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Association between poly-sensitisation and sensitisation to staphylococcal enterotoxin A and B affecting allergic severity in children

  • Rhinology
  • Published:
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Abstract

Purpose

Accumulating evidence suggests that Staphylococcus aureus plays a significant role as a disease modifier in upper and lower airway diseases. We aimed to assess the association between staphylococcal enterotoxins (SEs) with allergic diseases and the degree of allergen sensitisation in children, which remains unclear.

Methods

We retrospectively reviewed the medical records of 455 patients aged 3–18 years between March 2018 and March 2022. Clinical history and demographic data were obtained. The baseline study included paranasal sinus X-ray scan, multiple allergen simultaneous test, and ImmunoCAP® for measuring serum total and specific immunoglobulin E (IgE) levels to allergens and staphylococcal enterotoxin A and B (SEA and SEB).

Results

The mean age was 9.77 ± 4.3 years. 133 patients (29.2%) were sensitised to one inhalant allergen, and 188 patients (41.3%) showed polysensitisation. Patients sensitised to SEs showed higher total and specific IgE levels and total eosinophil counts compared to non-SE-sensitised patients. Sensitisation to SEs is closely associated with polysensitisation to inhalant allergens and allergic multimorbidity. When the SE-IgE value was 0.35 or higher, the odds ratio for allergen polysensitisation was significantly higher than when the SE-IgE value was lower than 0.35.

Conclusions

Association between polysensitisation and sensitisation to SEs in children shows the higher the specific IgE levels for SEs, the higher the likelihood of polysensitisation. Considering the relationship between polysensitisation, high IgE levels, and the severity of allergic morbidity, sensitisation to SEs is thought to be related to allergy severity.

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Funding

This work was supported by a faculty research grant from Yonsei University Wonju College of Medicine [grant no. 2022-52-0054 to E.J.L.] and by the Basic Science Research Program of the National Research Foundation of Korea (NRF), which is funded by the Ministry of Science and ICT, Republic of Korea [grant no. NRF-2021R1A2C1010082 to E.J.L.].

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    Authors and Affiliations

    1. Department of Otorhinolaryngology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju, Gangwon-do, Republic of Korea

      Young-Ha Lee, Minheon Kim, Cheol Hyo Ku, Hyun Su Lee, Joo Hyung Lee, Dong Hwan Kwon & Eun Jung Lee

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    Contributions

    E.J.L. and C.H.K. designed the study, managed data extraction, and interpreted the data. H.S.L., M.H.K. and D.H.K. performed the statistical analyses. E.J.L., Y.-H.L. and M.H.K. prepared the manuscript. Y.-H.L. and M.H.K. formatted the manuscript. E.J.L., Y.-H.L., C.H.K., H.S.L., M.H.K., D.H.K. and J.H.L. interpreted data and reviewed the manuscript. E.J.L. initiated and supervised this study. All authors have read and approved the final manuscript.

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    Correspondence to Eun Jung Lee.

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    This study was approved by the Institutional Review Board of Wonju Severance Christian Hospital, Wonju, Republic of Korea (IRB No. CR318104), in accordance with the Declaration of Helsinki.

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    Lee, YH., Kim, M., Ku, C.H. et al. Association between poly-sensitisation and sensitisation to staphylococcal enterotoxin A and B affecting allergic severity in children. Eur Arch Otorhinolaryngol 280, 4121–4129 (2023). https://doi.org/10.1007/s00405-023-07968-0

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