[Use of cultured epidermis of human origin for demonstrating the acantholytic action of staphylococcal exfoliatin A].

Cultured human epithelia obtained from epidermal cells in vitro were used to assay the activity of staphylococcal epidermolytic toxin and develop an in vitro experimental model for the staphylococcal scalded skin syndrome. Human epidermal cells were grown from single epidermal cell suspensions obtained through trypsinization of adult normal skin into multilayered epithelia (with a basal cell layer, several intermediate and one or two upper layers) on mouse 3T3 feeder cells. First passage cultures were incubated with exfoliative toxin A from phage Group II staphylococci at various concentrations in DMEM. They were examined at various time intervals by direct microscopic and histological examination of respectively the culture plates or the epidermal sheets after their detachment from the plates with dispase grad II. A total exfoliation could be obtained at 24 hour at concentrations of Img and 500 micrograms/ml, only local areas of epidermolysis noted at 100 micrograms/ml. The intraepithelial separation was noted to occur between the basal layer and the lowest intermediate layer. No exfoliation could be observed at lower concentrations. Up to 4-5 hours few changes were evident, but at this time small areas of epidermolysis developed. With exfoliatin 100 micrograms/ml, intraepidermal blisters were clearly visible, occurring either between the basal cells and the lowest intermediate layer or between the first two intermediate cell layers. At the ultrastructural level, desmosomes were sparse and altered, with enlargement of the intercellular spaces and condensation of tonofilaments. These data indicate that human epidermal cell cultures, although their differentiation in culture only mimics what occurs in vivo, can be used as an in vitro model of the staphylococcal TEN to further investigate the site of action of such a toxin and the cellular mechanism responsible for the syndrome.