Abstract
Superantigens (Sags) are a part of some viral or bacterial proteins that stimulate T cells and
antigen-presenting cells leading to systemic immune repose and inflammation. SAgs might have a
possible role in various inflammatory childhood diseases (e.g., Kawasaki disease, atopic dermatitis,
and chronic rhinosinusitis). Worldwide studies have been conducted to determine the role of staphylococcal
SAgs (TSST-1) in various inflammatory diseases. The SAgs (TSST-1) not only induce sepsis
and septic shock (even in negative blood culture for S. aureus), but may also have a significant role in
various childhood inflammatory diseases (e.g., KD, OMS, Polyp, dermatitis, psoriasis). In proven
Sags-induced inflammatory diseases, the inhibition of the cell-destructive process by SAgs suppressants
might be helpful. In toxic shock or sepsis-like presentation and even in cases with negative blood
cultures, immediate use of anti staphylococcal drugs is required. Occasionally, the clinical presentation
of some human viruses (e.g., coronavirus and adenovirus) mimics KD. In addition, coinfection with
adenovirus, coronavirus, and para-influenza virus type 3 has also been observed with KD. It has been
observed that in developed KD, bacterial sags induced an increase in acute-phase reactants and in the
number of white blood cells, and neutrophil counts. Multisystem inflammatory syndrome in children
(MISC) and KS were observed during the recent COVID-19 pandemic. This study summarized the
relationship between viral and bacterial SAgs and childhood inflammatory diseases.
Keywords:
Superantigens (Sags), MISC (multisystem inflammatory syndrome in children), COVID 19, S. aureus, adenovirus, white blood cells.
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