Different aspects of severe asthma in real life: Role of Staphylococcus aureus enterotoxins and correlation to comorbidities and disease severity
Background Asthma, with several phenotypes and endotypes, is considered particularly suited for precision medicine. The identification of different non‐invasive biomarkers may facilitate diagnosis and treatment. Recently, Staphylococcus aureus and its enterotoxins (SE) have been found to have a role...
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| Veröffentlicht in: | Allergy (Copenhagen) 2023-01, Vol.78 (1), p.131-140 |
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| creator | Caruso, Cristiano Colantuono, Stefania Ciasca, Gabriele Basile, Umberto Di Santo, Riccardo Bagnasco, Diego Passalacqua, Giovanni Caminati, Marco Michele, Schiappoli Senna, Gianenrico Heffler, Enrico Canonica, G. Walter Crimi, Nunzio Intravaia, Rossella De Corso, Eugenio Firinu, Davide Gasbarrini, Antonio Del Giacco, Stefano R. |
| description | Background
Asthma, with several phenotypes and endotypes, is considered particularly suited for precision medicine. The identification of different non‐invasive biomarkers may facilitate diagnosis and treatment. Recently, Staphylococcus aureus and its enterotoxins (SE) have been found to have a role in inducing persistent type 2 airway inflammation in severe asthma, but also in such comorbidities as chronic rhinosinusitis with nasal polyposis (CRSwNP).
Methods
The aim of this retrospective study was to evaluate the prevalence of SE‐IgE sensitization in a multicentric Italian cohort of severe asthmatic patients and correlate it with demographic and clinical characteristics.
Results
A total of 249 patients were included in the analysis, out of which 25.3% were staphylococcal enterotoxin B (SEB)‐IgE positive. We found a meaningful association between SEB‐IgE and female gender, a positive association was also measured between CRS and CRSwNP. No significant association was found between SEB‐IgE sensitization and atopy, the occurrence of exacerbations and corticosteroid dosages. In the SEB‐IgE‐positive patient, blood eosinophil count does not appear to be correlated with the severity of the disease. Patients with SEB‐IgE sensitization are, on average, younger and with an earlier disease onset, thus confirming the possibility to consider SEB‐IgE sensitization as an independent risk factor for developing asthma.
Conclusions
Our data confirm that the search for SE in the initial screening phase of these patients is helpful to better phenotype them, may predict the evolution of comorbidities and lead to a targeted therapeutic choice; in this point of view this represents a goal of precision medicine.
In patients diagnosed with severe asthma in Italy, the presence of enterotoxin sensitization for Staphylococcus appears to be an independent variable related to the development of comorbidities.Abbreviations: CI, confidence interval; CRS, chronic rhinosinusitis; CRSwNP, chronic rhinosinusitis with nasal polyps; IgE, immunoglobulin E; OR, odds ratio; SEB, staphylococcal enterotoxin B |
| doi_str_mv | 10.1111/all.15466 |
| format | Article |
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Asthma, with several phenotypes and endotypes, is considered particularly suited for precision medicine. The identification of different non‐invasive biomarkers may facilitate diagnosis and treatment. Recently, Staphylococcus aureus and its enterotoxins (SE) have been found to have a role in inducing persistent type 2 airway inflammation in severe asthma, but also in such comorbidities as chronic rhinosinusitis with nasal polyposis (CRSwNP).
Methods
The aim of this retrospective study was to evaluate the prevalence of SE‐IgE sensitization in a multicentric Italian cohort of severe asthmatic patients and correlate it with demographic and clinical characteristics.
Results
A total of 249 patients were included in the analysis, out of which 25.3% were staphylococcal enterotoxin B (SEB)‐IgE positive. We found a meaningful association between SEB‐IgE and female gender, a positive association was also measured between CRS and CRSwNP. No significant association was found between SEB‐IgE sensitization and atopy, the occurrence of exacerbations and corticosteroid dosages. In the SEB‐IgE‐positive patient, blood eosinophil count does not appear to be correlated with the severity of the disease. Patients with SEB‐IgE sensitization are, on average, younger and with an earlier disease onset, thus confirming the possibility to consider SEB‐IgE sensitization as an independent risk factor for developing asthma.
