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Staphylococcal Sensitization: A Correlate of Type 2-High Inflammation in Children With Severe Asthma

Mélisande Bourgoin-Heck1, Marion Duféal2, Sarah Saf2

  • 1Allergology Department, Hospital A. Trousseau, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Paris, France; CRESS, Inserm, INRAE, HERA Team, Université Paris Cité, Paris, France.

The Journal of Allergy and Clinical Immunology. in Practice
|April 28, 2023
PubMed

Insights

Staphylococcus aureus enterotoxin (SE) sensitization is linked to type 2-high inflammation in children with asthma. This finding highlights SE sensitization as a significant factor in pediatric asthma severity and inflammation.

Area of Science:

  • Allergy and Immunology
  • Pediatric Pulmonology
  • Microbial Immunology

Background:

  • Sensitization to Staphylococcus aureus enterotoxins (SEs) is a known risk factor for asthma.
  • The specific determinants and clinical significance of SE sensitization in pediatric asthma remain unclear.

Purpose of the Study:

  • To investigate the significance of SE sensitization in children diagnosed with moderate to severe asthma.
  • To explore the association between SE sensitization and markers of allergic inflammation in children.

Main Methods:

  • An observational, cross-sectional analysis of 377 children (233 preschool, 144 school-age) from the Severe Asthma Molecular Phenotype cohort (2011-2015).
  • Evaluation of sensitization to four specific SEs (SEA, SEB, SEC, TSST) using specific IgE levels.
  • Multivariable analysis and classification and regression trees were used to assess associations.

Main Results:

  • Overall, 11.2% of preschool-age and 41.0% of school-age children showed sensitization to at least one SE.
  • SE sensitization was significantly associated with elevated total IgE levels and bronchoalveolar lavage eosinophilia in both age groups.
  • Associations were also observed with age, total IgE, and blood eosinophilia, particularly in school-aged children.

Conclusions:

  • Staphylococcal enterotoxin sensitization is correlated with type 2-high inflammation, characterized by eosinophilic inflammation and elevated total IgE, in children with moderate to severe asthma.
  • These findings suggest SE sensitization plays a role in the inflammatory pathways of pediatric asthma.
Abstract

Keywords:
Asthma phenotypeChildrenEosinophilSevere asthmaStaphylococcal toxin sensitizationType 2 inflammation

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