Relationship Between Ige-Mediated Sensitization To Staphylococcus Aureus Enterotoxin B, Asthma Severity, And Atopy

The superantigenic properties of Staphylococcus aureus enterotoxins (SEs) (S aureus enterotoxins A [SEA], B [SEB], and C [SEC]) and of toxic shock syndrome toxin (TSST-1) considered as a group have been associated with atopic dermatitis [1], chronic rhinosinusitis [2,3], and asthma [2,4]. The presence of serum specific IgE (sIgE) against a mix of SEs (SE-sIgE) has been suggested as an important risk factor for severe asthma in adult asthma patients with poor lung function and eosinophilia [5-7]. However, few studies analyze each SE individually. In particular, the presence of sIgE to SEB (SEBsIgE) has been associated with severe atopic dermatitis [8], although there is still little evidence of an association between SEB-sIgE and asthma [9,10]. The aim of this study was to determine whether the presence of SEB-sIgE is associated with asthma severity, level of control, and atopy in an asthmatic population. A retrospective observational study was conducted among patients aged ≥18 years with a diagnosis of asthma in the Severe Asthma Unit at La Paz University Hospital in Madrid, Spain between 2009 and 2013. Sensitization was defined as SEB-sIgE ≥0.35 kU/L. The local Clinical Research Ethics Committee approved the study protocol (PI-2986). Patients were classified based on asthma severity as per the Spanish Guidelines on the Management of Asthma (GEMA) [11]. Uncontrolled patients were those who experienced exacerbations requiring oral corticosteroids for at least 3 consecutive days or admission to hospital in the year prior to the study [12]. Atopy was determined based on the results obtained with skin prick testing and/or sIgE to common aeroallergens, as follows: pollens (Cupressus arizonica, Platanus acerifolia, Olea europaea, Lolium perenne, Artemisia vulgaris, Salsola kali, Parietaria judaica), house dust mites (Dermatophagoides pteronyssinus, Dermatophagoides farinae), animal dander Manuscript received April 23, 2020; accepted for publication July 25, 2020.