Abstract

Staphylococcus aureus initiates infections and produces virulence factors, including superantigens (SAgs), at mucosal surfaces. The SAg, Toxic Shock Syndrome Toxin-1 (TSST-1) induces cytokine secretion from epithelial cells, antigen presenting cells (APCs) and T lymphocytes, and causes toxic shock syndrome (TSS). This study investigated the mechanism of TSST-1-induced secretion of proinflammatory cytokines from human vaginal epithelial cells (HVECs) and determined if curcumin, an anti-inflammatory agent, could reduce TSST-1-mediated pathology in a rabbit vaginal model of TSS. TSST-1 caused a significant increase in NF-κB-dependent transcription in HVECs that was associated with increased expression of TNF- α, MIP-3α, IL-6 and IL-8. Curcumin, an antagonist of NF-κB-dependent transcription, inhibited IL-8 production from ex vivo porcine vaginal explants at nontoxic doses. In a rabbit model of TSS, co-administration of curcumin with TSST-1 intravaginally reduced lethality by 60% relative to 100% lethality in rabbits receiving TSST-1 alone. In addition, TNF-α was undetectable from serum or vaginal tissue of curcumin treated rabbits that survived. These data suggest that the inflammatory response induced at the mucosal surface by TSST-1 is NF-κB dependent. In addition, the ability of curcumin to prevent TSS in vivo by co-administration with TSST-1 intravaginally suggests that the vaginal mucosal proinflammatory response to TSST-1 is important in the progression of mTSS.

Highlights

  • Staphylococcus aureus is a significant human pathogen that causes a wide range of diseases, including menstrual toxic shock syndrome

  • We hypothesized that vaginal mucosal proinflammatory cytokines contribute to toxic shock syndrome (TSS) by an outside-in proinflammatory signaling mechanism, which disrupts the mucosa and allows Toxic Shock Syndrome Toxin-1 (TSST-1) to penetrate into the submucosa and bloodstream

  • Previous studies were expanded using an unrelated, immortalized human vaginal epithelial cells (HVECs) line constructed from another woman, which was obtained from American Type Culture Collection (ATCC) [23]

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Summary

Introduction

Staphylococcus aureus is a significant human pathogen that causes a wide range of diseases, including menstrual toxic shock syndrome (mTSS). The staphylococcal superantigen (SAg), Toxic Shock Syndrome Toxin-1 (TSST-1), causes the majority of mTSS cases by penetrating the vaginal mucosa and non- crosslinking Major Histocompatibility Complex (MHC) class II molecules with T-cell receptors (TCR) causing massive systemic cytokine release from T cells (IL-2, TNF-b, and IFN-c) and macrophages (IL-1b and TNF-a). SAgs, including TSST-1, induce changes in cellular morphology and secretion of proinflammatory cytokines/chemokines from vaginal, bronchial, nasal, and intestinal epithelial cells [4,5,6,7]. The proinflammatory effect of TSST-1 on vaginal epithelial cells may be critical to mTSS progression as glycerol monolaurate (GML), a non-specific anti-inflammatory agent, protected against TSS in a rabbit vaginal model [8,9]. The vaginal epithelial cell proinflammatory signaling pathways activated in response to TSST-1 are unknown

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