title: Staphylococcus aureus enterotoxin-specific IgE is associated with asthma in the general population: a GA(2)LEN study.
abstract: BACKGROUND
  Specific IgE to Staphylococcus aureus enterotoxins (SE-IgE) has been associated with asthma. In the general population, we aimed to determine the prevalence of and risk factors for serum SE-IgE and to examine the association with asthma.
  
  
  METHODS
  A postal questionnaire was sent to a random sample of adults in 19 centers across Europe. A random sample of respondents was invited for clinical examination upon which they answered a questionnaire, underwent skin prick tests (SPTs) for common aeroallergens, and provided blood for measurement of total IgE and SE-IgE. Risks were analyzed within centers using weighted logistic regression, and overall estimates calculated using fixed-effects meta-analysis.
  
  
  RESULTS
  2908 subjects were included in this analysis. Prevalence of positive SE-IgE was 29.3%; no significant geographic variation was observed. In contrast to positive skin prick tests, SE-IgE was more common in smokers (<15 pack-year: OR 1.11, P = 0.079, ≥15 pack-year: OR 1.70, P < 0.001), and prevalence did not decrease in older age-groups or in those with many siblings. Total IgE concentrations were higher in those with positive SE-IgE than in those with positive SPT. SE-IgE was associated with asthma (OR 2.10, 95% confidence interval [1.60-2.76], P = 0.001) in a concentration-dependent manner. This effect was independent of SPT result and homogeneous across all centers.
  
  
  CONCLUSIONS
  We report for the first time that SE-IgE is common in the general population throughout Europe and that its risk factors differ from those of IgE against aeroallergens. This is the first study to show that SE-IgE is significantly and independently associated with asthma in the general population.
authors.affiliation: Upper Airways Research Laboratory, Department of Otorhinolaryngology and Head and Neck Surgery, Ghent University, Ghent, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Tomassen
authors.forename: D
authors.initials: D
authors.lastname: Jarvis
authors.forename: R
authors.initials: R
authors.lastname: Newson
authors.forename: R
authors.initials: R
authors.lastname: Van Ree
authors.forename: B
authors.initials: B
authors.lastname: Forsberg
authors.forename: P
authors.initials: P
authors.lastname: Howarth
authors.forename: C
authors.initials: C
authors.lastname: Janson
authors.forename: M L
authors.initials: ML
authors.lastname: Kowalski
authors.forename: U
authors.initials: U
authors.lastname: Krämer
authors.forename: P M
authors.initials: PM
authors.lastname: Matricardi
authors.forename: R J M
authors.initials: RJ
authors.lastname: Middelveld
authors.forename: A
authors.initials: A
authors.lastname: Todo-Bom
authors.forename: E
authors.initials: E
authors.lastname: Toskala
authors.forename: T
authors.initials: T
authors.lastname: Thilsing
authors.forename: G
authors.initials: G
authors.lastname: Brożek
authors.forename: C
authors.initials: C
authors.lastname: Van Drunen
authors.forename: P
authors.initials: P
authors.lastname: Burney
authors.forename: C
authors.initials: C
authors.lastname: Bachert
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000485:Allergens / Q000276:immunology; D000918:Antibody Specificity / Q000276:immunology*; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology*; D004768:Enterotoxins / Q000276:immunology*; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D012882:Skin Tests; D013211:Staphylococcus aureus / Q000276:immunology*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000485:Allergens; D004768:Enterotoxins; D007073:Immunoglobulin E
keywords: IgE; Staphylococcus aureus; asthma; epidemiology; superantigens