Association of erythrodermic cutaneous T-cell lymphoma, superantigen- positive Staphylococcus aureus, and oligoclonal T-cell receptor Vβ gene expansion

Clotilde M. Jackow, Jennifer C. Cather, Vicki Hearne, Arisa T. Asano, James M. Musser, Madeleine Duvic

Research output: Contribution to journalArticle

183 Scopus citations

Abstract

Forty-two patients with cutaneous T-cell lymphoma, including 31 with exfoliative erythroderma or Sezary syndrome and 11 with mycosis fungoides, were studied for the occurrence of staphylococcal infection. Thirty-two of 42 (76%) had a positive staphylococcal culture from skin or blood. One half of the patients with positive cultures grew Staphylococcus aureus. This group included 11 with Sezary syndrome and 5 with rapidly enlarging mycosis fungoides plaques or tumors. All of the S aureus carried enterotoxin genes. Surprisingly, 6 of 16 strains were the same toxic shock toxin-1 (TSST-1)- positive clone, designated electrophoretic type (ET)-41. Analysis of the T- cell receptor Vβ repertoire in 14 CTCL patients found that only 4 had the expected monoclonal expansion of a specific Vβ gene, whereas 10 had oligoclonal or polyclonal expansion of several Vβ families. All patients with TSST-1- S aureus had overexpansion of Vβ 2 in blood and/or skin lesions. These studies show that S aureus containing superantigen enterotoxins are commonly found in patients with CTCL, especially individuals with erythroderma where they could exacerbate and/or perpetuate stimulate chronic T-cell expansion and cutaneous inflammation. Attention to toxigenic S aureus in CTCL patients would be expected to improve the quality of care and outcome of this patient population.

Original languageEnglish (US)
Pages (from-to)32-40
Number of pages9
JournalBlood
Volume89
Issue number1
DOIs
StatePublished - Jan 1 1997

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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