Comparison of serum specific IgE antibodies to staphylococcal enterotoxinsbetween atopic children with and without atopic dermatitis

Background: The skin of patients with atopic dermatitis (AD) exhibits a str iking susceptibility to colonization and infection by,Staphylococcus aureus . The exotoxins secreted by S. aureus can act as superantigens and classic allergens, inducing the production of functionally relevant specific IgE an tibodies. The aim of this study was to compare the levels and positive rate s of serum staphylococcal enterotoxin A (SEA)- and staphylococcal enterotox in E (SEB)-specific IgE between atopic children with and without AD. Methods: Sixty children with AD, 55 children with respiratory allergy witho ut AD, and 24 nonatopic healthy children were studied. The levels and posit ive rates of serum SEA- and SEE-specific IgE were compared among three grou ps. The correlation between the levels or positive rates of serum SEA/SEB-s pecific IgE and the severity of AD or the presence of previous skin infecti ons was studied. Results: The children with AD had significantly higher levels and positive rates of serum SEA- and SEE-specific IgE than the atopic children without A D (P < 0.001) and the nonatopic children (P < 0.001). There was no signific ant difference in the levels and positive rates of serum SEA- and SEE-speci fic IgE between the atopic children without AD and the nonatopic children. With or without adjustment for the potential confounding effect of total se rum IgE levels, the levels and positive rates of serum SEA- and SEE-specifi c IgE were significantly correlated with severity of AD (P < 0.005), but th ey were not significantly different between AD children with and without pr evious skin infections. Conclusions: SEA and SEE may contribute to chronic inflammation and exacerb ation of AD through the IgE-mediated immune response.