title: IgE-binding components of staphylococcal enterotoxins in patients with atopic dermatitis.
abstract: BACKGROUND
  The exacerbation of atopic dermatitis may be associated with infection of the skin with Staphylococcus aureus (S.aureus). S. aureus isolated from the skin of patients with atopic dermatitis secretes enterotoxin A, B, and toxic shock syndrome toxin 1. This is of interest because these patients may develop specific IgE antibodies against components from staphylococci.
  
  
  OBJECTIVE
  The objective was to demonstrate IgE-sensitization to components of Staphylococcus aureus enterotoxins A and B (purified and partially purified), toxic shock syndrome toxin 1, and the bacterial cell component lipoteichoic acid, in patients with atopic dermatitis.
  
  
  METHODS
  Blood samples from 34 patients with atopic dermatitis and 10 controls were tested by leukocyte histamine release to the enterotoxins and lipoteichoic acid. The toxins were separated by sodium dodecylsulfate polyacrylamide gel electrophoresis and analyzed by IgE-immunoblotting with sera from the same patients.
  
  
  RESULTS
  The majority of patients (96%) with clinical signs of skin infection produced specific IgE-antibodies to all three toxins. Nearly half of the patients produced IgE to enterotoxin A and B. Only 63% of the patients with atopic dermatitis showed cellular response judged by the release of histamine from patient basophils when challenged in vitro with the toxins. This may indicate clinically unimportant sensitization in a number of patients. The immunoblotting revealed that the major allergens of the toxins were 24 and 28 kD proteins. Partially purified toxins showed a higher frequency of leukocyte histamine release responses than purified toxin. The only obvious difference was a difference in the content of pure toxin of the two preparations. Lipoteichoic acid showed nonspecific activity.
  
  
  CONCLUSIONS
  These findings suggest that staphylococcal enterotoxins may act as specific allergens and induce IgE-antibodies to enterotoxins that may exacerbate the skin inflammation in some patients with atopic dermatitis.
authors.affiliation: Laboratory of Medical Allergology, National University Hospital, Copenhagen, Denmark.
authors.forename: D
authors.initials: D
authors.lastname: Nissen
authors.forename: L J
authors.initials: LJ
authors.lastname: Pedersen
authors.forename: P S
authors.initials: PS
authors.lastname: Skov
authors.forename: G L
authors.initials: GL
authors.lastname: Vejlsgaard
authors.forename: L K
authors.initials: LK
authors.lastname: Poulsen
authors.forename: J O
authors.initials: JO
authors.lastname: Jarløv
authors.forename: T
authors.initials: T
authors.lastname: Karlsmark
authors.forename: H
authors.initials: H
authors.lastname: Nolte
mesh_terms: D000485:Allergens / Q000276:immunology; D000918:Antibody Specificity; D001427:Bacterial Toxins; D003876:Dermatitis, Atopic / Q000097:blood*; D004591:Electrophoresis, Polyacrylamide Gel; D004768:Enterotoxins / Q000737:chemistry / Q000276:immunology / Q000378:metabolism*; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology / Q000378:metabolism*; D008297:Male; D011485:Protein Binding; D012967:Sodium Dodecyl Sulfate; D013211:Staphylococcus aureus / Q000276:immunology; D018089:Superantigens / Q000737:chemistry
chemical_list: D000485:Allergens; D001427:Bacterial Toxins; D004768:Enterotoxins; D018089:Superantigens; C030107:enterotoxin F, Staphylococcal; D012967:Sodium Dodecyl Sulfate; D007073:Immunoglobulin E