Prevalence and role of serum IgE antibodies to the Staphylococcus aureus-derived superantigens SEA and SEB in children with atopic dermatitis.
BACKGROUND
The skin of patients with atopic dermatitis exhibits a striking susceptibility to colonization and infection with Staphylococcus aureus. In this context it has been previously shown that S aureus-derived superantigens could function as classic allergens, inducing production of functionally relevant specific IgE antibodies.


OBJECTIVE
The aim of this study was to determine the prevalence and the role of circulating staphylococcal enterotoxin A (SEA)- and staphylococcal enterotoxin B (SEB)-specific IgE antibodies in children with atopic dermatitis.


METHODS
In a cross-sectional study of 58 children with atopic dermatitis, the presence of IgE antibodies to SEA and SEB was correlated with the severity of the disease and the total and other unrelated allergen-specific IgE titers and density of colonization with S aureus strains on atopic skin and episodes of superficial S aureus skin infections.


RESULTS
Twenty of 58 children (34%) were sensitized to superantigens (45% to SEB, 10% to SEA, 45% to SEA and SEB). In this group, severity of atopic dermatitis and levels of specific IgE to food and air allergens were significantly higher. The degree of disease severity correlated to a higher extent with the presence of SEA/SEB-specific antibodies than with total serum IgE levels. Density of colonization with superantigen-secreting S aureus strains was higher in the superantigen IgE-positive group. Sixty-three percent of these children experienced repeated episodes of superficialS aureus skin infections.


CONCLUSIONS
Sensitization to S aureus-derived superantigens may be involved in disease exacerbation. The presence of SEA/SEB-specific antibodies had additional explanatory value for disease severity and therefore may be helpful in the characterization of children with severe atopic dermatitis.
Bunikowski
R
R
Department of Pediatrics, Charité Campus Virchow-Klinikum, Humboldt University, Berlin, Germany.
Mielke
M
M
Skarabis
H
H
Herz
U
U
Bergmann
R L
RL
Wahn
U
U
Renz
H
H
D000293:Adolescent; D000888:Antibodies, Anti-Idiotypic / Q000097:blood*; D000907:Antibodies, Bacterial / Q000097:blood*; D000918:Antibody Specificity; D002648:Child; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000453:epidemiology* / Q000276:immunology*; D005098:Exotoxins / Q000276:immunology; D005260:Female; D006801:Humans; D007114:Immunization; D007073:Immunoglobulin E / Q000097:blood; D007223:Infant; D008297:Male; D015995:Prevalence; D012867:Skin / Q000276:immunology / Q000382:microbiology; D013203:Staphylococcal Infections / Q000276:immunology; D013211:Staphylococcus aureus / Q000276:immunology*; D018089:Superantigens / Q000097:blood
D000888:Antibodies, Anti-Idiotypic; D000907:Antibodies, Bacterial; D005098:Exotoxins; D018089:Superantigens; C026408:anti-IgE antibodies; D007073:Immunoglobulin E