J Korean Med Sci.  2008 Oct;23(5):845-851. 10.3346/jkms.2008.23.5.845.

Association of Specific IgE to Staphylococcal Superantigens with the Phenotype of Chronic Urticaria

• Ye YM
• Hur GY
• Park HJ
• Kim SH
• Kim HM
• Park HS

• KMID: 1783071
• DOI: http://doi.org/10.3346/jkms.2008.23.5.845

Abstract

It has been well established that bacterial superantigens lead to the induction and aggravation of chronic inflammatory skin diseases. We investigated the clinical significance of serum specific immunoglobulin E (lgE) to the staphylococcal superantigens staphylococcal enterotoxin A (SEA), staphylococcal enterotoxin B (SEB), and toxic shock syndrome toxin (TSST)-1 in patients with chronic urticaria (CU), focusing on the differences in these prevalences between aspirin-intolerant CU (AICU) and aspirin-tolerant CU (ATCU) patients. Aspirin sensitivity was confirmed by oral aspirin provocation test. There were 66 patients AICU and 117 patients ATCU in the study. Serum IgE antibodies specific for SEA, SEB, and TSST-1 were measured by the ImmunoCAP test and the patients were compared with 93 normal controls (NC). The prevalences of serum specific IgE to staphylococcal superantigens were significantly higher in CU than in NC patients (IgE to SEA, 13.7% vs. 5.4%; IgE to SEB, 12.0% vs. 4.3%; IgE to TSST-1, 18.0% vs. 6.5%; p<0.05, respectively). The patients with specific IgE to SEA, SEB, and TSST-1 had higher serum total IgE levels and higher rates of atopy. Significant associations were noted between the prevalence of specific IgE to SEA and SEB and the HLA DQB1*0609 and DRB1*1302 alleles in the AICU group. We confirmed that a sub-population of patients with CU possesses serum IgE antibodies to SEA, SEB, and TSST- 1. Particularly, the IgE immune response to TSST-1 is associated with aspirin sensitivity in CU patients.

Keyword

Aspirin Hypersensitivity; Specific IgE; Superantigens; Chronic Urticaria

MeSH Terms

Adolescent
Adult
Aged
Anti-Inflammatory Agents, Non-Steroidal/pharmacology
Antigens/*chemistry
Aspirin/pharmacology
Bacterial Toxins/metabolism
Chronic Disease
Enterotoxins/metabolism
Female
Humans
Immunoglobulin E/*chemistry/metabolism
Male
Middle Aged
Phenotype
Staphylococcus/*genetics/immunology
Superantigens/metabolism
Urticaria/*immunology

Figure

• 

  Fig. 1 Prevalences of serum specific IgE to staphylococcal superantigens When the prevalences of specific IgE to the three staphylococcal superantigens were compared among the AICU, ATCU and NC groups, the highest values were noted for the AICU patients (18.2% for SEA, 16.7% for SEB, 25.8% for TSST-1, 31.8% for any SEs). Moreover significant differences were noted between the AICU and NC groups (p=0.001 for SEA and TSST-1, p=0.013 for SEB). The specific IgE to TSST-1 was the most prevalent in AICU patients, and statistical significance was noted in comparison with ATCU patients (p=0.047). AICU, aspirin-intolerant chronic urticaria; ATCU, aspirin-tolerant chronic urticaria; NC, normal control; SEA, staphylococcal enterotoxin A; SEB, staphylococcal enterotoxin B; TSST-1, toxic shock syndrome toxin-1; SEs, staphylococcal enterotoxins; NS, not significant.

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