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Infection and Immunity, August 2001, p. 5193-5197, Vol. 69, No. 8
0019-9567/01/$04.00+0   DOI: 10.1128/IAI.69.8.5193-5197.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Toxin Levels in Serum Correlate with the Development of Staphylococcal Scalded Skin Syndrome in a Murine Model

Lisa R. W. Plano,1 Becky Adkins,2 Markus Woischnik,2 Ruth Ewing,3 and Carleen M. Collins2,*

Departments of Pediatrics,1 Microbiology and Immunology,2 and Developmental Pathology,3 University of Miami School of Medicine, Miami, Florida 33101

Received 16 October 2000/Returned for modification 15 January 2001/Accepted 14 May 2001

Staphylococcal scalded skin syndrome (SSSS) is an exfoliative dermatitis that results from infection with exfoliative toxin-producing Staphylococcus aureus. SSSS is seen primarily in infants and children. Here we ask if there is a specific maturation process that protects healthy adults from this syndrome. For these studies, an active recombinant exfoliative toxin A (rETA) was used in a neonatal mouse model. A time course generated on the susceptibility to the toxin as a function of mouse age indicated that BALB/c mice developed the characteristic symptoms of SSSS until day 7 of life. Between day 7 and day 8 of life there was a dramatic decrease in susceptibility, such that mice at day 9 of life were resistant to the effects of the toxin. This time course corresponds approximately to the time needed for maturation of the adaptive immune response, and SSSS in adults is often identified with immunocompromised states. Therefore, mice deficient in this response were examined. Adult mice thymectomized at birth and adult SCID mice did not develop the symptoms of SSSS after injection with the toxin, indicating that the adaptive immune response is not responsible for the lack of susceptibility observed in the older mice. SSSS in adults is also associated with renal disorders, suggesting that levels of toxin in serum are important in the development of the disease. rETA was not cleared as efficiently from the serum of 1-day-old mice compared to clearance from 10-day-old mice. Ten-day-old mice were given repeated injections of toxin so that the maximal level of toxin was maintained for a sustained period of time, and exfoliation occurred in these mice. Thus, whereas the adaptive immune response is not needed for protection of adult mice from SSSS, efficient clearance of the toxin from the bloodstream is a critical factor.


* Corresponding author. Mailing address: Department of Microbiology and Immunology, P.O. Box 016960 (R-138), Miami, FL 33101. Phone: (305) 243-6118. Fax: (305) 243-4623. E-mail: ccollins{at}med.miami.edu.


Infection and Immunity, August 2001, p. 5193-5197, Vol. 69, No. 8
0019-9567/01/$04.00+0   DOI: 10.1128/IAI.69.8.5193-5197.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.



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