SELECTIVE EXPANSION OF T-CELLS EXPRESSING V-BETA-2 IN TOXIC SHOCK SYNDROME

Infection with Staphylococcus aureus and the production of toxic shock syndrome toxin-1 (TSST1) have been implicated in the pathogenesis of toxic shock syndrome. Previous in vitro studies have demonstrated that TSST1 is a powerful but selective stimulator of human T cells, and that the majority of activated cells express the TCR Vβ2 gene segment. We therefore studied patients with toxic shock syndrome using a modification of the PCR to determine if expansion of Vβ2+ T cells is a marker of the in vivo disease process. Five of eight patients studied demonstrated markedly elevated levels of circulating Vβ2+ T cells, whereas none showed significantly elevated levels of T cells expressing other Vβ gene segments. The results suggest that toxin-mediated T cell activation, which involves a large fraction of the human T cell repertoire, may be critical in the pathogenesis of this disease. © 1990, Rockefeller University Press., All rights reserved.