Conclusions
Our data confirm that the search for SE in the initial screening phase of these patients is helpful to better phenotype them, may predict the evolution of comorbidities and lead to a targeted therapeutic choice; in this point of view this represents a goal of precision medicine.
In patients diagnosed with severe asthma in Italy, the presence of enterotoxin sensitization for Staphylococcus appears to be an independent variable related to the development of comorbidities.Abbreviations: CI, confidence interval; CRS, chronic rhinosinusitis; CRSwNP, chronic rhinosinusitis with nasal polyps; IgE, immunoglobulin E; OR, odds ratio; SEB, staphylococcal enterotoxin B</description><identifier>ISSN: 0105-4538</identifier><identifier>EISSN: 1398-9995</identifier><identifier>DOI: 10.1111/all.15466</identifier><identifier>PMID: 35922152</identifier><language>eng</language><publisher>Denmark: Blackwell Publishing Ltd</publisher><subject>Asthma ; Asthma - diagnosis ; Asthma - epidemiology ; Atopy ; biologicals ; Comorbidity ; Enterotoxins ; Female ; Humans ; Immunoglobulin E ; Leukocytes (eosinophilic) ; nasal polyposis ; Nasal Polyps - epidemiology ; Patient Acuity ; Patients ; Phenotypes ; Polyposis ; Precision medicine ; Respiratory tract diseases ; Retrospective Studies ; Rhinosinusitis ; Risk factors ; severe eosinophilic asthma ; Staphylococcal enterotoxin B ; Staphylococcus aureus ; Staphylococcus aureus enterotoxins ; type 2 inflammation</subject><ispartof>Allergy (Copenhagen), 2023-01, Vol.78 (1), p.131-140</ispartof><rights>2022 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.</rights><rights>2023 EAACI and John Wiley and Sons A/S</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3886-799dce7c1c06b4b8172299caadd4355db1733bc398b8219f45fb03a6a9b87df33</citedby><cites>FETCH-LOGICAL-c3886-799dce7c1c06b4b8172299caadd4355db1733bc398b8219f45fb03a6a9b87df33</cites><orcidid>0000-0002-0492-5663 ; 0000-0002-5139-3604 ; 0000-0002-4517-1749 ; 0000-0002-4718-5984 ; 0000-0002-3661-5731 ; 0000-0001-7383-1487 ; 0000-0002-8328-2570 ; 0000-0002-5768-391X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fall.15466$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fall.15466$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35922152$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Caruso, Cristiano</creatorcontrib><creatorcontrib>Colantuono, Stefania</creatorcontrib><creatorcontrib>Ciasca, Gabriele</creatorcontrib><creatorcontrib>Basile, Umberto</creatorcontrib><creatorcontrib>Di Santo, Riccardo</creatorcontrib><creatorcontrib>Bagnasco, Diego</creatorcontrib><creatorcontrib>Passalacqua, Giovanni</creatorcontrib><creatorcontrib>Caminati, Marco</creatorcontrib><creatorcontrib>Michele, Schiappoli</creatorcontrib><creatorcontrib>Senna, Gianenrico</creatorcontrib><creatorcontrib>Heffler, Enrico</creatorcontrib><creatorcontrib>Canonica, G. Walter</creatorcontrib><creatorcontrib>Crimi, Nunzio</creatorcontrib><creatorcontrib>Intravaia, Rossella</creatorcontrib><creatorcontrib>De Corso, Eugenio</creatorcontrib><creatorcontrib>Firinu, Davide</creatorcontrib><creatorcontrib>Gasbarrini, Antonio</creatorcontrib><creatorcontrib>Del Giacco, Stefano R.</creatorcontrib><title>Different aspects of severe asthma in real life: Role of Staphylococcus aureus enterotoxins and correlation to comorbidities and disease severity</title><title>Allergy (Copenhagen)</title><addtitle>Allergy</addtitle><description>Background
Asthma, with several phenotypes and endotypes, is considered particularly suited for precision medicine. The identification of different non‐invasive biomarkers may facilitate diagnosis and treatment. Recently, Staphylococcus aureus and its enterotoxins (SE) have been found to have a role in inducing persistent type 2 airway inflammation in severe asthma, but also in such comorbidities as chronic rhinosinusitis with nasal polyposis (CRSwNP).
