Association of Staphylococcus aureus colonization with food allergy occurs independently of eczema severity

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:144

Article

Tsilochristou, Olympia^1,2  du Toit, George^1,2,3  Sayre, Peter H.⁴  Roberts, Graham^5,6,7  Lawson, Kaitie⁸  Sever, Michelle L.⁸  Bahnson, Henry T.⁹  Radulovic, Suzana^1,2,3  Basting, Monica^1,2,3  Plaut, Marshall¹⁰  Lack, Gideon^1,2,3 

[1] Kings Coll London, Sch Immunol & Microbial Sci, Peter Gorer Dept Immunobiol, London, England

[2] Kings Coll London, Sch Life Course Sci, Dept Women & Childrens Hlth, Pediat Allergy Grp, London, England

[3] Guys & St Thomas NHS Fdn Trust, Childrens Allergy Serv, 2nd Floor,Stairwell B,South Wing, London SE1 7EH, England

[4] Univ Calif San Francisco, Dept Med, Div Hematol Oncol, San Francisco, CA USA

[5] Univ Southampton, Southampton, Hants, England

[6] Southampton NIHR Biomed Res Ctr, Southampton, Hants, England

[7] David Hide Ctr, Newport, Wight, England

[8] Rho Fed Syst Div, Chapel Hill, NC USA

[9] Immune Tolerance Network, San Francisco, CA USA

[10] NIAID, 9000 Rockville Pike, Bethesda, MD 20892 USA

关键词: Food sensitization;    food allergy;    peanut allergy;    egg allergy;    eczema;    atopic dermatitis;    Staphylococcus aureus;    prevention;    Learning Early About Peanut Allergy;    microbiome;   

DOI  :  10.1016/j.jaci.2019.04.025

来源: Elsevier

【 摘 要 】

Background: Staphylococcus aureus has been implicated in the pathophysiology of eczema, allergic rhinitis, asthma, and food allergy. S aureus is a marker of more severe eczema, which is a risk factor for food sensitization/allergy. Therefore it might be that the association between S aureus and food allergy in eczematous patients is related to eczema severity. Objective: We sought to investigate the association of S aureus colonization with specific IgE (sIgE) production to common food allergens and allergies in early childhood independent of eczema severity. We additionally determined the association of S aureus colonization with eczema severity and persistence. Methods: In Learning Early About Peanut Allergy (LEAP) study participants eczema severity was assessed, and skin/nasal swabs were cultured for S aureus. Sensitization was identified by measuring sIgE levels. Peanut allergy was primarily determined by means of oral food challenge, and persistent egg allergy was primarily determined by using skin prick tests. Results: Skin S aureus colonization was significantly associated with eczema severity across the LEAP study, whereas at 12 and 60 months of age, it was related to subsequent eczema deterioration. Skin S aureus colonization at any time point was associated with increased levels of hen's egg white and peanut sIgE independent of eczema severity. Participants with S aureus were more likely to have persistent egg allergy and peanut allergy at 60 and 72 months of age independent of eczema severity. All but one of the 9 LEAP study consumers with peanut allergy (9/312) were colonized at least once with S aureus. Conclusion: S aureus, independent of eczema severity, is associated with food sensitization and allergy and can impair tolerance to foods. This could be an important consideration in future interventions aimed at inducing and maintaining tolerance to food allergens in eczematous infants.

【 授权许可】

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