期刊
NEPHROLOGY DIALYSIS TRANSPLANTATION
卷 15, 期 8, 页码 1170-1174出版社
OXFORD UNIV PRESS
DOI: 10.1093/ndt/15.8.1170
关键词
enterotoxin; glomerulonephritis; MRSA; superantigen
Background. We have previously reported that 10 patients who developed glomerulonephritis (GN) in association with methicillin-resistant Staphylococcus aureus (MRSA) infection showed a marked increase in DR + CD4+ and DR + CD8+ subsets of T cells and in T cells expressing several T-cell receptor (TCR) V beta + cells, perhaps representing VP-specific T-cell activation by MRSA-derived superantigens (Kidney Int 1995; 47: 207-216). In this study we examine cytokine levels, T-lymphocyte subsets, natural killer NK cells, memory T cells, and the expression of IL-2 receptors in order to better understand the role of bacterial superantigens and cytokines in the pathogenesis of MRSA-associated GN. Methods. Twenty-two patients with MRSA infection who later developed GN caused by staphylococcal enterotoxin were evaluated immunologically in comparison with patients whose MRSA infection was not followed by GN (non-GN group) and normal individuals. Results. Among peripheral lymphocytes, the frequency of T cells expressing several TCR V beta s, especially V beta 5-family TCR, was higher in the GN group than in both the non-GN group and the normal healthy control group. GN patients also showed increased serum levels of several cytokines, including tumour necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta), IL-2, IL-6, IL-8, and IL-10, which have been implicated in the onset of nephritis. Memory cells, and IL-2 receptors also were elevated in the GN group. Conclusion. These results suggest that T cells activated by MRSA-derived staphylococcal enterotoxins and subsequent production of cytokines may play an important role in the pathogenesis of MRSA-associated GN.
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