In toxic shock syndrome, which cytokine is primarily involved?

Toxic shock syndrome (TSS) is a severe condition often associated with bacterial infections, particularly from Staphylococcus aureus and Streptococcus pyogenes. The condition is characterized by a strong immune response, and the primary cytokine implicated in this process is tumor necrosis factor-alpha (TNF-alpha).

TNF-alpha is a potent pro-inflammatory cytokine that plays a critical role in the pathology of TSS. It is released in response to the toxins produced by the bacteria, leading to systemic inflammation, increased vascular permeability, and subsequent multi-organ dysfunction. The levels of TNF-alpha can lead to the clinical manifestations seen in TSS, such as fever, rash, and hypotension.

In contrast, while other cytokines, such as interleukin-6 (IL-6) and interferon-gamma (IFN-gamma), participate in the immune response and inflammation, they do not play as central a role in TSS as TNF-alpha. IL-10, known for its anti-inflammatory properties, is involved in limiting the immune response and would not be primarily responsible for the severe inflammatory response seen in TSS.