Staphylococcal Exotoxins as Trigger Factors of Atopic Dermatitis
S. aureus has been identified as a trigger factor of atopic dermatitis. 30–60% of S. aureus strains are capable to produce exotoxins with superantigenic properties in patients with atopic dermatitis. In order to investigate if these exotoxins exacerbate atopic dermatitis (AD) primarily as superantigens or as ‘conventional’ allergens, we generated exotoxin-reactive T cell lines (TCL) from skin and blood of three patients with atopic dermatitis, who were colonized with toxigenic S. aureus strains. Furthermore we determined the relationship between the severity of skin lesions and the sensitization to staphylococcal enterotoxins A and B in a group of 71 adult patients with atopic dermatitis.
Both super antigen-reactive and exotoxin-specific TCL were generated from skin and blood of the three patients colonized with toxigenic S. aureus strains, which points to the importance of the exotoxins not only as superantigens but also as allergens.
This finding and the recently published fact that patients sensitized to staphylococcal enterotoxin B have a higher disease activity than non-sensitized patients confirm the importance of allergen-specific responses to staphylococcal exotoxins.
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