Staphylococcal Enterotoxin A Detection from Rheumatoid Arthritis Patients’ Blood and Synovial Fluid
Keywords:
rheumatoid arthritis, staphylococcal enterotoxin A, ELISA, PCR, synovial fluidAbstract
Introduction: Direct detection of microbial super antigens in synovial fluid of patients with rheumatoid arthritis may be able to guide to the design of cost-effective therapies. The purpose of this study was to assess the existence of Staphylococcal enterotoxin A (superantigen A) in the synovial fluid of patients with RA by the PCR and ELISA methods.
Methods: This experimental study was conducted on the synovial fluid of 103 RA patients from Baqiyatallah University of Medical Sciences’ Rheumatology Clinic in Tehran, Iran in 2011-2014. Bacterial cultures, polymerase chain reaction with specific primer pairs and enzyme-linked immunosorbent assay (ELISA) methods were used. The PCR products were subjected to sequence as a confirmatory molecular method results. The data were descriptively analyzed by SPSS Version 19.
Results: The bacteriological study result indicated that, in four cases (3.8%) of the patients, bacterial strains were isolated. The result of PCR molecular method for staphylococcal enterotoxin A gene showed that, 42 of the patients (40.7%) tested positive for the ent A gene. The results of ELISA were positive for staphylococcal enterotoxin A (superantigen A) in 51 cases (49.51%) of the patients’ synovial fluids. The results indicated that the possibility of detecting superantigen A in the SF of RA patients, but the origin of the enterotoxin A gene remained unknown.
Conclusions: The findings of this study may be able to alter the actual theory on the pathogenesis, diagnosis, and treatment of RA patients. In addition, the results have shown the probability of an endogenous origin for the involved superantigen A in RA patients’ synovial fluids.
References
Bianchi DM, Gallina S, Bellio A, Chiesa F, Civera T, Decastelli L. Enterotoxin gene profiles of
Staphylococcus aureus isolated from milk and dairy products in Italy. Lett Appl Microbiol 2014 ;58:190- 196. doi: 10.1111/lam.12182.
Argudin MA, Mendoza MC, Rodicio MR. Food Poisoning and Staphylococcus aureus Enterotoxins.
Toxins (Basel) 2010;2:1751-1773. doi: 10.3390/toxins2071751.
Boynukara B, Gulhan T, Alisarli M, Gurturk K, Solmaz H. Classical enterotoxigenic characteristics of
Staphylococcus aureus strains isolated from bovine subclinical mastitis in Van, Turkey. Int J Food
Microbiol 2008;125:209-211. doi: 10.1016/j.ijfoodmicro.2008.03.024.
Principato M, Qian BF. Staphylococcal enterotoxins in the Etiopathogenesis of Mucosal Autoimmunity
within the Gastrointestinal Tract. Toxins (Basel) 2014;6:1471-1489. doi: 10.3390/toxins6051471.
Pichereau S, Moran JJ, Hayney MS, Shukla SK, Sakoulas G, Rose WE. Concentration-dependent effects of
antimicrobials on Staphylococcus aureus toxin-mediated cytokine production from peripheral blood
mononuclear cells. J Antimicrob Chemother 2012 ;67:123-129. doi: 10.1093/jac/dkr417.
Kissner TL, Cisney ED, Ulrich RG, Fernandez S, Saikh KU. Staphylococcal enterotoxin A induction of
pro-inflammatory cytokines and lethality in mice is primarily dependent on MyD88. Immunology
;130:516-526. doi: 10.1111/j.1365-2567.2010.03249.
Lee HW, Kim SM, Kim JM, Oh BM, Kim JY, Jung HJ, et al. Potential Immunoinflammatory Role of
Staphylococcal Enterotoxin A in Atopic Dermatitis: Immunohistopathological Analysis and in vitro Assay.
Ann Dermatol 2013;25:173-180. doi: 10.5021/ad.2013.25.2.
Brosnahan AJ, Schlievert PM: Gram Positive Bacterial Superantigen Outside-In Signaling Causes Toxic
Shock Syndrome. FEBS J 2011;278:4649-4667. doi: 10.1111/j.1742-4658.2011.08151.
Kraft M, Filsinger S, Kramer KL, Kabelitz D, Hansch GM, Schoels M. Synovial fibroblasts as target cells
for staphylococcal enterotoxin-induced T-cell cytotoxicity. Immunology 1995;93:20-25. PMID: 9536114.
