Use of intravenous immunoglobulin in the treatment of staphylococcal and streptococcal toxic shock syndromes and related illnesses

Pyrogenic toxin superantigens comprise a large family of exotoxins made by Staphylococcus aureus and group A streptococci. These toxins include toxic shock syndrome toxin-1, the staphylococcal enterotoxins, and the streptococ cal pyrogenic exotoxins (synonyms: scarlet fever toxins and erythrogenic to xins), all of which have the ability to cause toxic shock syndromes and rel ated illnesses. These toxins have a similar three-dimensional structure tha t allows them to interact with relatively invariant regions of major histoc ompatibility complex class II molecules on the surface of antigen-presentin g cells and with certain variable regions of the T-cell receptor-beta chain . The consequence of these interactions (and other immunobiological propert ies of the toxins) is the exaggerated release of bioactive cytokines. The l atter molecules are responsible for the clinical signs of illness associate d with these toxins.