{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T10:38:43Z","timestamp":1781174323970,"version":"3.54.1"},"reference-count":40,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2013,11,13]],"date-time":"2013-11-13T00:00:00Z","timestamp":1384300800000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microbiology and Immunology"],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:label\/><jats:p>Since 1992, many neonates in neonatal intensive care units in Japan have been developing fever and systemic exanthema. Immunological analyses of neonates with these symptoms has revealed that the bacterial superantigen, toxic shock syndrome toxin\u20101 (TSST\u20101) is the cause. The name neonatal TSS\u2010like exanthematous disease (NTED) has been applied to this condition. The most striking clinical finding has been that none of the term neonates have developed shock or died of NTED. The timing of NTED epidemics has coincided with the spread of emerging TSST\u20101\u2010producing methicillin\u2010resistant <jats:italic>Staphylococcus aureus<\/jats:italic> clones in Japan. The low frequency of pregnant women with positive anti\u2010TSST\u20101 antibody titers could be one reason for the spread of NTED in Japan. Neonates have immune tolerance against TSST\u20101 and may actively suppress the immune response to NTED with interleukin\u201010. According to the T cell responses in infants or young children with diseases induced by TSST\u20101, the pathophysiology of TSST\u20101\u2010related diseases may be age\u2010dependent. The precise mechanism of anergy and deletion of specific T cells stimulated with TSST\u20101 should be investigated in neonates infected with NTED. Both NTED and TSS might provide good models for analyzing the mechanism(s) of neonatal immune tolerance and the age\u2010dependence of human immunity. This disease has not only become representative of diseases caused by superantigens, but has also yielded a considerable amount of evidence about human immune reactions against superantigens.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1348-0421.12094","type":"journal-article","created":{"date-parts":[[2013,9,3]],"date-time":"2013-09-03T12:59:23Z","timestamp":1378213163000},"page":"737-745","source":"Crossref","is-referenced-by-count":9,"title":["Overall picture of an emerging neonatal infectious disease induced by a superantigenic exotoxin mainly produced by methicillin\u2010resistant <i>Staphylococcus aureus<\/i>"],"prefix":"10.1111","volume":"57","author":[{"given":"Naoto","family":"Takahashi","sequence":"first","affiliation":[{"name":"Department of Pediatrics The University of Tokyo Hospital Bunkyo\u2010ku, Tokyo 113\u20108655 Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken'ichi","family":"Imanishi","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology Tokyo Women's Medical University Shinjuku\u2010ku, Tokyo 162\u20108666 Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takehiko","family":"Uchiyama","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology Tokyo Women's Medical University Shinjuku\u2010ku, Tokyo 162\u20108666 Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,11,13]]},"reference":[{"key":"e_1_2_15_2_1","first-page":"371","article-title":"A new exanthematous disease in newborn infants","volume":"31","author":"Takahashi N.","year":"1995","journal-title":"Acta Neonat Jpn"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/fn.77.1.F77d"},{"key":"e_1_2_15_4_1","first-page":"146","article-title":"Exanthema of the newborn related to toxic shock syndrome toxin\u20101 (TSST\u20101)","volume":"7","author":"Sakata Y.","year":"1997","journal-title":"Jpn J Obstet Gynecol Neonat Hematol"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0065-2776(08)60534-9"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1348-0421.1994.tb01772.x"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-012088445-2\/50055-X"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(78)92274-2"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(81)92186-3"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/143.4.509"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0092-8674(89)90980-X"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)11125-4"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.41.10.4883-4884.2003"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1348-0421.2002.tb02696.x"},{"key":"e_1_2_15_15_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1442-200X.2003.01703.x"},{"key":"e_1_2_15_16_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.2524876"},{"key":"e_1_2_15_17_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.86.22.8941"},{"key":"e_1_2_15_18_1","doi-asserted-by":"crossref","first-page":"5213","DOI":"10.4049\/jimmunol.155.11.5213","article-title":"Evidence for immunologic immaturity of cord blood T cells. 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