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

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. and Bachert, C. (2013) Staphylococcus aureus enterotoxin-specific IgE is associated with asthma in the general population: a GA(2) LEN study. Allergy, 68 (10), 1289-1297. (doi:10.1111/all.12230). (PMID:24117882)

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.

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