TOXIC SHOCK SYNDROME AND BACTERIAL SUPERANTIGENS: An Update

Toxic shock syndrome (TSS) is an acute onset illness characterized by fever, rash formation, and hypotension that can lead to multiple organ failure and lethal shock, as well as desquamation in patients that recover. The disease is caused by bacterial superantigens (SAGs) secreted from Staphylococcu...

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Bibliographic Details
Published in:Annual review of microbiology 2001-01, Vol.55 (1), p.77-104
Main Authors: McCormick, John K, Yarwood, Jeremy M, Schlievert, Patrick M
Format: Article
Language:English
Subjects:
Allergic diseases
Amino Acid Sequence
Bacteria
Bacterial diseases
Biological and medical sciences
Cells
Composition
Experimental bacterial diseases and models
Fundamental and applied biological sciences. Psychology
Humans
hypotension
Immune system
Immunopathology
Infectious diseases
Medical sciences
Microbiology
Molecular Sequence Data
Other localizations
Sequence Alignment
Shock, Septic - diagnosis
Shock, Septic - epidemiology
Shock, Septic - microbiology
Staphylococcal infections
Staphylococcus aureus
Staphylococcus aureus - immunology
Streptococcus pyogenes
Streptococcus pyogenes - immunology
Superantigens - chemistry
Superantigens - genetics
Superantigens - immunology
T cell stimulation
Toxic shock syndrome
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Summary:Toxic shock syndrome (TSS) is an acute onset illness characterized by fever, rash formation, and hypotension that can lead to multiple organ failure and lethal shock, as well as desquamation in patients that recover. The disease is caused by bacterial superantigens (SAGs) secreted from Staphylococcus aureus and group A streptococci. SAGs bypass normal antigen presentation by binding to class II major histocompatibility complex molecules on antigen-presenting cells and to specific variable regions on the β-chain of the T-cell antigen receptor. Through this interaction, SAGs activate T cells at orders of magnitude above antigen-specific activation, resulting in massive cytokine release that is believed to be responsible for the most severe features of TSS. This review focuses on clinical and epidemiological aspects of TSS, as well as important developments in the genetics, biochemistry, immunology, and structural biology of SAGs. From the evolutionary relationships between these important toxins, we propose that there are five distinct groups of SAGs.
ISSN:0066-4227
1545-3251
DOI:10.1146/annurev.micro.55.1.77