Superantigens further incriminated in Kawasaki disease

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Suenaga et al at the Wakayama Medical University, Japan, obtained stool specimens from 60 patients with Kawasaki disease (KD) and 62 age-matched controls with and without acute illnesses, extracted DNA from stool specimens, and performed PCR to amplify 5 superantigen genes, and then did sequence analysis on compatible products. They found streptococcal and staphylococcal toxin gene(s) present in 70% of stools from patients with KD and 27% of stools from control children (P < .001). An important limitation of interpretation of findings is lack of information for all study children on receipt of antibiotics, which bactericidal effect could lead to heightened release of DNA fragments. This caution considered, the findings provide direct evidence of presence of superantigens in patients with KD. With the growing understanding that KD likely results from host factors, microbial factors, and possibly environmental factors, bacterial superantigens seem to be unshakably incriminated as playing a microbial role.

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