Staphylococcus aureus enterotoxin-specific IgE is associated with asthma in the general population: a GA(2)LEN study

• Published in: Allergy (Copenhagen) Vol. 68; no. 10; p. 1289
• Main Authors: Tomassen, P, Jarvis, D, Newson, R, Van Ree, R, Forsberg, B, Howarth, P, Janson, C, Kowalski, M L, Krämer, U, Matricardi, P M, Middelveld, R J M, Todo-Bom, A, Toskala, E, Thilsing, T, Brożek, G, Van Drunen, C, Burney, P, Bachert, C
• Format: Journal Article
• Language: English
• Published: Denmark 01.10.2013
• Subjects: Adolescent; Adult; Aged; Allergens - immunology; Antibody Specificity - immunology; asthma; Asthma - diagnosis; Asthma - epidemiology; Asthma - immunology; Enterotoxins - immunology; epidemiology; Female; Humans; IgE; Immunoglobulin E - immunology; Male; Middle Aged; Odds Ratio; Population Surveillance; Prevalence; Risk Factors; Skin Tests; Staphylococcus aureus; Staphylococcus aureus - immunology; superantigens; Surveys and Questionnaires; Young Adult; epidemiology; asthma; IgE; Staphylococcus aureus; superantigens
• ISSN: 1398-9995; 0105-4538; 1398-9995
• DOI: 10.1111/all.12230

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. 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. 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. 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.