Skip to main content
Infection and Immunity logoLink to Infection and Immunity
. 1997 Feb;65(2):366–372. doi: 10.1128/iai.65.2.366-372.1997

Intravenous immunoglobulin inhibits staphylococcal toxin-induced human mononuclear phagocyte tumor necrosis factor alpha production.

T Darville 1, L B Milligan 1, K K Laffoon 1
PMCID: PMC174604  PMID: 9009284

Abstract

Intravenous gamma immunoglobulin (IVIG) is used as therapy in superantigen-mediated disease, yet its mode of action is not clear. Pooled immunoglobulin G contains high concentrations of staphylococcal exotoxin (SE)-specific antibodies which inhibit the in vitro activation of T cells. However, SE and streptococcal exotoxins are potent stimulators of monocytes as well. Monocytes exposed to SE in vitro release large amounts of tumor necrosis factor alpha (TNF-alpha). The purpose of the present study was to determine if SE-specific antibodies in IVIG can inhibit the activation of monocytes by SE. We examined the in vitro effect of IVIG on the ability of staphylococcal exotoxin A (SEA) and staphylococcal exotoxin B (SEB) to stimulate release of TNF-alpha from human mononuclear phagocytes (MO). Pretreatment of SEA with 0.1 mg of IVIG per ml resulted in a slight decrease of SEA-induced TNF-alpha secretion by MO. In contrast, pretreatment of SEB with 0.1 mg of IVIG per ml resulted in significant (greater than 50%) inhibition of SEB-induced TNF-alpha secretion at 24, 48, 72, and 96 h (P < 0.05 for TNF-alpha levels induced by SEB alone versus SEB pretreated with IVIG at all time points). Enzyme-linked immunosorbent assay and Western immunoblotting assays of the IVIG revealed high concentrations of antibodies against SEB and lower concentrations of antibodies to SEA. These data indicate that IVIG can act in a toxin-specific manner to decrease the MO TNF-alpha response to superantigens. Such inhibition may be one mechanism by which IVIG exerts an immunoregulatory role in superantigen-mediated disease.

