Presence of specific IgE antibodies to staphylococcal enterotoxins in patients with atopic dermatitis

Atopic dermatitis (AD) is a pruritic, eczematous dermatosis, the symptoms of which fluctuate with remissions and relapses. Staphylococcus aureus has been suggested to contribute to the exacerbation of ED and specific IgE antibodies to S. aureus have been detected in a group of patients with AD. We investigated the presence of specific IgE antibodies to staphylococcal enterotoxins (SEA, SEE) in AD patients. The amount of anti-SEA and -SEB IgE antibodies were measured by liquid-phase enzyme immunoassay (AlaSTAT) in 96 patients. Seventy-seven (80.2%) of 96 patients tested had specific IgE antibodies against SEA and/or SEB. Of 27 patients with severe AD, 23 (85.2%) had both anti-SEA and -SEB IgE antibodies. Of 58 patients with high serum IgE levels (> 500 IU/ml), 48 (82.8%) had anti-SEA IgE antibodies and 51 (87.9%) had anti-SEB IgE antibodies. Only one of the serum samples in the control groups was positive to SEA alone. These results suggest that staphylococcal enterotoxins may play an important role, through IgE-mediated immunoresponse, in the exacerbation and prolongation of the inflammation of AD and that a subset of patients with AD raise an IgE response to enterotoxins produced by S. aureus on skin surfaces, leading to more severe dermatitis.