SELECTIVE DEPLETION OF V-BETA-BEARING T-CELLS IN PATIENTS WITH SEVERE INVASIVE GROUP-A STREPTOCOCCAL INFECTIONS AND STREPTOCOCCAL TOXIC SHOCK SYNDROME

The V beta 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 VB overexpression but a consistent pattern of depletion of V beta 1, V beta 5.1 and V beta 12 was observed in patients with severe GAS infections, This pattern of V beta 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 V beta depletion. There was no correlation with streptococcal M or T serotype or known spe genes. The depletion of specific V beta-hearing T cells in patients with severe GAS infections supports the role of a superantigen in these infections. The in vivo pattern of VP specificity implicates a novel superantigen(s) in this disease.