Superantigene sind bakterielle oder virale Proteine, die T-Lymphozyten oligoklonal aktivieren. Dabei reagieren je nach Superantigen bis zu 25% aller T-Zellen gleichzeitig. Diese massive T-Zell-Aktivierung führt zu einer fulminanten Zyto-kinfreisetzung aus T-Zellen (z.B. TNF, IFN-γ, IL-2), die einen tödlichen Schock auslösen kann. Wie beim endotoxininduzier-ten Schock spielt dabei TNF eine Schlüsselrolle. Nach der initialen Überreaktion beobachtet man später verschiedene Formen der Immunparalyse, die T-Zellen und antigenpräsentie-rende Zellen einschlieβt. Pathogene grampositive Bakterien (Staphylococcus aureus, Streptococcus pyogenes) produzieren häufíg Superantigene, die möglicherweise einen Induktor zur Auslösung einer grampositiven Sepsis darstellen.

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