Staphylococcal enterotoxin sensitization in a community-based population: a potential role in adult-onset asthma

Authors

  • W.-J. Song,

    1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
    2. Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea
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  • Y.-S. Chang,

    1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
    2. Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea
    3. Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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  • M.-K. Lim,

    1. National Cancer Control Institute, National Cancer Center, Goyang, Korea
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  • E.-H. Yun,

    1. National Cancer Control Institute, National Cancer Center, Goyang, Korea
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  • S.-H. Kim,

    1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
    2. Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea
    3. Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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  • H.-R. Kang,

    1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
    2. Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea
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  • H.-W. Park,

    1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
    2. Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea
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  • P. Tomassen,

    1. Upper Airways Research Laboratory, Department of Otorhinolaryngology, Ghent University, Ghent, Belgium, Korea
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  • M.-H. Choi,

    1. Department of Parasitology and Tropical Medicine, Seoul National University College of Medicine, Seoul, Korea
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  • K.-U. Min,

    1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
    2. Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea
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  • S.-H. Cho,

    Corresponding author
    1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
    2. Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea
    • Correspondence:

      Sang-Heon Cho, MD, PhD, Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Chongno-gu, Seoul, 110-744, Seoul, Korea.

      E-mail: shcho@snu.ac.kr

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  • C. Bachert

    1. Upper Airways Research Laboratory, Department of Otorhinolaryngology, Ghent University, Ghent, Belgium, Korea
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Summary

Background

Recent studies suggest that Staphylococcus aureus enterotoxin sensitization is a risk factor for asthma. However, there is a paucity of epidemiologic evidence on adult-onset asthma in community-based populations.

Objective

We sought to evaluate the epidemiology and the clinical significance of staphylococcal enterotoxin sensitization in community-based adult populations.

Methods

The present analyses were performed using the baseline data set of Korean adult population surveys, consisting of 1080 adults (mean age = 60.2 years) recruited from an urban and a rural community. Questionnaires, methacholine challenge tests, and allergen skin tests were performed for defining clinical phenotypes. Sera were analysed for total IgE and enterotoxin-specific IgE using ImmunoCAP.

Results

Staphylococcal enterotoxin sensitization (≥ 0.35 kU/L) had a prevalence of 27.0%. Risk factors were identified as male sex, current smoking, advanced age (≥ 61 years), and inhalant allergen sensitization. Current asthma was mostly adult onset (≥ 18 years old) and showed independent associations with high enterotoxin-specific IgE levels in multivariate logistic regression tests. In multivariate linear regressions, staphylococcal enterotoxin-specific IgE level was identified as the major determinant factor for total IgE level.

Conclusions and Clinical Relevance

Staphylococcal enterotoxin sensitization was independently associated with adult-onset asthma in adult community populations. Strong correlations between the enterotoxin-specific IgE and total IgE levels support the clinical significance. The present findings warrant further studies for the precise roles of staphylococcal enterotoxin sensitization in the asthma pathogenesis.

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