title: Diagnosis of toxic shock syndrome by two different systems; clinical criteria and monitoring of TSST-1-reactive T cells.
abstract: Two methods of TSS diagnosis were evaluated: comparison of symptoms with clinical criteria and monitoring for evidence of selective activation of Vbeta2(+) T cells by the causative toxin, TSS toxin-1 (TSST-1). Ten patients with acute and systemic febrile infections caused by Staphylococcus aureus were monitored for increase in TSST-1-reactive Vbeta2(+) T cells during their clinical courses. Nine of the ten patients were diagnosed with TSS based on evidence of selective activation of Vbeta2(+) T cells by TSST-1; however, clinical symptoms met the clinical criteria for TSS in only six of these nine patients. In the remaining patient, clinical symptoms met the clinical criteria, but selective activation of Vbeta2(+) T cells was not observed. Time taken to reach the diagnosis of TSS could be significantly shortened by utilizing the findings from tracing Vbeta2(+) T cells. In vitro studies showed that TSST-1- reactive T cells from TSS patients were anergic in the early phase of their illness. Examining selective activation of Vbeta2(+) T cells could be a useful tool to supplement clinical criteria for early diagnosis of TSS.
authors.affiliation: Department of Obstetrics and Gynecology, Tokyo Women's Medical University, Tokyo, Japan. ymatsuda@obgy.twmu.ac.jp
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Matsuda
authors.forename: Hidehito
authors.initials: H
authors.lastname: Kato
authors.forename: Erina
authors.initials: E
authors.lastname: Ono
authors.forename: Ken
authors.initials: K
authors.lastname: Kikuchi
authors.forename: Mitsue
authors.initials: M
authors.lastname: Muraoka
authors.forename: Koichiro
authors.initials: K
authors.lastname: Takagi
authors.forename: Ken'ichi
authors.initials: K
authors.lastname: Imanishi
authors.forename: Shun'ichi
authors.initials: S
authors.lastname: Itoh
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Itoh
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ogawa
authors.forename: Kosaku
authors.initials: K
authors.lastname: Nitta
authors.forename: Sayaka
authors.initials: S
authors.lastname: Inokuchi
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Hibi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ohta
authors.forename: Takehiko
authors.initials: T
authors.lastname: Uchiyama
mesh_terms: D000328:Adult; D001427:Bacterial Toxins / Q000276:immunology; D004768:Enterotoxins / Q000276:immunology; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008213:Lymphocyte Activation / Q000276:immunology; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000276:immunology; D008875:Middle Aged; D012772:Shock, Septic / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology; D018089:Superantigens / Q000276:immunology; D016176:T-Lymphocyte Subsets / Q000276:immunology / Q000378:metabolism*
chemical_list: D001427:Bacterial Toxins; D004768:Enterotoxins; D018089:Superantigens; C030107:enterotoxin F, Staphylococcal