Full Text

The Full Text of this article is available as a PDF (278.2 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abe J., Kotzin B. L., Jujo K., Melish M. E., Glode M. P., Kohsaka T., Leung D. Y. Selective expansion of T cells expressing T-cell receptor variable regions V beta 2 and V beta 8 in Kawasaki disease. Proc Natl Acad Sci U S A. 1992 May 1;89(9):4066–4070. doi: 10.1073/pnas.89.9.4066. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Carswell E. A., Old L. J., Kassel R. L., Green S., Fiore N., Williamson B. An endotoxin-induced serum factor that causes necrosis of tumors. Proc Natl Acad Sci U S A. 1975 Sep;72(9):3666–3670. doi: 10.1073/pnas.72.9.3666. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Damaj B., Mourad W., Naccache P. H. Superantigen-mediated human monocyte-T lymphocyte interactions are associated with an MHC class II-, TCR/CD3-, and CD4-dependent mobilization of calcium in monocytes. J Immunol. 1992 Sep 1;149(5):1497–1503. [PubMed] [Google Scholar]
  4. Darville T., Tabor D., Simpson K., Jacobs R. F. Intravenous immunoglobulin modulates human mononuclear phagocyte tumor necrosis factor-alpha production in vitro. Pediatr Res. 1994 Apr;35(4 Pt 1):397–403. [PubMed] [Google Scholar]
  5. Dwyer J. M. Manipulating the immune system with immune globulin. N Engl J Med. 1992 Jan 9;326(2):107–116. doi: 10.1056/NEJM199201093260206. [DOI] [PubMed] [Google Scholar]
  6. Fast D. J., Schlievert P. M., Nelson R. D. Toxic shock syndrome-associated staphylococcal and streptococcal pyrogenic toxins are potent inducers of tumor necrosis factor production. Infect Immun. 1989 Jan;57(1):291–294. doi: 10.1128/iai.57.1.291-294.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Fischer G. W., Hemming V. G., Hunter K. W., Jr, Gloser H., Bachmayer H., Von Pilar C. E., Helting T., Weisman L. E., Wilson S. R., Baron P. A. Intravenous immunoglobulin in the treatment of neonatal sepsis: therapeutic strategies and laboratory studies. Pediatr Infect Dis. 1986 May-Jun;5(3 Suppl):S171–S175. [PubMed] [Google Scholar]
  8. Fischer H., Dohlsten M., Andersson U., Hedlund G., Ericsson P., Hansson J., Sjögren H. O. Production of TNF-alpha and TNF-beta by staphylococcal enterotoxin A activated human T cells. J Immunol. 1990 Jun 15;144(12):4663–4669. [PubMed] [Google Scholar]
  9. Fischer H., Dohlsten M., Lindvall M., Sjögren H. O., Carlsson R. Binding of staphylococcal enterotoxin A to HLA-DR on B cell lines. J Immunol. 1989 May 1;142(9):3151–3157. [PubMed] [Google Scholar]
  10. Gjörloff A., Fischer H., Hedlund G., Hansson J., Kenney J. S., Allison A. C., Sjögren H. O., Dohlsten M. Induction of interleukin-1 in human monocytes by the superantigen staphylococcal enterotoxin A requires the participation of T cells. Cell Immunol. 1991 Oct 1;137(1):61–71. doi: 10.1016/0008-8749(91)90056-h. [DOI] [PubMed] [Google Scholar]
  11. Hackett S. P., Stevens D. L. Superantigens associated with staphylococcal and streptococcal toxic shock syndrome are potent inducers of tumor necrosis factor-beta synthesis. J Infect Dis. 1993 Jul;168(1):232–235. doi: 10.1093/infdis/168.1.232. [DOI] [PubMed] [Google Scholar]
  12. Hamill R. J., Musher D. M., Groover J. E., Zavell P. J., Watson D. A. IgG antibody reactive with five serotypes of Streptococcus pneumoniae in commercial intravenous immunoglobulin preparations. J Infect Dis. 1992 Jul;166(1):38–42. doi: 10.1093/infdis/166.1.38. [DOI] [PubMed] [Google Scholar]
  13. Herman A., Kappler J. W., Marrack P., Pullen A. M. Superantigens: mechanism of T-cell stimulation and role in immune responses. Annu Rev Immunol. 1991;9:745–772. doi: 10.1146/annurev.iy.09.040191.003525. [DOI] [PubMed] [Google Scholar]
  14. Ikejima T., Dinarello C. A., Gill D. M., Wolff S. M. Induction of human interleukin-1 by a product of Staphylococcus aureus associated with toxic shock syndrome. J Clin Invest. 1984 May;73(5):1312–1320. doi: 10.1172/JCI111334. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Imbach P., Barandun S., Cottier H., Gugler E., Hassig A., Morell A., Wagner H., Heiniger H. Immunomodulation by intravenous immunoglobulin. Am J Pediatr Hematol Oncol. 1990 Summer;12(2):134–140. doi: 10.1097/00043426-199022000-00002. [DOI] [PubMed] [Google Scholar]
  16. Irwin M. J., Hudson K. R., Ames K. T., Fraser J. D., Gascoigne N. R. T-cell receptor beta-chain binding to enterotoxin superantigens. Immunol Rev. 1993 Feb;131:61–78. doi: 10.1111/j.1600-065x.1993.tb01530.x. [DOI] [PubMed] [Google Scholar]
  17. Jupin C., Anderson S., Damais C., Alouf J. E., Parant M. Toxic shock syndrome toxin 1 as an inducer of human tumor necrosis factors and gamma interferon. J Exp Med. 1988 Mar 1;167(3):752–761. doi: 10.1084/jem.167.3.752. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Koesling M., Rott O., Fleischer B. Macrophages are dispensable for superantigen-mediated stimulation and anergy induction of peripheral T cells in vivo. Cell Immunol. 1994 Aug;157(1):29–37. doi: 10.1006/cimm.1994.1202. [DOI] [PubMed] [Google Scholar]
