Staphylococcus aureus enterotoxin-sensitization is associated with allergic poly-sensitization and allergic multimorbidity in adolescents

Abstract

Background

Staphylococcus aureus (S. aureus) carriage and sensitization to S. aureus enterotoxins (SEs) has been associated with allergic diseases. From the Tromsø Study Fit Futures 2, we have previously shown an association between S. aureus carriage and severe allergic disease and allergic multimorbidity. However, the role of S. aureus carriage and SE-sensitization on allergic multimorbidity and allergic sensitization is unclear.

Objective

To study associations of both nasal S. aureus carriage and SE-sensitization to allergic disease and allergic sensitization.

Methods

A cross-sectional study of a school-based cohort in late adolescence (age 18-19 years: The Tromsø Study Fit Futures 2). Self-reported allergic diseases were assessed using the Mechanisms of the Development of ALLergy questionnaire (MeDALL). Participants were tested for nasal S. aureus carriage, serum total IgE and specific IgE to SEs and food and inhalant allergens.

Results

868 participants were studied. Sensitization to at least one food or inhalant allergen was found in 319/765 (41.7%), and to at least one SE in 173/656 (26.2%) of the participants. SE-sensitization, but not S. aureus carriage, was associated with poly-sensitization to food and inhalant allergens. SE-sensitized participants had higher median specific IgE to inhalant allergens (41.4 kU_A/L, IQR 10.1-118.4) compared to non-SE-sensitized participants (18.0 kU_A/L, IQR 5.5-48.6, p=0.004), but not to food allergens. SE-sensitization was associated to allergic multimorbidity.

Conclusion

Sensitization to SEs may play a role in the development of allergen poly-sensitization and allergic multimorbidity.

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