Abstract
Staphylococcus aureus superantigens (SAgs) are among the most potent T cell mitogens known. They stimulate large fractions of T cells by cross-linking their T cell receptor with major histocompatibility complex class-II molecules on antigen presenting cells, resulting in T cell proliferation and massive cytokine release. To date, 26 different SAgs have been described in the species S. aureus; they comprise the toxic shock syndrome toxin (TSST-1), as well as 25 staphylococcal enterotoxins (SEs) or enterotoxin-like proteins (SEls). SAgs can cause staphylococcal food poisoning and toxic shock syndrome and contribute to the clinical symptoms of staphylococcal infection. In addition, there is growing evidence that SAgs are involved in allergic diseases. This review provides an overview on recent epidemiological data on the involvement of S. aureus SAgs and anti-SAg-IgE in allergy, demonstrating that being sensitized to SEs—in contrast to inhalant allergens—is associated with a severe disease course in patients with chronic airway inflammation. The mechanisms by which SAgs trigger or amplify allergic immune responses, however, are not yet fully understood. Here, we discuss known and hypothetical pathways by which SAgs can drive an atopic disease.
Highlights
Staphylococcus (S.) aureus is a multifaceted human pathobiont
Provides an overview on the function and diversity of staphylococcal superantigens (SAgs), Reports on advances in the development of SAg vaccines, Summarizes recent epidemiological data on the involvement of SAgs in allergy, Outlines mechanisms by which SAgs could induce or amplify allergic responses, Elaborates on the evolutionary advantage gained by the production of SAgs, and Discusses knowledge gaps that should be addressed in future research
Logistic regression analyses demonstrated significantly increased risks for staphylococcal enterotoxins (SEs)-immunoglobulin E (IgE) positive subjects compared to negative subjects to have any asthma or severe asthma
Summary
The most frequent encounter with S. aureus is symptom-free colonization, with 20% of the human population being persistently colonized, and the remainder being intermittently colonized [1,2]. These bacteria cause a wide spectrum of illnesses, ranging from self-limiting food poisoning and skin and soft tissue infections to life-threatening diseases, such as pneumonia, endocarditis, and sepsis [3]. Superantigens (SAgs) are the most notorious of this large arsenal of staphylococcal virulence factors These exotoxins activate large subpopulations of T lymphocytes, causing a massive cytokine release which may lead to systemic shock. Provides an overview on the function and diversity of staphylococcal superantigens (SAgs), Reports on advances in the development of SAg vaccines, Summarizes recent epidemiological data on the involvement of SAgs in allergy, Outlines mechanisms by which SAgs could induce or amplify allergic responses, Elaborates on the evolutionary advantage gained by the production of SAgs, and Discusses knowledge gaps that should be addressed in future research
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