title: Increased levels of serum-specific immunoglobulin e to staphylococcal enterotoxin a and B in patients with allergic rhinitis and bronchial asthma.
abstract: BACKGROUND
  The association between staphylococcal enterotoxins and atopic dermatitis (AD) is well characterized. We aim to evaluate the association between sensitization to staphylococcal enterotoxin A (SEA) and/or B (SEB) and the development of allergic airway disease.
  
  
  METHODS
  Two hundred and seventy-four patients were grouped into allergic rhinitis (AR) and/or bronchial asthma (BA) only, AD only and AR/BA+AD. The AR/BA only group was further divided into AR only, AR and airway hyperresponsiveness (AR+AHR) and BA. The allergen-specific and total immunoglobulin E (IgE) antibodies were determined by the CAP system. The associations of sensitization to SEA/SEB with allergic airway disease were analyzed by logistic regression analysis.
  
  
  RESULTS
  The overall rate of sensitization to SEA/SEB was 25.7%, whereas the rate of the AD only group (45.5%) was significantly higher than that of the AR/BA only group (24.5%, chi2=8.1). After sensitization to SEA/SEB, the geometric mean total IgE levels were significantly elevated in patients with AR+AHR and BA, but not in those with AR only. BA patients had higher geometric mean values of SEA- and SEB-specific IgE than AR only and AR+AHR patients. Logistic regression revealed that AR/BA only was more associated with sensitization to SEA/SEB (odds ratio 6.57) than AD only and AR/BA+AD (odds ratio 2.44 and 1.72).
  
  
  CONCLUSIONS
  Atopic status after sensitization to SEA/SEB was more closely associated with BA than with other airway allergy, implying that SEA/SEB may play a role in exacerbating airway allergy and increasing the risk of allergic airway disease. Our study suggests that staphylococcal enterotoxins play a prominent role in the pathogenesis of allergic airway disease as well as AD.
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan, ROC.
authors.forename: Jyh-Hong
authors.initials: JH
authors.lastname: Lee
authors.forename: Yu-Tsan
authors.initials: YT
authors.lastname: Lin
authors.forename: Yao-Hsu
authors.initials: YH
authors.lastname: Yang
authors.forename: Li-Chieh
authors.initials: LC
authors.lastname: Wang
authors.forename: Bor-Luen
authors.initials: BL
authors.lastname: Chiang
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D039741:Antigens, Dermatophagoides / Q000276:immunology; D001249:Asthma / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000276:immunology; D004768:Enterotoxins / Q000276:immunology*; D005260:Female; D006801:Humans; D007114:Immunization; D007073:Immunoglobulin E / Q000097:blood* / Q000276:immunology; D008297:Male; D012221:Rhinitis, Allergic, Perennial / Q000276:immunology*; D012737:Sex Factors; D018709:Statistics, Nonparametric
chemical_list: D039741:Antigens, Dermatophagoides; D004768:Enterotoxins; C026066:enterotoxin A, Staphylococcal; D007073:Immunoglobulin E; C031818:enterotoxin B, staphylococcal