. Children colo
nized with toxigenic S aureus strains had higher disease severity compared,
vith the nontoxigenic and S aureus-negative groups. Patients colonized with
toxigenic S aureus exhibited shifts in the intradermal T-cell receptor V b
eta repertoire that correspond to the respective superantigen-responsive T-
cell subsets.
Conclusion: The data demonstrate that S aureus-released exotoxins can modul
ate disease severity and dermal T-cell infiltration.