Staphylococcus aureus enterotoxin-specific IgE is associated with asthma in the general population: a GA(2)LEN study

Allergy. 2013 Oct;68(10):1289-97. doi: 10.1111/all.12230. Epub 2013 Oct 5.


Background: Specific IgE to Staphylococcus aureus enterotoxins (SE-IgE) has been associated with asthma. In the general population, we aimed to determine the prevalence of and risk factors for serum SE-IgE and to examine the association with asthma.

Methods: A postal questionnaire was sent to a random sample of adults in 19 centers across Europe. A random sample of respondents was invited for clinical examination upon which they answered a questionnaire, underwent skin prick tests (SPTs) for common aeroallergens, and provided blood for measurement of total IgE and SE-IgE. Risks were analyzed within centers using weighted logistic regression, and overall estimates calculated using fixed-effects meta-analysis.

Results: 2908 subjects were included in this analysis. Prevalence of positive SE-IgE was 29.3%; no significant geographic variation was observed. In contrast to positive skin prick tests, SE-IgE was more common in smokers (<15 pack-year: OR 1.11, P = 0.079, ≥15 pack-year: OR 1.70, P < 0.001), and prevalence did not decrease in older age-groups or in those with many siblings. Total IgE concentrations were higher in those with positive SE-IgE than in those with positive SPT. SE-IgE was associated with asthma (OR 2.10, 95% confidence interval [1.60-2.76], P = 0.001) in a concentration-dependent manner. This effect was independent of SPT result and homogeneous across all centers.

Conclusions: We report for the first time that SE-IgE is common in the general population throughout Europe and that its risk factors differ from those of IgE against aeroallergens. This is the first study to show that SE-IgE is significantly and independently associated with asthma in the general population.

Keywords: IgE; Staphylococcus aureus; asthma; epidemiology; superantigens.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Allergens / immunology
  • Antibody Specificity / immunology*
  • Asthma / diagnosis
  • Asthma / epidemiology*
  • Asthma / immunology*
  • Enterotoxins / immunology*
  • Female
  • Humans
  • Immunoglobulin E / immunology*
  • Male
  • Middle Aged
  • Odds Ratio
  • Population Surveillance*
  • Prevalence
  • Risk Factors
  • Skin Tests
  • Staphylococcus aureus / immunology*
  • Surveys and Questionnaires
  • Young Adult


  • Allergens
  • Enterotoxins
  • Immunoglobulin E