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In chronic spontaneous urticaria, IgE against staphylococcal enterotoxins is common and functional
Author(s) -
Altrichter S.,
Hawro T.,
Liedtke M.,
Holtappels G.,
Bachert C.,
Skov P. S.,
Maurer M.
Publication year - 2018
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/all.13381
Subject(s) - immunoglobulin e , medicine , immunology , basophil , omalizumab , pathogenesis , histamine , allergy , angioedema , enterotoxin , clinical significance , antibody , biology , biochemistry , escherichia coli , gene
Background Chronic spontaneous urticaria ( CSU ) is a frequent disorder with recurrent itchy wheals and/or angioedema. Despite the known effectiveness of omalizumab therapy, the relevant IgE antigens are largely unknown. Recently, increased rates of elevated levels of IgE towards Staphylococcus aureus enterotoxins ( SE s) were described in CSU . Aim To assess the prevalence and functional relevance of IgE to SE s in CSU . Method We investigated serum levels of IgE against SE s in 49 CSU patients and in 15 CSU patients additional specific IgE to SE components and basophil histamine release ( BHR ). Sera of 15 healthy controls ( HC s) served as control group. Results Twenty‐five (51%) of the CSU patients had detectable levels of SE ‐IgE as compared to 5 (33%) of HC s. Specific IgE to one of the SE s, Staphylococcus enterotoxin B ( SEB ), was present in 5 (33%) of 15 randomly selected CSU patients vs 3 (20%) of HC . Total IgE serum levels in CSU patients were significantly correlated with SE ‐IgE ( r = .52, P < .001) and SEB ‐IgE ( r = .54, P = .04) serum concentrations. Interestingly, SEB ‐IgE levels were strongly correlated with disease activity ( UAS day) in CSU patients ( r = .657, P = .01). Furthermore, BHR in response to SEB was significantly higher in basophils loaded with the serum of CSU patients compared to HC ( P < .05) and was clinically correlated with duration of disease ( r > .51, P < .05). Discussion IgE against SE s may contribute to the pathogenesis of CSU in a subpopulation of patients. Its role and relevance in the pathophysiology of CSU need to be further analysed.