[Toxic shock syndrome toxin level in wound samples of hospitalized children with burn: a case control study]

Background: Toxic shock syndrome [TSS], a dangerous consequence of Toxic shock syndrome toxin-1 [TSST-1] caused by Staphylococcus aureus. The early detection for infections of Staphylococcus aureus in burned children is very important, also the prevention for consequences of TSST-1. Fever is one of the most noticeable sign in burned children. On the other hand, fever is one of the important consequences of TSST-1 production

Methods: This study aimed to assess the toxic shock syndrome toxin-1 level in the wound's specimens of two groups febrile and afebrile in the hospitalized burned children in Motahari hospital Tehran, Iran in the year 2013. In this case-control study, 90 children who admitted to the burn unit, divided in two groups of 45 patients: febrile [cases group] and afebrile [control group]

All of burned children under went wound biopsy, and then all of wound's specimens were tested by PCR for specific primer of toxin producing genome. Finally all of data collected and statistically analyzed. This data include group febrile and afebrile, demographic characteristics, percentage of burned surface severity and result of PCR

Results: The positive result for PCR test, production of TSST-1 in febrile burned children [cases group] was 37.7% and in afebrile burned children [control group] was 11.1% that this different was statistically significant [P=0.003]

The mean and standard deviation for percentage of burned surface [severity] in samples with positive result for PCR test was 30.9+/- 16.93 and in samples with negative result for PCR test was 20.09+/-11.02 that this different was statistically significant [P<0.01]. There was no difference between positive PCR result and negative PCR result of age and sex

Conclusion: Direct association was approved between the production of TSST-1 and the occurrence of fever in burned children. Increased surface severity

[Streptococcus super antigen in polyp tissue of patients with nasal polyposis and chronic rhinosinusitis in comparison to normal population]

Nasal polyp [NP] is a benign mucosal mass located in both sinuses and nares which is mostly seen in association with cystic fibrosis, asthma or oversensitivity to aspirin. The prominent histological feature of NP is inflammatory cell infiltration with eosinophil predominance. Superantigens role in causing NP complications is already proven. Superantigens, which are mostly originated from Streptococci and Staphylococci, activate T cells strongly and increase the process of production and release of cytokines, and secretion of IgE from B cells, which in turn directly affects proinflammatory cells such as eosinophils, both in their tissues infiltration and functions. The samples are collected from patients referring to ENT clinic in Rasoul Akram training Hospital in Tehran after thorough clinical and paraclinical examinations. For control group the samples collected from patients undergoing rhinoplasty. All the samples kept frozen and sent to immunology lab. The DNA of the excised tissues extracted and amplified by using the superantigens specific primers and PCR product detected by gel electrophoresis. The date analyzed by using mean and SD and CHI[2] analytical tools. Fifteen healthy individuals, 25 patients with rhinosinusitis and 24 with polyposis entered this trial. Group A Streptococcus toxin detection was significantly more frequent in those with nasal polyp and rhinosinusitis compared to healthy individuals [P=0.001 and 0.005, respectively], but the results were almost the same for those with nasal polyp and rhinosinusitis [P=0.4]. Streptococci may play an important role in induction or clinical exacerbation of polyposis and group A Streptococcus pyogenes exotoxin [SPEs] with superantigenic effects may have a crucial role in etiology and pathogenesis of polyps with or without rhinosinusitis. It is postulated that, T cells polyclonal activation by SPEs may cause recruitment of inflammatory cells in nasal mucosa. These inflammatory cells include IgE producing B cells leading to allergic and inflammatory reactions in NP.

[Superantigens in polyp tissue of patients with chronic rhino-sinusitis, a comparative study: a brief report]

Staphylococcus aureus secretes numerous superantigenes which trigger the inflammatory mechanisms of sinus mucosa and cause chronic rhino-sinusitis. This study was designed to evaluate the role of staphylococcus aureus superantigens in polyp tissues of patients with chronic rhino-sinusitis in comparison with a control group. Polyp tissue samples of 28 patients and mucosal specimens of 19 healthy individuals were evaluated for staphylococcus aureus bacterium superantigens, exotoxins A, B, C and D and TSST-1 with RT-PCR and ELISA methods Rasoul Akram Hospital during 2 years. Polymerase chain reaction [PCR] results revealed that 88.2% of the patients and 45.5% of the controls had at least one type of superantigen [P=0.03]. Evaluation of superantigens using ELISA method showed presence of at least one type of superantigen in the nasal samples of all patients and in 35.3% of the controls [P < 0.001]. A relationship between staphylococcal superantigens and nasal polyps is concluded from this study which indicates the probable role of these superantigens in the pathogenesis of nasal polyposis

[ comparison of TH1 and TH2 cytokines gene expression in allergic and non-allergic patients with nasal polyps by PCR]

Too many studies are in the process of determining the probable role of immune system in the etiopathogenesis of nasal polyposis. This study was designed to identify the probable participation of Th1, Th2 lymphocytes in the induction and progression of nasal polyposis. Seventy-five patients, 42 male and 33 female, with nasal polyposis were examined for total serum IgE, specific serum IgE and reaction to skin test for differentiating allergic from non-allergic participants in Rasoul Akram Hospital during 2010. To determine the possible correlation of allergic reactions in the upper respiratory tract and nasal polyposis, cytokine gene expression was evaluated on the extracted RNA by RT-PCR. The data were analyzed by using c2, independent t-test, correlation and Receiver operating characteristic [ROC] curve. The mean age of participants was 38 years [18-81 years]. IFN-gamma and IL-4 gene expressions were more prevalent in allergic than non-allergic individuals [IFN-gamma: 39.5% vs. 14.2%, P=0.3 and IL-4: 44.7% vs. 18.9%, P=0.02, respectively]. IL-10 and IL-12 [P35 and P40 fractions] genes were not significantly different between the two groups. IL-10 and IL-12 [P35, P40] genes did not differ significantly either. This research suggests that overproduction of cytokines and an imbalance of Th1 and Th2 cell production may play an important role in the pathophysiology of allergic or non-allergic nasal polyp formation. Thus, although nasal polyposis is a multifactorial disease with several different etiological factors, chronic persistent inflammation is undoubtedly a major factor irrespective of the etiology