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You are here: Home / Teams / Vandenesch F - Stapath / Projects / Pathogenesis of menstrual Toxic Shock Syndrome

Pathogenesis of menstrual Toxic Shock Syndrome

Led by G. Lina (PU-PH) with contribution of A. Tristan (MCU-PH) and assistance of Cedric Badiou (engineer) in collaboration with C. Pringent- Combaret and D. Muller from UMR CNRS 5557 Ecologie Microbienne, Université Lyon 1, France, V. Brun from the Unité de Biologie à Grande Echelle, CEA, Grenoble, and W. Van Wamel from the Medical Microbiology and Infectious Diseases Department, Erasmus MC, Rotterdam, The Netherlands

TSS is a rare life-threatening infectious disease associated with use of intra-vaginal protection1. The colonizing S. aureus strain uses catamenial products absorbed in the tampon as a growth medium for its proliferation2.  When S. aureus reaches a certain concentration, S. aureus produces TSST-1, which gains access from the vagina to the bloodstream and induce the systemic illness in non-immunized women against TSST-13,4. Although, 70% of women in Western world use tampons and 4% of women has vaginal colonization by S. aureus producing TSST-15 and 10% are no immunized against TSST-1, the estimated rate of mTSS is only 1/100,000 per year. Thus, only a very small proportion of women at risk develops mTSS, questioning factors that may trigger and/or protect against mTSS5. The objectives of our projects will be to identify the mechanisms by which environmental and host factors influence S. aureus TSST-1+ pathogenicity in mTSS by (i) quantification of S. aureus toxins/enzymes and corresponding antibodies in menstrual fluids from healthy women to that of patients with mTSS by mass spectrometry, RNAseq and Luminex anaysis; (ii) Characterization of TSST-1 trans-vaginal epithelial passage by using human cellular, artificial tissue models and vaginal explants; (iii) determine at risk-practice for the women by large cases controls study.

1- Shands KN, Schmid GP, Dan BB, Blum D, Guidotti RJ, Hargrett NT, Anderson RL, Hill DL, Broome CV, Band JD, Fraser DW. Toxic-shock syndrome in menstruating women: association with tampon use and Staphylococcus aureus and clinical features in 52 cases. N Engl J Med. 1980;303:1436-42.

2- Melish ME, Murata S, Fukunaga,C, Frogner K, McKissick C. Rev Infect Dis. 1989;1 Suppl 1:S238-46.

3- Sarafian SK, Morse, SA. J Med Microbiol. 1987;24:75-8.

4- Davis CC, Kremer MJ, Schlievert PM. Am J Obset Gynecol. 2003;189:1785-91.

5- Jacquemond I, Muggeo A, Lamblin G, Tristan A, Gillet Y, Bolze PA, Bes M, Gustave CA, Rasigade JP, Golfier F, Ferry T, Dubost A, Abrouk D, Barreto S, Prigent-Combaret C, Thioulouse J, Lina G, Muller D. Sci Rep. 2018;8:9942.

Other team publications on the thematic:

Chiaruzzi M, Barbry A, Muggeo A, Tristan A, Jacquemond I, Badiou C, Cluzeau L, Bourdeau S, Durand T, Engelmann A, Bosquet D, Bes M, Prigent-Combaret C, Thioulouse J, Muller D, Lina G. Vaginal Tampon Colonization by Staphylococcus aureus in Healthy Women. Appl Environ Microbiol. 2020 Sep 1;86(18):e01249-20. doi: 10.1128/AEM.01249-20. Print 2020 Sep 1.

Billon A, Gustin MP, Tristan A, BŽnet T, Berthiller J, Gustave CA, Vanhems P, Lina G. Association of characteristics of tampon use with menstrual toxic shock syndrome in France. EClinicalMedicine. 2020 Mar 10;21:100308. doi: 10.1016/j.eclinm.2020.100308. eCollection 2020 Apr. 

Nonfoux L, Chiaruzzi M, Badiou C, Baude J, Tristan A, Thioulouse J, Muller D, Prigent-Combaret C, Lina G. Impact of Currently Marketed Tampons and Menstrual Cups on Staphylococcus aureus Growth and Toxic Shock Syndrome Toxin 1 Production In Vitro. Appl Environ Microbiol. 2018 May 31;84(12):e00351-18. doi: 10.1128/AEM.00351-18. Print 2018 Jun 15.