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Infection and Immunity, August 2001, p. 5193-5197, Vol. 69, No. 8
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.
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
*
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.
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