Original ArticleDetection of Multiple Superantigen Genes in Stools of Patients with Kawasaki Disease
Section snippets
Patients and Stool Samples
The study was approved by the Ethics Committee of Wakayama Medical University (Wakayama, Japan). Informed consent was obtained from the parents of the patients. Sixty patients who fulfilled the diagnostic criteria for KD14 and were admitted to our hospital between June 2004 and June 2007 were enrolled consecutively.
Stool specimens were obtained from the 60 patients with KD at the acute stage of the disease (KD group) and from 62 age-matched children without KD: 36 with acute illnesses (febrile
Results
Patients with KD, febrile control children, and healthy control children had similar sex ratios (male:female) (34:26, 18:18, and 13:13) and mean ages (24.6, 25.9, and 25.5 months, respectively). The stools were collected from the patients with KD at a mean of 5.7 days from disease onset. Although not significantly different, the concentrations of DNA extracted from stools of healthy control children (m = 59.7 ng/μL) were slightly higher than those of patients with KD (m = 37.8 ng/μL) and
Discussion
It is still controversial whether the etiology of KD may involve a conventional antigen or a SAg.16 We have investigated SAgs derived from S pyogenes as causative agents of KD because the main symptoms of KD are similar to those of streptococcal infection. Although investigations have indirectly linked SAgs with KD, few articles have detected either SAgs themselves or SAg-producing bacteria in patients with KD).11 We sought to detect SAg genes as antigenic agents in stool specimens because all
References (27)
- et al.
Toxic shock syndrome toxin-secreting Staphylococcus aureus in Kawasaki syndrome
Lancet
(1993) - et al.
Prevalence of superantigen-secreting bacteria in patients with Kawasaki disease
J Pediatr
(2002) Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of fingers and toes in children: clinical observation of 50 cases
Jpn J Allergol
(1967)- et al.
Results of 12 nationwide epidemiological incidence surveys of Kawasaki disease in Japan
Arch Pediatr Adolesc Med
(1995) - et al.
ITPKC functional polymorphism associated with Kawasaki disease susceptibility and formation of coronary artery aneurysms
Nat Genet
(2008) - et al.
Selective expansion of T cells expressing T-cell receptor variable regions V beta 2 and V beta 8 in Kawasaki disease
Proc Natl Acad Sci U S A
(1992) - et al.
Evidence for a superantigen mediated process in Kawasaki disease
Arch Dis Child
(1995) - et al.
Relation of streptococcal pyrogenic exotoxin C as a causative superantigen for Kawasaki disease
Pediatr Res
(2003) - et al.
Analysis of T-cell receptor V-beta 2 in peripheral blood lymphocytes as a diagnostic marker for Kawasaki disease
Infection
(2002) - et al.
Selective increase of V beta 2 + T cells in the small intestinal mucosa in Kawasaki disease
Pediatr Res
(1996)
T cell activation profiles in Kawasaki syndrome
Clin Exp Immunol
Possible relationship between streptococcal pyrogenic exotoxin A and Kawasaki syndrome in patients older than six months of age
Pediatr Infect Dis J
Development of serum IgM antibodies against superantigens of Staphylococcus aureus and Streptococcus pyogenes in Kawasaki disease
Clin Exp Immunol
Cited by (29)
Immune and non-immune mechanisms that determine vasculitis and coronary artery aneurysm topography in Kawasaki disease and MIS-C
2023, Autoimmunity ReviewsCitation Excerpt :The pathogenesis of TSS itself has been viewed ultimately in terms of a type of capillary leak syndrome with multiorgan dysfunction with much of this, in turn, attributed to superantigen activation of a large proportion of T-cells [101,119]. This link is supported by some pieces of evidence of the presence of TSS toxin-producing staphylococcus and other bacterial superantigens in the majority of KD patients [119–122]. The absence of supportive evidence for the persistence of respiratory SARS-CoV-2 infection in MIS-C and MIS-A might have initially argued against a superantigen-driven process- given that no such antigen was recoverable.
Streptococcal superantigens: Categorization and clinical associations
2014, Trends in Molecular MedicineThe role of infection in Kawasaki syndrome
2013, Journal of InfectionCitation Excerpt :Furthermore, a number of studies analysing the T lymphocyte receptor repertoire and the titres of antibodies against selected SAs have indirectly demonstrated that these proteins may be related to the development of KS.52,54–56 In addition, Suenaga et al. examined five SA genes in the stools of KS patients, febrile controls and healthy children,57 and found at least one of the genes in 42 specimens from the patients with KS (70%), in 14 from the febrile group (38.9%), and in seven from the healthy group (26.9%). The detection rate between subjects with and without KS was of at least one of the 5 SA genes (p < 0.001), and more than two SA genes were significantly different (p = 0.002), thus suggesting the direct involvement of SAs in the development of KS.
Superantigens in dermatology
2011, Journal of the American Academy of DermatologyCitation Excerpt :In another study, the number of Vβ2 cells in the small intestinal mucosa in KD patients was increased compared with controls.89 Suenega et al90 studied stool samples from 60 patients with KD, 36 patients with acute febrile illness, and another 26 healthy controls. The samples were examined for SAg genes (TSST-1, SPE-A, SPE-C, SPE-G, and SPE-J) derived from bacteria present in the respiratory and gastrointestinal tracts.
Streptococcal infection and autoimmune diseases
2024, Frontiers in Immunology
Supported by a Grant-in-Aid from the Ministry of Education, Culture, Sports, Science, and Technology, Japan (2006-2008) and a grant from Japan Kawasaki Disease Research Center (2007).
Presented in part at the Ninth International Kawasaki Disease Symposium, Taipei, Taiwan (April 2008).