Overall picture of an emerging neonatal infectious disease induced by a superantigenic exotoxin mainly produced by methicillin‐resistant Staphylococcus aureus
Overall picture of an emerging neonatal infectious disease induced by a superantigenic exotoxin mainly produced by methicillin‐resistant Staphylococcus aureus
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主要由耐甲氧西林金黄色葡萄球菌产生的超抗原外毒素引起的一种新发新生儿传染病的总体情况
DOI：
10.1111/1348-0421.12094
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发表时间：
2013
影响因子：
2.6
通讯作者：
T. Uchiyama
中科院分区：
文献类型：
--
作者：
N. Takahashi;K. Imanishi;T. Uchiyama
自1992年以来，日本新生儿重症监护室的许多新生儿出现发烧和全身性皮疹。对有这些症状的新生儿的免疫学分析显示，细菌超抗原中毒性休克综合征毒素-1（TSST-1）是病因。新生儿TSS样外展性疾病（NTED）的名称已应用于这种情况。最引人注目的临床发现是，没有足月新生儿发生休克或死于NTED。NTED流行的时间与日本新兴的TSST-1耐甲氧西林金黄色葡萄球菌克隆的传播相吻合。抗TSST-1抗体滴度阳性的孕妇频率较低可能是NTED在日本传播的原因之一。新生儿对TSST-1具有免疫耐受性，并可通过白细胞介素-10积极抑制对NTED的免疫应答。根据TSST-1诱导疾病的婴儿或幼儿的T细胞应答，TSST-1相关疾病的病理生理学可能具有年龄依赖性。应在感染NTED的新生儿中研究TSST-1刺激的特异性T细胞无反应性和缺失的确切机制。NTED和TSS都可能为分析新生儿免疫耐受机制和人类免疫的年龄依赖性提供良好的模型。这种疾病不仅成为由超抗原引起的疾病的代表，而且还产生了关于人类对超抗原的免疫反应的大量证据。
Since 1992, many neonates in neonatal intensive care units in Japan have been developing fever and systemic exanthema. Immunological analyses of neonates with these symptoms has revealed that the bacterial superantigen, toxic shock syndrome toxin‐1 (TSST‐1) is the cause. The name neonatal TSS‐like exanthematous disease (NTED) has been applied to this condition. The most striking clinical finding has been that none of the term neonates have developed shock or died of NTED. The timing of NTED epidemics has coincided with the spread of emerging TSST‐1‐producing methicillin‐resistant Staphylococcus aureus clones in Japan. The low frequency of pregnant women with positive anti‐TSST‐1 antibody titers could be one reason for the spread of NTED in Japan. Neonates have immune tolerance against TSST‐1 and may actively suppress the immune response to NTED with interleukin‐10. According to the T cell responses in infants or young children with diseases induced by TSST‐1, the pathophysiology of TSST‐1‐related diseases may be age‐dependent. The precise mechanism of anergy and deletion of specific T cells stimulated with TSST‐1 should be investigated in neonates infected with NTED. Both NTED and TSS might provide good models for analyzing the mechanism(s) of neonatal immune tolerance and the age‐dependence of human immunity. This disease has not only become representative of diseases caused by superantigens, but has also yielded a considerable amount of evidence about human immune reactions against superantigens.
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DOI：
--
发表时间：
2006
期刊：
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发表时间：
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DOI：
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发表时间：
2006
期刊：
Am J Perinatol 23
影响因子：
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Naoto Takahashi;Minako Hattori;Keishi Miwa;Hiroshi Nishida
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DOI：
--
发表时间：
2006
期刊：
NICU Manual (Kanehara-shuppan Co.)
影响因子：
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