Bacterial superantigens: provocateurs of gut dysfunction and inflammation?

Inflammatory bowel diseases (IBDs) are chronic debilitating conditions, which impair the patient's quality of life significantly. Among them, Crohn's disease and ulcerative colitis are idiopathic disorders for which an infective etiology has long been sought. Here, we present an opinion in support of the hypothesis that bacterial superantigens can participate in the initiation, exaggeration or reactivation of enteric inflammatory disease, at least in some patients. Although the identification of a specific pathogen responsible for IBD remains a worthy pursuit, an awareness of the response to bacterial products per se will be of value in providing a comprehensive understanding of enteric pathophysiological mechanisms and their potential role in IBDs.