Diagnosis of toxic shock syndrome by two different systems; clinical criteria and monitoring of TSST-1-reactive T cells.
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.
Matsuda
Yoshio
Y
Department of Obstetrics and Gynecology, Tokyo Women's Medical University, Tokyo, Japan. ymatsuda@obgy.twmu.ac.jp
Kato
Hidehito
H
Ono
Erina
E
Kikuchi
Ken
K
Muraoka
Mitsue
M
Takagi
Koichiro
K
Imanishi
Ken'ichi
K
Itoh
Shun'ichi
S
Itoh
Tatsuo
T
Ogawa
Tetsuya
T
Nitta
Kosaku
K
Inokuchi
Sayaka
S
Hibi
Toshifumi
T
Ohta
Hiroaki
H
Uchiyama
Takehiko
T
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*
D001427:Bacterial Toxins; D004768:Enterotoxins; D018089:Superantigens; C030107:enterotoxin F, Staphylococcal