Methods
The aim of this retrospective study was to evaluate the prevalence of SE‐IgE sensitization in a multicentric Italian cohort of severe asthmatic patients and correlate it with demographic and clinical characteristics.
Results
A total of 249 patients were included in the analysis, out of which 25.3% were staphylococcal enterotoxin B (SEB)‐IgE positive. We found a meaningful association between SEB‐IgE and female gender, a positive association was also measured between CRS and CRSwNP. No significant association was found between SEB‐IgE sensitization and atopy, the occurrence of exacerbations and corticosteroid dosages. In the SEB‐IgE‐positive patient, blood eosinophil count does not appear to be correlated with the severity of the disease. Patients with SEB‐IgE sensitization are, on average, younger and with an earlier disease onset, thus confirming the possibility to consider SEB‐IgE sensitization as an independent risk factor for developing asthma.
Conclusions
Our data confirm that the search for SE in the initial screening phase of these patients is helpful to better phenotype them, may predict the evolution of comorbidities and lead to a targeted therapeutic choice; in this point of view this represents a goal of precision medicine.
In patients diagnosed with severe asthma in Italy, the presence of enterotoxin sensitization for Staphylococcus appears to be an independent variable related to the development of comorbidities.Abbreviations: CI, confidence interval; CRS, chronic rhinosinusitis; CRSwNP, chronic rhinosinusitis with nasal polyps; IgE, immunoglobulin E; OR, odds ratio; SEB, staphylococcal enterotoxin B</description><subject>Asthma</subject><subject>Asthma - diagnosis</subject><subject>Asthma - epidemiology</subject><subject>Atopy</subject><subject>biologicals</subject><subject>Comorbidity</subject><subject>Enterotoxins</subject><subject>Female</subject><subject>Humans</subject><subject>Immunoglobulin E</subject><subject>Leukocytes (eosinophilic)</subject><subject>nasal polyposis</subject><subject>Nasal Polyps - epidemiology</subject><subject>Patient Acuity</subject><subject>Patients</subject><subject>Phenotypes</subject><subject>Polyposis</subject><subject>Precision medicine</subject><subject>Respiratory tract diseases</subject><subject>Retrospective Studies</subject><subject>Rhinosinusitis</subject><subject>Risk factors</subject><subject>severe eosinophilic asthma</subject><subject>Staphylococcal enterotoxin B</subject><subject>Staphylococcus aureus</subject><subject>Staphylococcus aureus enterotoxins</subject><subject>type 2 inflammation</subject><issn>0105-4538</issn><issn>1398-9995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kUtrFTEYhoMo9lhd-Ack4EYX0-YymUnclXqFA4KXdcjlG5qSmRyTjPX8DP-xqVNdCGbzkZeHJ-F7EXpKyRlt59zEeEZFPwz30I5yJTullLiPdoQS0fWCyxP0qJRrQsjIFHmITrhQjFHBdujn6zBNkGGp2JQDuFpwmnCB7y1rSb2aDQ4LzmAijmGCV_hTinDLfK7mcHWMySXn1oLNmqGNJoKcavoRlpYtHruUM0RTQ1pwTe06p2yDDzXABvhQwBTY3gz1-Bg9mEws8ORunqKvb998uXzf7T---3B5se8cl3LoRqW8g9FRRwbbW0lHxpRyxnjfcyG8pSPn1rVtWMmomnoxWcLNYJSVo584P0UvNu8hp28rlKrnUBzEaBZIa9FsUHLgdBxoQ5__g16nNS_td5qNQoq2e9I36uVGuZxKyTDpQw6zyUdNib7tSbee9O-eGvvszrjaGfxf8k8xDTjfgJsQ4fh_k77Y7zflL2VGnuk</recordid><startdate>202301</startdate><enddate>202301</enddate><creator>Caruso, Cristiano</creator><creator>Colantuono, Stefania</creator><creator>Ciasca, Gabriele</creator><creator>Basile, Umberto</creator><creator>Di Santo, Riccardo</creator><creator>Bagnasco, Diego</creator><creator>Passalacqua, Giovanni</creator><creator>Caminati, Marco</creator><creator>Michele, Schiappoli</creator><creator>Senna, Gianenrico</creator><creator>Heffler, Enrico</creator><creator>Canonica, G. Walter</creator><creator>Crimi, Nunzio</creator><creator>Intravaia, Rossella</creator><creator>De Corso, Eugenio</creator><creator>Firinu, Davide</creator><creator>Gasbarrini, Antonio</creator><creator>Del Giacco, Stefano R.