Selective Depletion Of V -Bearing T Cells In Patients With Severe Invasive Group A Streptococcal Infections And Streptococcal Toxic Shock Syndrome

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Abstract
The Vβ repertoire of T cells of patients with gram-positive group A streptococcal (GAS) and non-GAS infections was analyzed to seek evidence for the role of superantigens in streptococcal toxic shock syndrome. No evidence of Vβ overexpression but a consistent pattern of depletion of Vβ1, Vβ5.1, and Vβ12 was observed in patients with severe GAS infections. This pattern of Vβ depletion was not observed in patients with nonsevere GAS infections or with severe non-GAS gram-positive infections. T cells from patients with severe GAS infections showed evidence of apoptosis; no apoptosis was found when there was no evidence of Vβ depletion. There was no correlation with streptococcal M or T serotype or known spe genes. The depletion of specific Vβ-bearing T cells in patients with severe GAS infections supports the role of a superantigen in these infections. The in vivo pattern of Vβ specificity implicates a novel superantigen(s) in this disease.