The Staphylococcal Scalded-Skin Syndrome: Isolation and Partial Characterization of the Exfoliative Toxin

Melish, Marion E.; Glasgow, Lowell A.; Turner, Michael D.

doi:10.1093/infdis/125.2.129

Cited by 174 publications

(94 citation statements)

References 13 publications

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“…In 1970, Melish and Glasgow (10) established an experimental model of SSSS using newborn mice injected with Staphylococcus aureus isolated from patients. Soon several workers isolated and characterized an exotoxin of S. aureus which was responsible for the skin exfoliation in SSSS (1,4,11). The exotoxin was named "exfoliative toxin" (ET).…”

mentioning

confidence: 99%

Purification of Protease from a Mixture of Exfoliative Toxin and Newborn-Mouse Epidermis

2000

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Although the role of exfoliative toxin in staphylococcal scalded-skin syndrome has been suggested to be that of a serine protease, it has not been demonstrated to show proteolytic activity. Our purpose was to purify a proteolytic enzyme from a mixture of exfoliative toxin and newborn-mouse epidermis. We used gel filtration and ion-exchange and hydroxyapatite chromatography with a high-pressure liquid chromatography system. A casein-hydrolyzing enzyme was isolated from the mixture. The molecular mass of the enzyme was confirmed to be 20 kDa by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Subcutaneous injection of the purified enzyme into newborn mice reproduced the epidermal splitting that is seen in staphylococcal scalded-skin syndrome. These results suggest that exfoliative toxin does not work as a protease itself but that some reaction between exfoliative toxin and an epidermal component(s) first produces a protease, after which epidermal splitting occurs.

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confidence: 99%

Purification of Protease from a Mixture of Exfoliative Toxin and Newborn-Mouse Epidermis

2000

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“…Criteria required for diagnosis of SSSS are typical clinical patterns, isolation of an exotoxin-producing S. aureus strain and histopathological evidence of intraepidermal cleavage through stratum granulosum [9,21]. Many authors assume that the presence of characteristic skin lesions along with the isolation of phage group II S. aureus is sufficient for the diagnosis of SSSS [3,6,22], but there are also reports on exfoliative toxinproducing S. aureus strains other than phage group II [1,4,11,23]. Recent investigations of the pathogenetical mechanisms of SSSS led to the identification of the exfoliative toxins of S. aureus as glutamate-specific trypsin-like serine proteases.…”

Section: Discussionmentioning

confidence: 99%

Staphylococcal Scalded Skin Syndrome in an Adult Patient with T-Lymphoblastic Non-Hodgkin’s Lymphoma

Scheinpflug¹,

Schalk²,

Mohren³

2008

Oncol Res Treat

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Background: Staphylococcal scalded skin syndrome (SSSS) is an exfoliative dermatitis caused by Staphylococcus aureus infection. In contrast to infants, it is rarely observed in adults. SSSS in adults usually occurs in predisposed individuals such as those with renal failure or immunodeficiency, but has also been reported in otherwise healthy subjects. The reported mortality rate in adults is usually high because of serious underlying disease. Patient and Methods: We report a case of SSSS in a young female patient with T-lymphoblastic lymphoma, who survived this potentially lethal complication. Conclusions: To the best of our knowledge, this is the first case of SSSS in an adult patient with T-lymphoblastic non-Hodgkin’s lymphoma. Clinicians should be aware of SSSS as a rare but potentially fatal disorder, particularly in adult patients with malignancies undergoing aggressive chemotherapy.

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“…In the 1970s Melish et al (5)(6)(7) showed that ETs produced by S. aureus injected into neonatal mice caused blister formation in skin similar to that seen in patients with bullous impetigo and SSSS. It remained unclear exactly how ETs cause this blister until it was discovered that they have structural and sequence homologies to serine proteases, at which time it was suggested that they act as proteolytic enzymes that were predicted to cleave after either a glutamic or aspartic acid (8).…”

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confidence: 98%

Enzymatic and Molecular Characteristics of the Efficiency and Specificity of Exfoliative Toxin Cleavage of Desmoglein 1

Hanakawa

Schechter

Lin

et al. 2004

Journal of Biological Chemistry

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Exfoliative toxins (ETs) from؊1 , suggesting very efficient proteolysis. Proteolysis by ETA was not efficiently inhibited by broad spectrum serine protease inhibitors, suggesting that the enzyme cleavage site may be inactive or inaccessible before specific binding to its substrate. Using truncated mutants of human Dsg1 and chimeric molecules between human Dsg1 and either human Dsg3 or canine Dsg1, we show that for cleavage, humanspecific amino acids from Dsg1 are necessary in extracellular domain 3 upstream of the scissile bond. If these residues are canine rather than human, ETA binds, but does not cleave, canine Dsg1. These data suggest that the exquisite specificity and efficiency of ETA may depend on the enzyme's binding upstream of the cleavage site with a very specific fit, like a key in a lock.

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The Staphylococcal Scalded-Skin Syndrome: Isolation and Partial Characterization of the Exfoliative Toxin

Cited by 174 publications

References 13 publications

Purification of Protease from a Mixture of Exfoliative Toxin and Newborn-Mouse Epidermis

Purification of Protease from a Mixture of Exfoliative Toxin and Newborn-Mouse Epidermis

Staphylococcal Scalded Skin Syndrome in an Adult Patient with T-Lymphoblastic Non-Hodgkin’s Lymphoma

Enzymatic and Molecular Characteristics of the Efficiency and Specificity of Exfoliative Toxin Cleavage of Desmoglein 1

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