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

PurposeAccumulating 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.MethodsWe 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 (R) for measuring serum total and specific immunoglobulin E (IgE) levels to allergens and staphylococcal enterotoxin A and B (SEA and SEB).ResultsThe 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.ConclusionsAssociation 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.

Automated summary

This study aimed to assess the association between staphylococcal enterotoxins (SEs) and allergic diseases and the degree of allergen sensitisation in children. The results showed that patients sensitised to SEs had higher IgE levels and eosinophil counts, and were more likely to have polysensitisation and allergic multimorbidity. When the SE-IgE value was 0.35 or higher, the likelihood of allergen polysensitisation was significantly higher.