title: Staphylococcal enterotoxin B induces specific IgG4 and IgE antibody serum levels in atopic dermatitis.
abstract: BACKGROUND
  Atopic dermatitis (AD) is a chronic recurrent inflammatory disease, with prevalence of about 10-20% in children and 1-3% in adults. Staphylococcus aureus is present in 80-100% of skin from atopic patients and is related to worsening of the disease by the action of enterotoxins. The aim of this study was to evaluate the profile of anti-Staphylococcus aureus enterotoxin B (SEB) antibody isotypes and IgG subclass levels in adult AD.
  
  
  METHODS
  We selected 38 patients with AD, diagnosed by Hanifin and Rajka's criteria, aged between 18 and 65, and 26 healthy controls (HC). The severity of the disease was established according to the Eczema Area and Severity Index and patients graded as mild (28%), moderate (58%), and severe (14%). Sera were assessed for IgG subclasses, IgA, IgM, and IgE against SEB by ELISA.
  
  
  RESULTS
  Elevated circulating IgE and IgG4 anti-SEB antibody levels associated with decreased IgA and IgM levels were detected in patients with AD, when compared to HC individuals. The severity of AD was related to low IgG1 and IgG3 levels and a high IgE antibody response to SEB. Interestingly, absence of IgG4 response to SEB was lower in patients with AD (2.63%), when compared to controls (34.6%), while a similar absence was detected for IgG1 and IgE antibodies (AD, 23.3 and 18.4% vs. HC, 38.5 and 19.2%).
  
  
  CONCLUSIONS
  Our findings evidenced a contributing role for IgG4 and IgE antibodies in AD pathogenesis, which are triggered by staphylococcal superantigens.
authors.affiliation: Department of Dermatology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
authors.forename: Raquel L
authors.initials: RL
authors.lastname: Orfali
authors.affiliation: Laboratory of Medical Investigation in Dermatology and Immunodeficiency, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
authors.forename: Maria N
authors.initials: MN
authors.lastname: Sato
authors.affiliation: Laboratory of Medical Investigation in Dermatology and Immunodeficiency, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
authors.forename: Vanessa G
authors.initials: VG
authors.lastname: Santos
authors.affiliation: Laboratory of Medical Investigation in Dermatology and Immunodeficiency, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
authors.forename: Tiago O
authors.initials: TO
authors.lastname: Titz
authors.affiliation: Laboratory of Medical Investigation in Dermatology and Immunodeficiency, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
authors.forename: Cyro A
authors.initials: CA
authors.lastname: Brito
authors.affiliation: Laboratory of Medical Investigation in Dermatology and Immunodeficiency, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
authors.forename: Alberto J S
authors.initials: AJ
authors.lastname: Duarte
authors.affiliation: Department of Dermatology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
authors.forename: Roberto
authors.initials: R
authors.lastname: Takaoka
authors.affiliation: Department of Dermatology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
authors.forename: Valéria
authors.initials: V
authors.lastname: Aoki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003876:Dermatitis, Atopic / Q000276:immunology*; D004768:Enterotoxins / Q000276:immunology*; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007073:Immunoglobulin E / Q000097:blood*; D007074:Immunoglobulin G / Q000097:blood*; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013211:Staphylococcus aureus; D055815:Young Adult
chemical_list: D004768:Enterotoxins; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D007073:Immunoglobulin E; C031818:enterotoxin B, staphylococcal