Superantigens and Allergic Disease

We are still in the early phases of a new era of investigation into the immunopathogenesis and treatment for chronic inflammatory diseases. Understanding of the interfaces between microbes and chronic inflammatory diseases promises to be a fruitful avenue for continued investigation. Since the landmark discovery of the superantigen concept in 1989 [1], our understanding of the potential biological roles of superantigens has expanded from acute intoxication into chronic inflammation, including a possible role in autoimmune diseases. Multiple lines of evidence now support a central role for S. aureus superantigens in the immunopathogenesis of AD since the initial observations were made in 1993 [58, 61]. Since the seminal work in 2001 identifying S. aureus superantigens as likely operatives in CRS [84], S. aureus has continued to be the primary choice for superantigen research in CRS, asthma, and AD. However, as predicted in the “superantigen hypothesis” published in 2001 [7], not only S. aureus, but additional microbes with superantigenic potential will likely be a focus of future investigations into the immunopathogenesis of chronic inflammatory respiratory tract diseases, as well as other chronic inflammatory diseases, including a possible role for the intriguing human endogenous retroviruses (HERVs). Armed with a better understanding of their immunopathogenesis, all of these potentially interrelated inflammatory diseases should ultimately be curable.