title: Application of Staphylococcal enterotoxin B on normal and atopic skin induces up-regulation of T cells by a superantigen-mediated mechanism.
abstract: BACKGROUND
  The skin of patients with inflammatory skin diseases such as atopic dermatitis is frequently colonized with Staphylococcus aureus. Colonization with S aureus has been reported to exacerbate atopic dermatitis. Recent studies have demonstrated that S aureus isolated from the skin of patients with atopic dermatitis releases bacterial toxins that act as superantigens. We have previously applied the staphylococcal superantigen staphylococcal enterotoxin B (SEB) on intact human skin and found that the application led to induction of dermatitis.
  
  
  OBJECTIVE
  The purpose of the study was to determine whether superantigen-induced dermatitis is primarily due to a T cell-superantigen-mediated reaction or represents nonspecific cytokine-driven inflammation.
  
  
  METHODS
  We applied SEB, vehicle, and sodium lauryl sulfate on normal skin in healthy (n = 6) and atopic subjects (n = 6) and biopsy specimens were taken from all treated areas. The biopsy specimens from all subjects and peripheral blood from the atopic subjects were analyzed for the T-cell receptor (TCR) Vbeta repertoire with mAbs against TCR Vbeta 2, 3, 8.1, 12, 14, and 17.
  
  
  RESULTS
  From all subjects, both healthy and patients with atopic dermatitis, skin biopsy specimens from SEB-treated areas demonstrated selective accumulation of T cells expressing SEB-reactive TCR Vbeta 12 and 17 (P <.05). This selective up-regulation was not found in the sodium lauryl sulfate-treated areas.
  
  
  CONCLUSIONS
  Our data strongly support that superantigen-induced T-cell activation is involved in the dermatitis seen after experimental application of SEB on intact skin.
authors.affiliation: Department of Dermatology, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
authors.forename: L
authors.initials: L
authors.lastname: Skov
authors.forename: J V
authors.initials: JV
authors.lastname: Olsen
authors.forename: R
authors.initials: R
authors.lastname: Giorno
authors.forename: P M
authors.initials: PM
authors.lastname: Schlievert
authors.forename: O
authors.initials: O
authors.lastname: Baadsgaard
authors.forename: D Y
authors.initials: DY
authors.lastname: Leung
mesh_terms: D000287:Administration, Topical; D000328:Adult; D002455:Cell Division / Q000276:immunology; D003872:Dermatitis / Q000276:immunology; D003876:Dermatitis, Atopic; D004485:Eczema / Q000139:chemically induced; D004768:Enterotoxins / Q000008:administration & dosage*; D006801:Humans; D012867:Skin / Q000166:cytology / Q000276:immunology; D013211:Staphylococcus aureus / Q000276:immunology; D018089:Superantigens / Q000008:administration & dosage / Q000494:pharmacology; D013601:T-Lymphocytes / Q000166:cytology / Q000502:physiology; D015854:Up-Regulation / Q000502:physiology
chemical_list: D004768:Enterotoxins; D018089:Superantigens; C031818:enterotoxin B, staphylococcal