Sensitization to Staphylococcus aureus enterotoxins in smokers with asthma

Staphylococcal Enterotoxin-Specific IgE Sensitization: A Potential Predictor of Fixed Airflow Obstruction in Elderly Asthma

PURPOSE

Staphylococcus aureus enterotoxin-specific immunoglobulin E (SE-sIgE) sensitization tends to increase with age and is known to be associated with asthma and severity in older adults. However, the long-term impact of SE-sIgE in the elderly remains unknown. This study aimed to examine the relationships between SE-sIgE and fixed airflow obstruction (FAO) in a cohort of elderly asthmatics.

METHODS

A total of 223 elderly asthmatics and 89 controls were analyzed. Patients were assessed for demographics, history of chronic rhinosinusitis (CRS), asthma duration, acute exacerbation frequency, and lung function at baseline and then were prospectively followed up for 2 years. Serum total IgE and SE-sIgE levels were measured at baseline. Airflow obstruction was defined as forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) ratio < 0.7 at baseline and FAO was defined as FEV1/FVC ratio < 0.7 over the 2-year follow-up.

RESULTS

At baseline, the prevalence of airflow obstruction was 29.1%. Patients with airflow obstruction were significantly more likely to be male, and have a positive smoking history, comorbid CRS, and higher levels of SE-sIgE than those without airflow obstruction. Multivariate logistic regression analysis showed that airflow obstruction was significantly associated with current smoking and SE-sIgE sensitization at baseline. After the 2-year follow-up, baseline SE-sIgE sensitization was consistently related to FAO. Meanwhile, the number of exacerbations per year was significantly correlated with SE-sIgE levels.

CONCLUSIONS

Baseline SE-sIgE sensitization was significantly associated with the number of asthma exacerbations and FAO after the 2-year follow-up in elderly asthmatics. These findings warrant further investigation of the direct and mediating roles of SE-sIgE sensitization on airway remodeling.

Differences between Staphylococcus aureus nasal carriage and IgE-sensitization to Staphylococcus aureus enterotoxin on risk factors and effects in adult population

Background

Staphylococcus aureus (SA) nasal carriage (SA carriage) and IgE-sensitization to SA enterotoxin (SE IgE-sensitization) are known to be associated with chronic airway disease.

Objective

This study aimed to evaluate the differences in risk factors, type 2 inflammation and respiratory symptoms between SA carriage and SE IgE-sensitization.

Methods

We conducted a cross-sectional study of a community-based adult population to evaluate the environmental exposure and health impact of the Pohang Industrial Complex, Korea. Participants were examined based on self-reported questionnaires, nasal swab, and blood sampling.

Results

There were 307 participants, and the overall prevalence of SA carriage and SE IgE-sensitization was 26.1% (80/307) and 25.7% (79/307), respectively. An urban environment was significantly correlated with SA carriage, whereas age and obesity were significantly correlated with SE IgE-sensitization. SA carriage was not associated with an increase in total IgE and blood eosinophil count, whereas SE IgE-sensitization was associated with an increased total IgE and blood eosinophil count. SA carriage was significantly correlated with cough persisting for more than three weeks (OR, 3.044; 95% CI, 1.137–8.153) and sputum (OR, 2.429; 95% CI, 1.008–5.854). SE IgE-sensitization was a significant correlation with only sputum (OR, 2.452; 95% CI, 1.066–5.640). SA carriage and SE IgE-sensitization showed a synergistic effect on the prevalence of cough and sputum.

Conclusion

SA carriage was associated with the urban environment, and SE IgE-sensitization was associated with the elderly and obesity. SA carriage and SE IgE-sensitization had different correlation with type 2 inflammation and airway symptoms.

Staphylococcus Aureus in chronic airway diseases: An overview

This review investigates about the role of Staphylococcus Aureus (S. aureus) and S. aureus enterotoxins (SEs) in the pathogenesis of several chronic airway diseases. S. aureus is part of normal human flora and may colonize the skin and the upper airways. SEs acting as superantigens can induce an intense T cell activation and through the release of interleukin (IL) - 4, 5, and 13, can promote a polyclonal IgE response and eosinophilic inflammation. S. aureus can damage epithelial cells inducing the release of the so-called "alarmins" responsible of the activation of Type 2 innate lymphoid cells (ILC-2) linked to an IL-5 mediated airway eosinophilic inflammation. SEs sensitization has been recently associated with the eosinophilic endotypes of both nasal polyps and late onset severe asthma. Studies investigating the effect of biological therapies in SEs sensitized patients should be performed in order to better define the role played by S. aureus in the different endotypes of severe asthma and/or chronic rhinosinusitis.

