title: T-cell response to superantigen restimulation during menstrual toxic shock syndrome.
abstract: Menstrual toxic shock syndrome (MTSS) is a severe toxin-mediated disease associated with Staphylococcus aureus producing toxic shock syndrome toxin 1 (TSST-1), a superantigen that mediates a potent activation of Vβ-2 T cells. In animal models, superantigen treatment of responsive T cells induces their initial proliferation, followed by unresponsiveness upon further superantigen stimulation. To determine whether T cell unresponsiveness occurs in humans during the acute phase of MTSS, we collected T cells from a patient with MTSS and restimulated them ex vivo with recombinant TSST-1. The expansion of T cells collected during the acute phase of disease was compared with positive controls including basal-state T cells (collected 70 days after MTSS) restimulated with TSST-1, and T cells stimulated with enterotoxin B superantigen. We found that TSST-1-induced expansion of acute phase T cells was not inferior to that observed in positive controls. We conclude that T cells were still reactive to TSST-1 during the acute phase of MTSS in this patient. As the persistence of TSST-1 production could thus be associated with further expansion of TSST-1-reactive T cells and a rapid worsening of symptoms, this study adds further support to the need for immediate eradication of the focus of infection as soon as MTSS is suspected.
authors.affiliation: INSERM U851, National Reference Center for Staphylococci, University of Lyon Claude Bernard, Lyon, France. jean-philippe.rasigade@chu-lyon.fr
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Rasigade
authors.forename: Damien
authors.initials: D
authors.lastname: Thomas
authors.forename: Thomas
authors.initials: T
authors.lastname: Perpoint
authors.forename: Dominique
authors.initials: D
authors.lastname: Peyramond
authors.forename: Christian
authors.initials: C
authors.lastname: Chidiac
authors.forename: Jerome
authors.initials: J
authors.lastname: Etienne
authors.forename: François
authors.initials: F
authors.lastname: Vandenesch
authors.forename: Gerard
authors.initials: G
authors.lastname: Lina
authors.forename: Tristan
authors.initials: T
authors.lastname: Ferry
mesh_terms: D000293:Adolescent; D001427:Bacterial Toxins / Q000276:immunology*; D002478:Cells, Cultured; D004768:Enterotoxins / Q000276:immunology*; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000276:immunology; D008213:Lymphocyte Activation; D008598:Menstruation; D012772:Shock, Septic / Q000276:immunology*; D013203:Staphylococcal Infections / Q000276:immunology*; D013211:Staphylococcus aureus / Q000276:immunology / Q000378:metabolism; D018089:Superantigens / Q000276:immunology*; D013601:T-Lymphocytes / Q000166:cytology / Q000276:immunology*
chemical_list: D001427:Bacterial Toxins; D004768:Enterotoxins; D018089:Superantigens; C030107:enterotoxin F, Staphylococcal; C031818:enterotoxin B, staphylococcal