Selective depletion of V beta-bearing T cells in patients with severe invasive group a streptococcal infections and streptococcal toxic shock syndrome. Ontario Streptococcal Study Project

Watanabe-Ohnishi, R.; Low, D.E.; McGeer, A.; Stevens, D.L.; Schlievert, P.M.; Newton, D.; Schwartz, B.; Kreiswirth, B.; Kotb, M.

Journal of Infectious Diseases 171(1): 74-84


ISSN/ISBN: 0022-1899
PMID: 7798684
DOI: 10.1093/infdis/171.1.74
Accession: 044286785

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The V beta repertoire of T cells of patients with gram-positive group A streptococcal (GAS) and non-GAS infections was analyzed to seek evidence for the role of superantigens in streptococcal toxic shock syndrome. No evidence of V beta overexpression but a consistent pattern of depletion of V beta 1, V beta 5.1, and V beta 12 was observed in patients with severe GAS infections. This pattern of V beta depletion was not observed in patients with nonsevere GAS infections or with severe non-GAS gram-positive infections. T cells from patients with severe GAS infections showed evidence of apoptosis; no apoptosis was found when there was no evidence of V beta depletion. There was no correlation with streptococcal M or T serotype or known spe genes. The depletion of specific V beta-bearing T cells in patients with severe GAS infections supports the role of a superantigen in these infections. The in vivo pattern of V beta specificity implicates a novel superantigen(s) in this disease.