</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0492-5663</orcidid><orcidid>https://orcid.org/0000-0002-5139-3604</orcidid><orcidid>https://orcid.org/0000-0002-4517-1749</orcidid><orcidid>https://orcid.org/0000-0002-4718-5984</orcidid><orcidid>https://orcid.org/0000-0002-3661-5731</orcidid><orcidid>https://orcid.org/0000-0001-7383-1487</orcidid><orcidid>https://orcid.org/0000-0002-8328-2570</orcidid><orcidid>https://orcid.org/0000-0002-5768-391X</orcidid></search><sort><creationdate>202301</creationdate><title>Different aspects of severe asthma in real life: Role of Staphylococcus aureus enterotoxins and correlation to comorbidities and disease severity</title><author>Caruso, Cristiano ; Colantuono, Stefania ; Ciasca, Gabriele ; Basile, Umberto ; Di Santo, Riccardo ; Bagnasco, Diego ; Passalacqua, Giovanni ; Caminati, Marco ; Michele, Schiappoli ; Senna, Gianenrico ; Heffler, Enrico ; Canonica, G. Walter ; Crimi, Nunzio ; Intravaia, Rossella ; De Corso, Eugenio ; Firinu, Davide ; Gasbarrini, Antonio ; Del Giacco, Stefano R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3886-799dce7c1c06b4b8172299caadd4355db1733bc398b8219f45fb03a6a9b87df33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Asthma</topic><topic>Asthma - diagnosis</topic><topic>Asthma - epidemiology</topic><topic>Atopy</topic><topic>biologicals</topic><topic>Comorbidity</topic><topic>Enterotoxins</topic><topic>Female</topic><topic>Humans</topic><topic>Immunoglobulin E</topic><topic>Leukocytes (eosinophilic)</topic><topic>nasal polyposis</topic><topic>Nasal Polyps - epidemiology</topic><topic>Patient Acuity</topic><topic>Patients</topic><topic>Phenotypes</topic><topic>Polyposis</topic><topic>Precision medicine</topic><topic>Respiratory tract diseases</topic><topic>Retrospective Studies</topic><topic>Rhinosinusitis</topic><topic>Risk factors</topic><topic>severe eosinophilic asthma</topic><topic>Staphylococcal enterotoxin B</topic><topic>Staphylococcus aureus</topic><topic>Staphylococcus aureus enterotoxins</topic><topic>type 2 inflammation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Caruso, Cristiano</creatorcontrib><creatorcontrib>Colantuono, Stefania</creatorcontrib><creatorcontrib>Ciasca, Gabriele</creatorcontrib><creatorcontrib>Basile, Umberto</creatorcontrib><creatorcontrib>Di Santo, Riccardo</creatorcontrib><creatorcontrib>Bagnasco, Diego</creatorcontrib><creatorcontrib>Passalacqua, Giovanni</creatorcontrib><creatorcontrib>Caminati, Marco</creatorcontrib><creatorcontrib>Michele, Schiappoli</creatorcontrib><creatorcontrib>Senna, Gianenrico</creatorcontrib><creatorcontrib>Heffler, Enrico</creatorcontrib><creatorcontrib>Canonica, G. Walter</creatorcontrib><creatorcontrib>Crimi, Nunzio</creatorcontrib><creatorcontrib>Intravaia, Rossella</creatorcontrib><creatorcontrib>De Corso, Eugenio</creatorcontrib><creatorcontrib>Firinu, Davide</creatorcontrib><creatorcontrib>Gasbarrini, Antonio</creatorcontrib><creatorcontrib>Del Giacco, Stefano R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Allergy (Copenhagen)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Caruso, Cristiano</au><au>Colantuono, Stefania</au><au>Ciasca, Gabriele</au><au>Basile, Umberto</au><au>Di Santo, Riccardo</au><au>Bagnasco, Diego</au><au>Passalacqua, Giovanni</au><au>Caminati, Marco</au><au>Michele, Schiappoli</au><au>Senna, Gianenrico</au><au>Heffler, Enrico</au><au>Canonica, G. Walter</au><au>Crimi, Nunzio</au><au>Intravaia, Rossella</au><au>De Corso, Eugenio</au><au>Firinu, Davide</au><au>Gasbarrini, Antonio</au><au>Del Giacco, Stefano R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Different aspects of severe asthma in real life: Role of Staphylococcus aureus enterotoxins and correlation to comorbidities and disease severity</atitle><jtitle>Allergy (Copenhagen)</jtitle><addtitle>Allergy</addtitle><date>2023-01</date><risdate>2023</risdate><volume>78</volume><issue>1</issue><spage>131</spage><epage>140</epage><pages>131-140</pages><issn>0105-4538</issn><eissn>1398-9995</eissn><abstract>Background
Asthma, with several phenotypes and endotypes, is considered particularly suited for precision medicine. The identification of different non‐invasive biomarkers may facilitate diagnosis and treatment. Recently, Staphylococcus aureus and its enterotoxins (SE) have been found to have a role in inducing persistent type 2 airway inflammation in severe asthma, but also in such comorbidities as chronic rhinosinusitis with nasal polyposis (CRSwNP).
