Background: Specific immunoglobulin E (IgE) sensitization to staphylococcal enterotoxin (SE) has been recently considered to be related to allergic disease, including asthma. Despite studies on specific IgE (sIgE) to SE and its relationship to asthma diagnosis and severity, the association of sIgE t...
Background: Specific immunoglobulin E (IgE) sensitization to staphylococcal enterotoxin (SE) has been recently considered to be related to allergic disease, including asthma. Despite studies on specific IgE (sIgE) to SE and its relationship to asthma diagnosis and severity, the association of sIgE to SE with airway hyperresponsiveness (AHR) remains unclear. Methods: We enrolled 81 asthma patients admitted to the Severance Hospital in Korea from March 1, 2013, to February 28, 2015 and retrospectively reviewed the electronic medical records of the enrolled subjects. The serum levels of sIgE to SE (A/B) of all subjects was measured using the ImmunoCAP 250 (Phadia) system with SE-sIgE positive defined as >0.10 kU/mL. Results: The SE-sIgE level was not significantly correlated with asthma severity (forced expiratory volume in 1 second [$FEV_1$], $FEV_1$/forced vital capacity, sputum eosinophils, and serum eosinophils), whereas the SE-sIgE level in patients with positive AHR ($mean{\pm}standard$ error of the mean, $0.606{\pm}0.273kU/mL$) was significantly higher than that in patients with negative AHR ($0.062{\pm}0.015kU/mL$, p=0.034). In regression analysis, SE sensitization (sIgE to SE ${\geq}0.010kU/mL$) was a significant risk factor for AHR, after adjustment for age, sex, $FEV_1$, and sputum eosinophils (odds ratio, 7.090; 95% confidence interval, 1.180-42.600; p=0.032). Prevalence of SE sensitization was higher in patients with allergic rhinitis and non-atopic asthma patients, as compared to patients without allergic rhinitis and atopic asthma patients, respectively, but without statistical significance. Conclusion: SE sensitization is significantly associated with AHR.
Background: Specific immunoglobulin E (IgE) sensitization to staphylococcal enterotoxin (SE) has been recently considered to be related to allergic disease, including asthma. Despite studies on specific IgE (sIgE) to SE and its relationship to asthma diagnosis and severity, the association of sIgE to SE with airway hyperresponsiveness (AHR) remains unclear. Methods: We enrolled 81 asthma patients admitted to the Severance Hospital in Korea from March 1, 2013, to February 28, 2015 and retrospectively reviewed the electronic medical records of the enrolled subjects. The serum levels of sIgE to SE (A/B) of all subjects was measured using the ImmunoCAP 250 (Phadia) system with SE-sIgE positive defined as >0.10 kU/mL. Results: The SE-sIgE level was not significantly correlated with asthma severity (forced expiratory volume in 1 second [$FEV_1$], $FEV_1$/forced vital capacity, sputum eosinophils, and serum eosinophils), whereas the SE-sIgE level in patients with positive AHR ($mean{\pm}standard$ error of the mean, $0.606{\pm}0.273kU/mL$) was significantly higher than that in patients with negative AHR ($0.062{\pm}0.015kU/mL$, p=0.034). In regression analysis, SE sensitization (sIgE to SE ${\geq}0.010kU/mL$) was a significant risk factor for AHR, after adjustment for age, sex, $FEV_1$, and sputum eosinophils (odds ratio, 7.090; 95% confidence interval, 1.180-42.600; p=0.032). Prevalence of SE sensitization was higher in patients with allergic rhinitis and non-atopic asthma patients, as compared to patients without allergic rhinitis and atopic asthma patients, respectively, but without statistical significance. Conclusion: SE sensitization is significantly associated with AHR.
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가설 설정
We assessed whether the prevalence of positive sensitization to SE will be different according to the presence of allergic rhinitis and atopy or not. The positive sensitization rate to SE in patients without allergic rhinitis was 30.
제안 방법
The complete blood count test was performed using an automated analyzer to determine blood eosinophil counts. The eosinophil percentages in induced sputum were assessed as follows.
Further study concerning total IgE with AHR might be interesting. This study has additional limitation concerning severity parameters. The most important severity parameter, medication type and dose used in subjects to control symptoms, was not included in this study.
대상 데이터
We enrolled a total of 81 asthma patients. The mean age of subjects and the standard deviation from the mean was 56.
데이터처리
We determined the odds ratio (OR) using logistic regression analysis, including univariate and multivariate analysis. Cross-correlation analysis was performed using chi-square tests to analyze the correlation between categorized variables in SPSS version 18.0 (SPSS Inc., Chicago, IL, USA). We considered a p<0.
We assessed correlation between two continuous variables using Pearson’s test. The t test was used to compare levels of sIgE to SE according to AHR. We selected, as the parameters, sex and age, which are most commonly among the variables considered, and FEV1 and sputum eosinophil count, which are known to be highly related to asthma severity.
We assessed correlation between two continuous variables using Pearson’s test.
성능/효과
The percentage of sputum eosinophils was an independent risk factor for AHR (OR, 1.059; 95% CI, 1.007–1.114; p=0.025).
We assessed whether the prevalence of positive sensitization to SE will be different according to the presence of allergic rhinitis and atopy or not. The positive sensitization rate to SE in patients without allergic rhinitis was 30.0%, and that in patients with allergic rhinitis was 42.6% without statistically significant difference (p=0.431). The positive sensitization rate to SE in non-atopic asthma patients was 40.
When we adjust the cut-off value to 0.014 kU/mL to define 30% of patients as positive to SE sensitization, SE sensitization was a significant risk factor without adjustment (OR, 4.667; 95% CI, 1.037–21.010; p=0.045) and also with adjustment (OR, 14.096; 95% CI, 1.823–108.970; p=0.011).
후속연구
Assessment of AHR, when challenged by SE, is likely to reveal the direct association between SE and asthma development. Further basic study should be followed to reveal the mechanisms how the SE sensitization induce AHR and asthma. Although the data are not shown due to the insignificance of results, we found that total IgE (n=7, 713.
This result implies that SE sensitization might be associated with development of asthma. Further large-scale studies should be conducted to harden these results.
The failure of this result to reach statistical significance might be due to the small number of subjects studied. Further study with larger sample of allergic rhinitis patients should be performed to evaluate whether SE sensitization is frequently observed in patients with allergic rhinitis rather than patients without.
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