Nephrol Dial Transplant (2000) 15: 1170-1174
© 2000 European Renal Association-European Dialysis and Transplant Association
Cytokines and T-cell responses in superantigen-related glomerulonephritis following methicillin-resistant Staphylococcus aureus infection
1 Department of Internal Medicine, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, 2 Department of Nephrology, Tokyo Medical University Kasumigaura Hospital, Ibaraki, 3 Department of Nephrology, Kamitsuga General Hospital, Tochigi and 4 Department of Nephrology, Hitachi General Hospital, Ibaraki, Japan
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) Vß+cells, perhaps representing Vß-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 Vßs, especially Vß5-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-
(TNF-), interleukin-1ß (IL-1ß), 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.
Keywords: enterotoxin; glomerulonephritis; MRSA; superantigen
Correspondence and offprint requests to: Akio Koyama, MD, Department of Internal Medicine, Institute of Clinical Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki 305–8575, Japan.
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