[Proceedings: Mitral valve replacement in severe hemolytic anemia after an open commissurotomy].
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Biomedical subjects
Publications and source records attributed to S Sakurai.
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Four strains of Staphylococcus aureus of a phage type other than the second group, isolated from patients with impetigo and Ritter's disease, were found to produce an exotoxin similar to those reported by Melish et al. (1972), Kapral and Miller (1971), and Arbuthnott et al. (1973). This toxin could elicit a general exfoliation of the epidermis with the so-called Nikolsky sign when subcutaneously inoculated into neonatal mice within 4 days after birth. The new toxin was serologically different from exfoliatin produced by the phage group II staphylococci previously reported (Kondo et al., 1973) and showed an electrophoretic pattern corresponding to that of the B-type toxin of the latter in acrylamide disc electrophoresis. It had the same molecular weight as that of the latter, which was estimated to be about 24,000. It was thermolabile and lost its toxic activity by heating at 60 C for 30 min; in addition, most of the toxicity was lost within 1 month of storage even at -30 C. We propose to designate the old typical heat-stable exfoliatin as S. aureus exfoliatin A and the new heat-susceptible exfoliatin as S. aureus exfoliatin B.
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An effective method for the isolation and purification of exfoliatin which has been recently reported by Melish and others as the staphylococcal toxin responsible for the scalded skin syndrome and the physicochemical properties of the purified toxin were described. From an active crude toxin produced by one of the clinical isolates of phage group 2, four types of toxic proteins which were all capable of causing the typical Nikolsky sign in neonatal mice were obtained and designated A, B, C, and D toxins. They had a molecular weight of about 24,000 and showed the same serological features in neutralization and precipitation tests, but were different from each other in showing a different single band with their respective mobilities in polyacrylamide disk electrophoresis. They were precipitated between pH 4.0 and 4.5 and lost their exfoliative capabilities. The resulting precipitates, however, could be solubilized in acetate buffer containing 0.5% sodium dodecyl sulfate, restoring their toxicities to almost the same extent as before. They were all stable when heated at 60 C for 60 min and at 100 C for 20 min, but lost their toxicities when heated at 100 C for 40 min. Additionally, the present authors observed that some staphylococcal strains not belonging to the typical phage group 2, isolated from patients with the scalded skin syndrome, were also capable of producing a similar but serologically unrelated exfoliative toxin.
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