Bacteria in Asthma Pathogenesis

The airways are under continuous assault from aerosolized bacteria and oral flora. The bacteria present in the airways and gastrointestinal tract of neonates promote immune maturation and protect against asthma pathogenesis. Later bacterial infections and perturbations to the microbiome can contribute to asthma pathogenesis, persistence, and severity.

A Novel Human Microbe-Disease Association Prediction Method Based on the Bidirectional Weighted Network

The survival of human beings is inseparable from microbes. More and more studies have proved that microbes can affect human physiological processes in various aspects and are closely related to some human diseases. In this paper, based on known microbe-disease associations, a bidirectional weighted network was constructed by integrating the schemes of normalized Gaussian interactions and bidirectional recommendations firstly. And then, based on the newly constructed bidirectional network, a computational model called BWNMHMDA was developed to predict potential relationships between microbes and diseases. Finally, in order to evaluate the superiority of the new prediction model BWNMHMDA, the framework of LOOCV and 5-fold cross validation were implemented, and simulation results indicated that BWNMHMDA could achieve reliable AUCs of 0.9127 and 0.8967 ± 0.0027 in these two different frameworks respectively, which is outperformed some state-of-the-art methods. Moreover, case studies of asthma, colorectal carcinoma, and chronic obstructive pulmonary disease were implemented to further estimate the performance of BWNMHMDA. Experimental results showed that there are 10, 9, and 8 out of the top 10 predicted microbes having been confirmed by related literature in these three kinds of case studies separately, which also demonstrated that our new model BWNMHMDA could achieve satisfying prediction performance.

A Bidirectional Label Propagation Based Computational Model for Potential Microbe-Disease Association Prediction

A growing number of clinical observations have indicated that microbes are involved in a variety of important human diseases. It is obvious that in-depth investigation of correlations between microbes and diseases will benefit the prevention, early diagnosis, and prognosis of diseases greatly. Hence, in this paper, based on known microbe-disease associations, a prediction model called NBLPIHMDA was proposed to infer potential microbe-disease associations. Specifically, two kinds of networks including the disease similarity network and the microbe similarity network were first constructed based on the Gaussian interaction profile kernel similarity. The bidirectional label propagation was then applied on these two kinds of networks to predict potential microbe-disease associations. We applied NBLPIHMDA on Human Microbe-Disease Association database (HMDAD), and compared it with 3 other recent published methods including LRLSHMDA, BiRWMP, and KATZHMDA based on the leave-one-out cross validation and 5-fold cross validation, respectively. As a result, the area under the receiver operating characteristic curves (AUCs) achieved by NBLPIHMDA were 0.8777 and 0.8958 ± 0.0027, respectively, outperforming the compared methods. In addition, in case studies of asthma, colorectal carcinoma, and Chronic obstructive pulmonary disease, simulation results illustrated that there are 10, 10, and 8 out of the top 10 predicted microbes having been confirmed by published documentary evidences, which further demonstrated that NBLPIHMDA is promising in predicting novel associations between diseases and microbes as well.

Severe asthma in Japan

The characteristic phenotype of severe asthma in Japan seems to be distilled into the following two features: low incidence of obesity and high prevalence of patients with type 2 inflammation. Only 5-7% of Japanese severe asthma patients had a body mass index (BMI) ≥30 kg/m², and more than 80% of patients with severe asthma exhibited type 2 inflammation. Although the relationship between obesity and non-type 2 inflammation is complex, the low incidence of obesity might explain the prevalence of type 2 inflammation. Some asthma cohorts in Japan have investigated the roles of type 2 biomarkers extensively, including periostin, to identify a severe phenotype, suggesting the utility of combining biomarkers to identify an exacerbation-prone subgroup. Although the prevalence of severe asthma is comparable to Western countries, the rate of asthma death and disease burden seems to be lower in Japan. These trends might be due to the system of public health insurance for the whole nation, leading to good access to hospital and asthma specialists due to the geographically narrow country. In this review article, we will discuss the definition, epidemiology, comorbidities, biomarkers, specific phenotype, and current treatment for severe asthma in Japan.