Scratching beneath the surface: the Pathogenic Role of Staphylococcal Superantigens in Atopic Dermatitis

Abstract

Atopic dermatitis (AD) is a chronic, highly pruritic, multifactorial and relapsing inflammatory skin disease, affecting 10-20% of all children worldwide. It commonly presents during early infancy and childhood but can persist or even start in adulthood, making it one of the most common skin diseases in adults as well. Over 90% of all AD patients are colonized by Staphylococcus aureus and up to 80% of S. aureus strains isolated from AD patients secrete SAg. Both the colonization and secretion of SAg are important trigger factors in AD and associate with disease aggravation. This review focuses on the pathogenic role of the bacterium Staphylococcus aureus in AD and covers more specifically all aspects of Staphylococcal superantigens in their contribution to AD. It also touches upon the potential of neutralizing superantigen-specific VHHs as novel therapy for (a subgroup of) AD patients.