Evidence for a disease-promoting effect of Staphylococcus aureus–derived exotoxins in atopic dermatitis

In an attempt to explain pathophysiologically the impact of exotoxin production on disease severity, we investigated 4 patients who had staphylococcal enterotoxin B -positive S aureus and 5 patients colonized with nontoxigenic S aureus for both the response of peripheral blood lymphocyte cells to S aureus –derived culture filtrate and the presence of SAg-responsive T-cell subsets in affected skin

Rita Bunikowski; Martin E.A. Mielke; Horst Skarabis; Magitta Worm; Ioannis Anagnostopoulos; Gerhard Kolde; Ulrich Wahn; Harald Renz

2003

Scholarcy highlights

  • The skin of patients with atopic dermatitis exhibits a striking susceptibility to colonization with Staphylococcus aureus
  • SAg-producing strains were obtained from 40 of these AD patients but from only 1 control subject
  • All supernatants negative for the above exotoxins were tested for undefined mitogenic activity, which was found in 7 patients with AD and in none of the controls
  • In an attempt to explain pathophysiologically the impact of exotoxin production on disease severity, we investigated 4 patients who had staphylococcal enterotoxin B-positive S aureus and 5 patients colonized with nontoxigenic S aureus for both the response of peripheral blood lymphocyte cells to S aureus –derived culture filtrate and the presence of SAg-responsive T-cell subsets in affected skin
  • SAg nonresponsive T-cell subsets did not preferentially accumulate in skin, the observed preferential in vitro expansion of T cells positive for these T-cell receptor Vβ subsets known to be responsive to SEB suggests that SAgs were the major driving force in S aureus –derived exoproducts and the preferential accumulation of the respective subsets
  • To further elucidate the role of SEB in the pathogenesis of AD, we have recently developed a humanized SCID mouse model in which the epidermal application of SEB to mice reconstituted with PBMCs from AD patients caused marked dermal T-cell infiltration and inflammatory lesions consistent with those observed in AD
  • That this may take place in skin of patients with atopic dermatitis colonized by toxigenic strains of S aureus is suggested by our finding that a majority of T cells found in lesional skin expressed a T-cell receptor Vβ repertoire that corresponded to the SAg produced by the colonizing S aureus strain

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