Kraft M, Filsinger S, Kramer KL, Kabelitz D, Hansch GM, Schoels M. Synovial fibroblasts as accessory
cells for staphylococcal enterotoxin-mediated T-cell activation. Immunology 1995;85:461-466. PMID:
PMid:7558136, PMCid:PMC1383921
Origuchi T, Eguchi K, Kawabe Y, Mizokami A, Ida H, Nagataki S. Synovial cells are potent antigen- presenting cells for superantigen, staphylococcal enterotoxin B (SEB). Clin Exp Immunol 1995;99 (3):345- 351. PMID: 7882555.
Colque-Navarro P, Jacobsson G, Andersson R, Flock JI, Mollby R. Levels of Antibody against 11
Staphylococcus aureus Antigens in a Healthy Population. Clin Vaccine Immunol 2010;17:1117-1123. doi:
1128/CVI.00506-09.
Miwa K, Fukuyama M, Sakai R, Shimizu S, Ida N, Endo M, et al. Sensitive enzyme-linked immunosorbent
assays for the detection of bacterial superantigens and antibodies against them in human plasma. Microbiol
Immunol 2000;44:519-523, PMid:10941935
Poli MA, Rivera VR, Neal D. Sensitive and specific colorimetric ELISAs for Staphylococcus aureus
enterotoxins A and B in urine and buffer. Toxicon 2002;40:1723-1726. doi:10.1016/S0041-0101(02)00202- 7.
Podkowik M, Park JY, Seo KS, Bystron J, Bania J. Enterotoxigenic potential of coagulase-negative
staphylococci. Int J Food Microbiol 2013;163:34-40. doi: 10.1016/j.ijfoodmicro.2013.02.005.
Ataee RA, Mehrabi-Tavana A, Izadi M, Hosseini SM, Ataee MH. Bacterial meningitis: a new risk factor. J
Res Med Sci 2011;16:207-210. PMCID: PMC3214305.
M.Sc theses: (Emkanian B, M.Sc thesis, Baqiyatallah Medical Science University, (2010).
Aletaha D, Neogi T, Silman JA, Funovits J, Felson TD, Bingham OC, et al. Rheumatoid Arthritis
Classification Criteria. Arthritis & Rheumatism 2010; 62(9):2569–2581. doi: 10.1002/art.27584.
Patricia M Tille. Bailey & Scott's Diagnostic Microbiology. Thirteenth Edition. Brooking, South Dakota:
Mosby; 2014, PP 232-247.
Sambrook J, Russel DW. Molecular Cloning: a laboratory manual. 3Ed. New York, Coldspring Harbour
Laboratory Press, 2001, 417- 421.
Sharma KN, Catherine EDR, and Dodd REC. Development of a Single-Reaction Multiplex PCR Toxin
Typing Assay for Staphylococcus aureus Strains. Appl and Environ Microbiol 2000; 66(4): 1347-1353.
PMID: 10742210, PMCid:PMC91991
Colavite-Machado PM, Ishikawa LL, Franca TG, Zorzella-Pezavento SF, da Rosa LC, Chiuso-Minicucci F,
et al. Differential arthritogenicity of Staphylococcus aureus strains isolated from biological samples. BMC
Infect Dis 2013; 13:- 413. doi: 10.1186/1471-2334-13-400.
Salgado-Pabon W, Case-Cook LC, Schlievert PM. Molecular analysis of staphylococcal superantigens.
Methods Mol Biol 2014;1085:169-85. PMid:24085696
Ataee RA, Mohoseni-Moghadam Z, Salimzadeh A, Latifi AM, Ataee MH and Alishiri GH. Enzyme-linked
immunosorbent assay for detection of staphylococcal enterotoxins in synovial fluid of rheumatoid arthritis
pateints. JAPM 2013; 7: 1113-1119.
Liu MF, Li JS, Lin YS, Lei HY. Lack of evidence for the role of staphylococcal enterotoxins in rheumatoid
arthritis. Clin Exp Rheumatol 1997;15:67-70. PMID: 9093775
Lee HW, Kim SM, Kim JM, Oh BM, Kim JY, Jung HJ, et al. Potential Immunoinflammatory Role of
Staphylococcal Enterotoxin A in Atopic Dermatitis: Immunohistopathological Analysis and in vitro Assay.
Ann Dermatol 2013;25:173-180. doi: 10.5021/ad.2013.25.2.173.
Published
Issue
Section
License
Copyright (c) 2020 KNOWLEDGE KINGDOM PUBLISHING
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.