Staph's Toxins IgE Antibodies and Its Relation to the Severity of Allergic Rhinitis

J Asthma Allergy. 2022 May 17:15:665-671. doi: 10.2147/JAA.S356419. eCollection 2022.

Abstract

Background: Specific IgE against Staphylococcus can be found in approximately 40% of patients with allergies, also in patients without allergies because they may be sensitized. These antibodies are functional, and they can induce histamine release contributing to chronic pruritus which can worsen disease severity. The objective of this study was to compare levels of specific IgE against S. aureus toxins in those populations.

Methods: A cross-sectional, comparative non-blinded survey was made at the Regional Center for Allergy and Clinical Immunology. Ninety-nine adults between 18 and 70 years of age with allergic rhinitis (AR) and without allergic rhinitis (wAR) were recruited. A clinical history and demographic data, and allergic sensitization patterns to 35 aeroallergens were obtained, and participants were classified according to their severity using the Allergic Rhinitis and Its Impact on Asthma (ARIA) classification. Specific IgE levels were determined using ImmunoCAP™ 100 platform.

Results: The median age (IQR) of the participants was 23 (20-33.7); 56.2% were women. The most frequent comorbidities were asthma and obesity. Of the patients with AR, 46.7% were classified as mild intermittent and 25% as moderate persistent. IgE levels against staph toxins A, B, and TSST were significantly higher in the AR group vs the wAR group [median IQR 0.01 (0.01-0.03) vs. 0.01 (0-0.02), p = 0.01; 0.02 (0.01-0.03) vs. 0.01 (0-0.02), p= 0.02; 0.04 (0.02-0.09) vs. 0.01 (0-0.04), p=0.002, respectably]. A significant difference was found in serum IgE levels against Staph B toxin between severity subgroups.

Conclusion: People with AR have higher IgE levels against staph toxins A, B and TSST than wAR subjects. However, it is not possible declare that the IgE titers were related to disease severity.

Keywords: ARIA; IgE; Staphylococcus aureus; allergic rhinitis; staphylococcal superantigens.