Methods
The aim of this retrospective study was to evaluate the prevalence of SE‐IgE sensitization in a multicentric Italian cohort of severe asthmatic patients and correlate it with demographic and clinical characteristics.
Results
A total of 249 patients were included in the analysis, out of which 25.3% were staphylococcal enterotoxin B (SEB)‐IgE positive. We found a meaningful association between SEB‐IgE and female gender, a positive association was also measured between CRS and CRSwNP. No significant association was found between SEB‐IgE sensitization and atopy, the occurrence of exacerbations and corticosteroid dosages. In the SEB‐IgE‐positive patient, blood eosinophil count does not appear to be correlated with the severity of the disease. Patients with SEB‐IgE sensitization are, on average, younger and with an earlier disease onset, thus confirming the possibility to consider SEB‐IgE sensitization as an independent risk factor for developing asthma.
Conclusions
Our data confirm that the search for SE in the initial screening phase of these patients is helpful to better phenotype them, may predict the evolution of comorbidities and lead to a targeted therapeutic choice; in this point of view this represents a goal of precision medicine.
In patients diagnosed with severe asthma in Italy, the presence of enterotoxin sensitization for Staphylococcus appears to be an independent variable related to the development of comorbidities.Abbreviations: CI, confidence interval; CRS, chronic rhinosinusitis; CRSwNP, chronic rhinosinusitis with nasal polyps; IgE, immunoglobulin E; OR, odds ratio; SEB, staphylococcal enterotoxin B</abstract><cop>Denmark</cop><pub>Blackwell Publishing Ltd</pub><pmid>35922152</pmid><doi>10.1111/all.15466</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-0492-5663</orcidid><orcidid>https://orcid.org/0000-0002-5139-3604</orcidid><orcidid>https://orcid.org/0000-0002-4517-1749</orcidid><orcidid>https://orcid.org/0000-0002-4718-5984</orcidid><orcidid>https://orcid.org/0000-0002-3661-5731</orcidid><orcidid>https://orcid.org/0000-0001-7383-1487</orcidid><orcidid>https://orcid.org/0000-0002-8328-2570</orcidid><orcidid>https://orcid.org/0000-0002-5768-391X</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Allergy (Copenhagen), 2023-01, Vol.78 (1), p.131-140 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; Wiley Online Library Free Content; EZB-FREE-00999 freely available EZB journals |
| subjects | Asthma Asthma - diagnosis Asthma - epidemiology Atopy biologicals Comorbidity Enterotoxins Female Humans Immunoglobulin E Leukocytes (eosinophilic) nasal polyposis Nasal Polyps - epidemiology Patient Acuity Patients Phenotypes Polyposis Precision medicine Respiratory tract diseases Retrospective Studies Rhinosinusitis Risk factors severe eosinophilic asthma Staphylococcal enterotoxin B Staphylococcus aureus Staphylococcus aureus enterotoxins type 2 inflammation |
| title | Different aspects of severe asthma in real life: Role of Staphylococcus aureus enterotoxins and correlation to comorbidities and disease severity |
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