ABSTRACT
It has been well established that bacterial superantigens lead to the induction and aggravation of chronic inflammatory skin diseases. We investigated the clinical significance of serum specific immunoglobulin E (lgE) to the staphylococcal superantigens staphylococcal enterotoxin A (SEA), staphylococcal enterotoxin B (SEB), and toxic shock syndrome toxin (TSST)-1 in patients with chronic urticaria (CU), focusing on the differences in these prevalences between aspirin-intolerant CU (AICU) and aspirin-tolerant CU (ATCU) patients. Aspirin sensitivity was confirmed by oral aspirin provocation test. There were 66 patients AICU and 117 patients ATCU in the study. Serum IgE antibodies specific for SEA, SEB, and TSST-1 were measured by the ImmunoCAP test and the patients were compared with 93 normal controls (NC). The prevalences of serum specific IgE to staphylococcal superantigens were significantly higher in CU than in NC patients (IgE to SEA, 13.7% vs. 5.4%; IgE to SEB, 12.0% vs. 4.3%; IgE to TSST-1, 18.0% vs. 6.5%; p<0.05, respectively). The patients with specific IgE to SEA, SEB, and TSST-1 had higher serum total IgE levels and higher rates of atopy. Significant associations were noted between the prevalence of specific IgE to SEA and SEB and the HLA DQB1*0609 and DRB1*1302 alleles in the AICU group. We confirmed that a sub-population of patients with CU possesses serum IgE antibodies to SEA, SEB, and TSST- 1. Particularly, the IgE immune response to TSST-1 is associated with aspirin sensitivity in CU patients.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Anti-Inflammatory Agents, Non-Steroidal/pharmacology , Antigens/chemistry , Aspirin/pharmacology , Bacterial Toxins/metabolism , Chronic Disease , Enterotoxins/metabolism , Immunoglobulin E/chemistry , Phenotype , Staphylococcus/genetics , Superantigens/metabolism , Urticaria/immunologyABSTRACT
El descubrimiento de los superatígenos (SAgs) aportó nuevos conceptos en el estudio de las interacciones entre los microorganismos y el sistema inmune. Se trata de moléculas que, asociadas a las de Clase II del Complejo Mayor de Histocompatibilidad (CMH), se unen al dominio variable de la cadena Beta Vbeta) del receptor de antígenos Ags) de los linfocitos T alphaBeta (TCRalphaBeta) que les confiere la especialidad de familia. Así, los SAgs son capaces de activar a un alto número de linfocitos T y de células portadoras de las moléculas de Classe II del CMH, generando una masiva liberación de linfoquinas y mediadores inflamatorios que ha sido relaciona con sus efectos tóxicos. Los SAgs endógenos están codificados por los provirus de tumores murinos (Mtv) que se hallan integrados al genoma de los ratones. Los exógenos son producidos por bacterias y virus, siendo los mejor caracterizados los relacionados con las intoxicaciones alimentarias. Aun no se han hallado datos concluyentes en cuanto a la existencia de SAgs de parásitos y se requieren estudos más detallados para establecer su presencia y posible efecto en las infecciones parasitarias.