Superantigen antagonist peptides 英文参考文献.docVIP

Available online /content/5/2/053 Commentary Superantigen antagonist peptides Martin Llewelyn and Jonathan Cohen Department of Infectious Diseases, Imperial College School of Medicine, Hammersmith Hospital, London, UK Correspondence: Jon Cohen, Department of Infectious Diseases and Microbiology, Division of Investigative Science, Imperial College of Medicine, The Hammersmith Hospital, Du Cane Road, London W12 0NN, UK. Tel: +44 (0) 20 8383 3243; fax: +44 (0) 20 8383 3394; email: j.cohen@ic.ac.uk Received: 8 January 2001 Accepted: 19 January 2001 Published: 26 February 2001 Critical Care 2001, 5:53–55 ? 2001 BioMed Central Ltd (Print ISSN 1364-8535; Online ISSN 1466-609X) Abstract The production of superantigenic exotoxins by Gram positive bacteria underlies the pathology of toxic shock syndrome. Future treatment strategies for superantigen-mediated diseases are likely to be directed at blocking the three-way interaction between superantigen, T cell receptor and major histocompatibility class II molecule, which inititates an excessive and disordered inflammatory response. In this article, we review the first published data to address one such strategy in the context of other recognised and experimental treatments. Keywords: exotoxins, immunology, septic, shock, superantigen, treatment Gram-positive infections account for up to 50% of cases of severe sepsis in the modern intensive care unit. The complex processes by which Gram-positive organisms cause sepsis are poorly understood by comparison with Gram-negative sepsis. Much interest is currently focused on the role of certain protein exotoxins synthesized by Staphylococcus aureus and Streptococcus pyogenes, which share the immunological property of being super- antigens. Superantigens are characterized by the ability to bypass normal major histocompatibility complex (MHC)- restricted, intracellular, antigen proce