Specific IgE against Staphylococcus aureus enterotoxins: An independent risk factor for asthma - 30/07/12
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, Kristel van Steen, PhD b, c, e, Nan Zhang, MD a, Gabriele Holtappels a, Tom Cattaert, PhD b, c, Bärbel Maus, PhD b, c, e, Roland Buhl, MD, PhD d, Christian Taube, MD, PhD d, i, Stephanie Korn, MD d, Marek Kowalski, MD f, Jean Bousquet, MD, PhD g, Peter Howarth, MD hCorresponding author: Claus Bachert, MD, PhD, Upper Airway Research Laboratory (URL), Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.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.
Le texte complet de cet article est disponible en PDF.Key words : Asthma, asthma severity, hospitalizations, FEV1, IgE, Staphylococcus aureus, enterotoxins, superantigens
Abbreviations used : BMI, ECP, GP, HDM, OR, SE, tIgE
Plan
| Supported by grants to C.B. from the Flemish Scientific Research Board, FWO, nos. A12/5-HB-KH3 and G.0436.04, and the Interuniversity Attraction Poles Programme (IUAP), Belgian state, Belgian Science Policy P6/35, and to P.H. from the UK Medical Research Council, G0800649 (Wessex Severe Asthma Cohort), and by the Global Allergy and Asthma European Network (GA²LEN). T.C. is a Postdoctoral Researcher of the Fonds de la Recherche Scientifique (FNRS). T.C. and K.S. acknowledge research support by the Belgian Network BioMAGNet (Bioinformatics and Modelling: from Genomes to Networks), funded by the Interuniversity Attraction Poles Programme (Phase VI/4), and by the IST Programme of the European Community under the PASCAL2 Network of Excellence (Pattern Analysis, Statistical Modelling and Computational Learning), IST-2007-216886. |
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| Disclosure of potential conflict of interest: J. Bousquet has received honoraria from Stallergenes, Actelion, Almirall, AstraZeneca, Chiesi, GlaxoSmithKline, Merck, Novartis, OM Pharma, Sanofi, Teva, and Uriach. The rest of the authors declare that they have no relevant conflicts of interest. |
Vol 130 - N° 2
P. 376 - août 2012 Retour au numéro
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