Device-Associated Menstrual Toxic Shock Syndrome

In the 1980s, menstrual toxic shock syndrome (mTSS) became a household topic, particularly among mothers and their daughters. The research performed at the time, and for the first time, exposed the American public as well as the biomedical community, in a major way, to understanding disease progression and investigation. Those studies led to the identification of the cause, Staphylococcus aureus and the pyrogenic toxin superantigen TSS toxin 1 (TSST-1), and many of the risk factors, for example, tampon use. Those studies in turn led to TSS warning labels on the outside and inside of tampon boxes and, as important, uniform standards worldwide of tampon absorbency labeling. This review addresses our understanding of the development and conclusions related to mTSS and risk factors. We leave the final message that even though mTSS is not commonly in the news today, cases continue to occur. Additionally, S. aureus strains cycle in human populations in roughly 10-year intervals, possibly dependent on immune status. TSST-1-producing S. aureus bacteria appear to be reemerging, suggesting that physician awareness of this emergence and mTSS history should be heightened.

The Immunomodulatory Effect of Trichophyton Rubrum Exoantigens in the Treatment of Experimental Septic Arthritis

Background:

Understanding the nature and function of fungal exoantigens might lead to novel approaches in the treatment and prophylaxis of some infectious diseases. Septic arthritis represents a serious problem for medicine due to the high incidence rate and severe complications.

Objective:

The present study aimed at assessing the immunomodulatory effects of Trichophyton rubrum culture filtrate as a novel compound in experimental septic arthritis.

Method:

The septic arthritis was haematogenously induced in Sprague-Dawley rats by a single intravenous injection of 10⁹ colony forming units of the human clinical isolate Staphylococcus aureus producing toxic shock syndrome toxin-1. Trichophyton rubrum culture filtrate at two different doses 20 and 40 mg/kg was administered intraperituneally two days after bacterial inoculation in the treatment groups and concurrently with the appearance of clinical signs in the patient groups. The administration of Trichophyton rubrum solution was continued every other day for 10 injections.

Results:

The clinical evaluation showed that Trichophyton rubrum-treated rats were significantly protected from disease development compared with untreated controls. This finding was correlated with results of radiological evaluation of the involved joints. Although, the inflammatory cell infiltration, cartilage/bone destruction and synovial hypertrophy had been decreased in the treatment groups in comparison with arthritic controls however, the histological changes were not significant in these two groups.

Conclusion:

It is possible that Trichophyton rubrum antigens may play a role in modulating the immune responses and would be efficient in septic arthritis treatment.

Staphylococcus aureus Pore-Forming Toxins

Staphylococcus aureus (S. aureus) is a formidable foe equipped with an armamentarium of virulence factors to thwart host defenses and establish a successful infection. Among these virulence factors, S. aureus produces several potent secreted proteins that act as cytotoxins, predominant among them the beta-barrel pore-forming toxins. These toxins play several roles in pathogenesis, including disruption of cellular adherens junctions at epithelial barriers, alteration of intracellular signaling events, modulation of host immune responses, and killing of eukaryotic immune and non-immune cells. This chapter provides an updated overview on the S. aureus beta-barrel pore-forming cytotoxins, the identification of toxin receptors on host cells, and their roles in pathogenesis.