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Specific IgE against Staphylococcus aureus enterotoxins: an independent risk factor for asthma

Claus Bachert UGent, Kristel Van Steen UGent, Nan Zhang UGent, Gabriële Holtappels UGent, Tom Cattaert, Bärbel Maus, Roland Buhl, Christian Taube, Stephanie Korn and Marek Kowalski, et al. (2012) JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. 130(2). p.376-381
abstract
Background: The role of IgE in patients with severe asthma is not fully understood. Objective: We sought to investigate whether IgE to Staphylococcus aureus enterotoxins might be relevant to disease severity in adult asthmatic patients. Methods: Specific IgE antibody concentrations in serum against enterotoxins, grass pollen (GP), and house dust mite allergens and total IgE levels were measured in adult cohorts of 69 control subjects, 152 patients with nonsevere asthma, and 166 patients with severe asthma. Severe asthma was defined as inadequately controlled disease despite high-dose inhaled corticosteroids plus at least 2 other controller therapies, including oral steroids. Results: Enterotoxin IgE positivity was significantly greater in patients with severe asthma (59.6%) than in healthy control subjects (13%, P < .001). Twenty-one percent of patients with severe asthma with enterotoxin IgE were considered nonatopic. Logistic regression analyses demonstrated significantly increased risks for enterotoxin IgE-positive subjects to have any asthma (OR, 7.25; 95% CI, 2.7-19.1) or severe asthma (OR, 11.09; 95% CI, 4.1-29.6) versus enterotoxin IgE-negative subjects. The presence of GP or house dust mite IgE antibodies was not associated with either significantly increased risk for asthma or severity. Oral steroid use and hospitalizations were significantly increased in patients with enterotoxin IgE and nonatopic asthma. GP IgE was associated with a higher FEV1 percent predicted value, and enterotoxin IgE was associated with a lower FEV1 percent predicted value. Conclusions: Staphylococcal enterotoxin IgE antibodies, but not IgE against inhalant allergens, are risk factors for asthma severity. We hypothesize that the presence of enterotoxin IgE in serum indicates the involvement of staphylococcal superantigens in the pathophysiology of patients with severe asthma.
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author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
ATOPIC-DERMATITIS, NASAL POLYPOSIS, RESEARCH-PROGRAM, T-CELLS, SENSITIZATION, SUPERANTIGENS, INFLAMMATION, PHENOTYPE, SEVERITY, EXPOSURE, asthma severity, hospitalizations, FEV1, IgE, superantigens, Staphylococcus aureus, Asthma, enterotoxins
journal title
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
J. Allergy Clin. Immunol.
volume
130
issue
2
pages
376 - 381
Web of Science type
Article
Web of Science id
000307002200016
JCR category
ALLERGY
JCR impact factor
12.047 (2012)
JCR rank
1/23 (2012)
JCR quartile
1 (2012)
ISSN
0091-6749
DOI
10.1016/j.jaci.2012.05.012
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
3022401
handle
http://hdl.handle.net/1854/LU-3022401
date created
2012-10-11 11:29:34
date last changed
2012-10-12 13:49:28
@article{3022401,
  abstract     = {Background: The role of IgE in patients with severe asthma is not fully understood. 
Objective: We sought to investigate whether IgE to Staphylococcus aureus enterotoxins might be relevant to disease severity in adult asthmatic patients. 
Methods: Specific IgE antibody concentrations in serum against enterotoxins, grass pollen (GP), and house dust mite allergens and total IgE levels were measured in adult cohorts of 69 control subjects, 152 patients with nonsevere asthma, and 166 patients with severe asthma. Severe asthma was defined as inadequately controlled disease despite high-dose inhaled corticosteroids plus at least 2 other controller therapies, including oral steroids. 
Results: Enterotoxin IgE positivity was significantly greater in patients with severe asthma (59.6\%) than in healthy control subjects (13\%, P {\textlangle} .001). Twenty-one percent of patients with severe asthma with enterotoxin IgE were considered nonatopic. Logistic regression analyses demonstrated significantly increased risks for enterotoxin IgE-positive subjects to have any asthma (OR, 7.25; 95\% CI, 2.7-19.1) or severe asthma (OR, 11.09; 95\% CI, 4.1-29.6) versus enterotoxin IgE-negative subjects. The presence of GP or house dust mite IgE antibodies was not associated with either significantly increased risk for asthma or severity. Oral steroid use and hospitalizations were significantly increased in patients with enterotoxin IgE and nonatopic asthma. GP IgE was associated with a higher FEV1 percent predicted value, and enterotoxin IgE was associated with a lower FEV1 percent predicted value. 
Conclusions: Staphylococcal enterotoxin IgE antibodies, but not IgE against inhalant allergens, are risk factors for asthma severity. We hypothesize that the presence of enterotoxin IgE in serum indicates the involvement of staphylococcal superantigens in the pathophysiology of patients with severe asthma.},
  author       = {Bachert, Claus and Van Steen, Kristel and Zhang, Nan and Holtappels, Gabri{\"e}le and Cattaert, Tom and Maus, B{\"a}rbel and Buhl, Roland and Taube, Christian and Korn, Stephanie and Kowalski, Marek and Bousquet, Jean and Howarth, Peter},
  issn         = {0091-6749},
  journal      = {JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY},
  keyword      = {ATOPIC-DERMATITIS,NASAL POLYPOSIS,RESEARCH-PROGRAM,T-CELLS,SENSITIZATION,SUPERANTIGENS,INFLAMMATION,PHENOTYPE,SEVERITY,EXPOSURE,asthma severity,hospitalizations,FEV1,IgE,superantigens,Staphylococcus aureus,Asthma,enterotoxins},
  language     = {eng},
  number       = {2},
  pages        = {376--381},
  title        = {Specific IgE against Staphylococcus aureus enterotoxins: an independent risk factor for asthma},
  url          = {http://dx.doi.org/10.1016/j.jaci.2012.05.012},
  volume       = {130},
  year         = {2012},
}

Chicago
Bachert, Claus, Kristel Van Steen, Nan Zhang, Gabriële Holtappels, Tom Cattaert, Bärbel Maus, Roland Buhl, et al. 2012. “Specific IgE Against Staphylococcus Aureus Enterotoxins: An Independent Risk Factor for Asthma.” Journal of Allergy and Clinical Immunology 130 (2): 376–381.
APA
Bachert, C., Van Steen, K., Zhang, N., Holtappels, G., Cattaert, T., Maus, B., Buhl, R., et al. (2012). Specific IgE against Staphylococcus aureus enterotoxins: an independent risk factor for asthma. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 130(2), 376–381.
Vancouver
1.
Bachert C, Van Steen K, Zhang N, Holtappels G, Cattaert T, Maus B, et al. Specific IgE against Staphylococcus aureus enterotoxins: an independent risk factor for asthma. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. 2012;130(2):376–81.
MLA
Bachert, Claus, Kristel Van Steen, Nan Zhang, et al. “Specific IgE Against Staphylococcus Aureus Enterotoxins: An Independent Risk Factor for Asthma.” JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY 130.2 (2012): 376–381. Print.