Role of staphylococcal superantigen-specific IgE antibodies in aspirin-intolerant asthma

Abstract

IgE antibodies specific for staphylococcal superantigens (SAg) have been implicated in the pathology of several allergic diseases such as rhinosinusitis, nasal polyposis, asthma, and aspirin intolerance. We sought to determine whether SAg-specific IgE levels associate with clinical parameters in patients with aspirin-intolerant asthma (AIA), as compared with patients with aspirin-tolerant asthma (ATA) and nonatopic controls. Eighty patients with AIA, 62 patients with ATA, and 52 normal controls were enrolled in this study. Total serum IgE and IgE specific for staphylococcal enterotoxin A, staphylococcal enterotoxin B, and staphylococcal toxic shock syndrome toxin 1 (TSST-1) were measured using the CAP system (Pharmacia, Uppsala, Sweden). The prevalence of staphylococcal enterotoxin B-specific IgE and TSST-1-specific IgE was significantly higher in the asthma patients than in the healthy controls. The prevalence of SEB-specific IgE was slightly higher in patients with AIA than in those with ATA (22.5% versus 14.5%), although this difference was not statistically significant. No significant difference in staphylococcal enterotoxin A-specific or TSST-1-specific IgE was found between AIA and ATA subjects. Total serum IgE levels were higher in asthma patients with detectable SAg-specific serum IgE than in those without. Airway hyperresponsiveness, as measured by PC20 methacholine, was significantly increased in asthma patients with detectable SAg-specific IgE than in asthma patients without (p = 0.038). There were no significant differences in other clinical parameters between AIA and ATA patients with and without detectable SAg-specific antibody responses. These findings suggest that the staphylococcal SAg may contribute to airway inflammation and the development of airway hyperresponsiveness in asthma.

Clinical Significance of Immunoglobulin E Responses to Staphylococcal Superantigens in Patients with Aspirin-Exacerbated Respiratory Disease

“…A significant negative correlation between the levels of SEA- specific IgE and PC 20 methacholine was found. These data are in agreement with those of other studies, supporting the notion that SAg contributes to increased airway hyperresponsiveness in asthmatic patients [12,23]. In addition, the peripheral eosinophil count was significantly increased in patients with AERD with high specific IgE to SEB.…”

“…In addition, a few reports have demonstrated the presence or increased level of specific IgE to SAg in nasal polyp tissue of patients with aspirin-exacerbated respiratory disease (AERD). However, the presence of serum-specific IgE to SAg and its clinical relevance in patients with AERD has been reported only rarely [12,13,14,15]. Considering that chronic eosinophilic inflammation is a key feature of upper and lower airway inflammation in AERD, we hypothesized that SAg might be relevant to eosinophilic airway inflammation in patients with AERD [16].…”

Matrix Metalloproteinase-9 and Airway Remodeling in Asthma

“…The expression of c-NOS, as well as i-NOS, was noted in epithelium, smooth muscle, and mucous glands of airway mucosa in TDIinduced asthma patients [107]. As for nocturnal asthma, Pham et al recently demonstrated a positive correlation of nocturnal asthma to increased MMP-9 and decreased TIMP-1 at night [108].…”

Forkhead box P3+ T cells express interleukin-17 in nasal mucosa of patients with both allergic rhinitis and polyposis

“…Published studies have noted that staphylococcal enterotoxin B (SEB) has a relation with allergic disorders [11,12]. SEB can induce IL-6 expression in the nasal mucosa [13].…”