Association of erythrodermic cutaneous T-cell lymphoma, superantigen-positive Staphylococcus aureus, and oligoclonal T-cell receptor V beta gene expansion
Association of erythrodermic cutaneous T-cell lymphoma, superantigen-positive Staphylococcus aureus, and oligoclonal T-cell receptor V beta gene expansion
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DOI：
10.1182/blood.v89.1.32
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发表时间：
1997-01-01
期刊：
影响因子：
20.3
通讯作者：
Duvic, M
中科院分区：
文献类型：
--
作者：
Jackow, CM;Cather, JC;Duvic, M
本文报告42例皮肤T细胞淋巴瘤，其中剥脱性红皮病或Sezary综合征31例，蕈样肉芽肿11例。42例患者中有32例（76%）的胫骨或血液葡萄球菌培养阳性。培养阳性的患者中有一半生长金黄色葡萄球菌。该组包括11例Sezary综合征和5例快速扩大的蕈样肉芽肿斑块或肿瘤。所有金黄色葡萄球菌均携带肠毒素基因。令人惊讶的是，16株中有6株是相同的中毒性休克毒素-1（TSST-1）阳性克隆，命名为电泳型（ET）-41。对14例CTCL患者的T细胞受体V β库进行分析发现，只有4例具有特定V β基因的预期单克隆扩增，而In具有几个V β家族的寡克隆或多克隆扩增。所有TSST-1（-）金黄色葡萄球菌患者的血液和/或皮肤病变中均存在V β 2过度扩增。这些研究表明，含有超抗原肠毒素的金黄色葡萄球菌常见于CTCL患者，特别是红皮病患者，它们可能加剧和/或永久刺激慢性T细胞扩增和皮肤炎症。关注CTCL患者中的致炎性金黄色葡萄球菌有望改善该患者人群的护理质量和结局。(C)1997年，美国血液学会。
Forty-two patients with cutaneous T-cell lymphoma, including 31 with exfoliative erythroderma or Sezary syndrome and 11 with mycosis fungoides, were studied for the occurrence of staphylococcal infection. Thirty-two of 42 (76%) had a positive staphylococcal culture from shin or blood. One half of the patients with positive cultures grew Staphylococcus aureus. This group included 11 with Sezary syndrome and 5 with rapidly enlarging mycosis fungoides plaques or tumors. Ail of the S aureus carried enterotoxin genes. Surprisingly, 6 of 16 strains were the same toxic shock toxin-l (TSST-1)-positive clone, designated electrophoretic type (ET)-41. Analysis of the T-cell receptor V beta repertoire in 14 CTCL patients found that only 4 had the expected monoclonal expansion of a specific V beta gene, whereas In had oligoclonal or polyclonal expansion of several V beta families. AII patients with TSST-1(-) S aureus had overexpansion of V beta 2 in blood and/or skin lesions. These studies show that S aureus containing superantigen enterotoxins are commonly found in patients with CTCL, especially individuals with erythroderma where they could exacerbate and/or perpetuate stimulate chronic T-cell expansion and cutaneous inflammation. Attention to toxigenic S aureus in CTCL patients would be expected to improve the quality of care and outcome of this patient population. (C) 1997 by The American Society of Hematology.