  19. Kotb M. Bacterial pyrogenic exotoxins as superantigens. Clin Microbiol Rev. 1995 Jul;8(3):411–426. doi: 10.1128/cmr.8.3.411. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Kotb M., Ohnishi H., Majumdar G., Hackett S., Bryant A., Higgins G., Stevens D. Temporal relationship of cytokine release by peripheral blood mononuclear cells stimulated by the streptococcal superantigen pep M5. Infect Immun. 1993 Apr;61(4):1194–1201. doi: 10.1128/iai.61.4.1194-1201.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Laemmli U. K. Cleavage of structural proteins during the assembly of the head of bacteriophage T4. Nature. 1970 Aug 15;227(5259):680–685. doi: 10.1038/227680a0. [DOI] [PubMed] [Google Scholar]
  22. Marrack P., Kappler J. The staphylococcal enterotoxins and their relatives. Science. 1990 May 11;248(4956):705–711. doi: 10.1126/science.2185544. [DOI] [PubMed] [Google Scholar]
  23. Matsuyama S., Koide Y., Yoshida T. O. HLA class II molecule-mediated signal transduction mechanism responsible for the expression of interleukin-1 beta and tumor necrosis factor-alpha genes induced by a staphylococcal superantigen. Eur J Immunol. 1993 Dec;23(12):3194–3202. doi: 10.1002/eji.1830231223. [DOI] [PubMed] [Google Scholar]
  24. Nadal D., Lauener R. P., Braegger C. P., Kaufhold A., Simma B., Lütticken R., Seger R. A. T cell activation and cytokine release in streptococcal toxic shock-like syndrome. J Pediatr. 1993 May;122(5 Pt 1):727–729. doi: 10.1016/s0022-3476(06)80014-4. [DOI] [PubMed] [Google Scholar]
  25. Newburger J. W., Takahashi M., Burns J. C., Beiser A. S., Chung K. J., Duffy C. E., Glode M. P., Mason W. H., Reddy V., Sanders S. P. The treatment of Kawasaki syndrome with intravenous gamma globulin. N Engl J Med. 1986 Aug 7;315(6):341–347. doi: 10.1056/NEJM198608073150601. [DOI] [PubMed] [Google Scholar]
  26. Paliard X., West S. G., Lafferty J. A., Clements J. R., Kappler J. W., Marrack P., Kotzin B. L. Evidence for the effects of a superantigen in rheumatoid arthritis. Science. 1991 Jul 19;253(5017):325–329. doi: 10.1126/science.1857971. [DOI] [PubMed] [Google Scholar]
  27. Parsonnet J., Gillis Z. A. Production of tumor necrosis factor by human monocytes in response to toxic-shock-syndrome toxin-1. J Infect Dis. 1988 Nov;158(5):1026–1033. doi: 10.1093/infdis/158.5.1026. [DOI] [PubMed] [Google Scholar]
  28. Parsonnet J., Hickman R. K., Eardley D. D., Pier G. B. Induction of human interleukin-1 by toxic-shock-syndrome toxin-1. J Infect Dis. 1985 Mar;151(3):514–522. doi: 10.1093/infdis/151.3.514. [DOI] [PubMed] [Google Scholar]
  29. Scholl P. R., Trede N., Chatila T. A., Geha R. S. Role of protein tyrosine phosphorylation in monokine induction by the staphylococcal superantigen toxic shock syndrome toxin-1. J Immunol. 1992 Apr 1;148(7):2237–2241. [PubMed] [Google Scholar]
  30. Scholl P., Diez A., Mourad W., Parsonnet J., Geha R. S., Chatila T. Toxic shock syndrome toxin 1 binds to major histocompatibility complex class II molecules. Proc Natl Acad Sci U S A. 1989 Jun;86(11):4210–4214. doi: 10.1073/pnas.86.11.4210. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Silverman E. D., Laxer R. M., Greenwald M., Gelfand E., Shore A., Stein L. D., Roifman C. M. Intravenous gamma globulin therapy in systemic juvenile rheumatoid arthritis. Arthritis Rheum. 1990 Jul;33(7):1015–1022. doi: 10.1002/art.1780330714. [DOI] [PubMed] [Google Scholar]
  32. Skansén-Saphir U., Andersson J., Björk L., Andersson U. Lymphokine production induced by streptococcal pyrogenic exotoxin-A is selectively down-regulated by pooled human IgG. Eur J Immunol. 1994 Apr;24(4):916–922. doi: 10.1002/eji.1830240420. [DOI] [PubMed] [Google Scholar]
  33. Takei S., Arora Y. K., Walker S. M. Intravenous immunoglobulin contains specific antibodies inhibitory to activation of T cells by staphylococcal toxin superantigens [see comment]. J Clin Invest. 1993 Feb;91(2):602–607. doi: 10.1172/JCI116240. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Trede N. S., Geha R. S., Chatila T. Transcriptional activation of IL-1 beta and tumor necrosis factor-alpha genes by MHC class II ligands. J Immunol. 1991 Apr 1;146(7):2310–2315. [PubMed] [Google Scholar]
  35. Walker S. M., Shaham B., McCrudy D. K., Wietting H., Arora Y. K., Hanson V., Bernstein B. Prevalence and concentration of IgM rheumatoid factor in polyarticular onset disease as compared to systemic or pauciarticular onset disease in active juvenile rheumatoid arthritis as measured by ELISA. J Rheumatol. 1990 Jul;17(7):936–940. [PubMed] [Google Scholar]

Articles from Infection and Immunity are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES