Department of Dermatology, Erasmus MC University Medical Centre, Wytemaweg 80, 3015 CN, Rotterdam, the Netherlands.
Br J Dermatol. 2018 Jun;178(6):1263-1271. doi: 10.1111/bjd.16251. Epub 2018 Mar 23.
Staphylococcus aureus plays a role in the pathogenesis of atopic dermatitis (AD), possibly via the expression of various virulence antigens. An altered antibody response towards these antigens might contribute to inflammation.
To provide an overview of the varying prevalences and odds of antibody responses against S. aureus antigens in patients with AD.
Data were systematically obtained from Embase, MEDLINE, Web of Science, Scopus, Cochrane, PubMed and Google Scholar up to 12 February 2016. We selected all original observational and experimental studies assessing antistaphylococcal antibodies in serum of patients with AD. Prevalences and odds ratios (ORs) of IgE, IgG, IgM and IgA against S. aureus in patients with AD vs. healthy controls were pooled using the random-effects model. We calculated I statistics to assess heterogeneity and rated study quality using the Newcastle-Ottawa Scale.
Twenty-six articles (2369 patients) were included, of which 10 were controlled studies. Study quality was fair to poor. Patients with AD had higher prevalences of IgE against staphylococcal enterotoxin (SE)A (OR 8·37, 95% confidence interval 2·93-23·92) and SEB (OR 9·34, 95% confidence interval 3·54-24·93) compared with controls. Prevalences of antistaphylococcal IgE were 33% for SEA, 35% for SEB and 16% for toxic shock syndrome toxin-1. However, study heterogeneity and imprecision should be taken into consideration when interpreting the results. Data on IgG, IgM and IgA, as well as other antigens, are limited.
Patients with AD more often show an IgE antibody response directed against S. aureus superantigens than healthy controls, supporting a role for S. aureus in AD pathogenesis.
金黄色葡萄球菌（Staphylococcus aureus）在特应性皮炎（atopic dermatitis，AD）发病机制中起作用，可能通过表达各种毒力抗原来实现。针对这些抗原的抗体反应的改变可能会导致炎症。
综述 AD 患者对金黄色葡萄球菌抗原的抗体反应的不同流行率和比值比（odds ratio，OR）。
我们系统性地从 Embase、MEDLINE、Web of Science、Scopus、Cochrane、PubMed 和 Google Scholar 中获取截至 2016 年 2 月 12 日的数据，纳入评估 AD 患者血清中抗葡萄球菌抗体的所有原始观察性和实验性研究。使用随机效应模型汇总 AD 患者与健康对照者之间针对金黄色葡萄球菌的 IgE、IgG、IgM 和 IgA 的流行率和 OR。我们使用 I 2 统计量评估异质性，并使用纽卡斯尔-渥太华量表（Newcastle-Ottawa Scale）评价研究质量。
纳入 26 篇文章（2369 例患者），其中 10 篇为对照研究。研究质量为差到中等。与对照组相比，AD 患者针对葡萄球菌肠毒素（staphylococcal enterotoxin，SEA）A（OR 8.37，95%置信区间 2.93-23.92）和 SEB（OR 9.34，95%置信区间 3.54-24.93）的 IgE 抗体的流行率更高。SEA 的抗葡萄球菌 IgE 流行率为 33%，SEB 为 35%，毒性休克综合征毒素-1（toxic shock syndrome toxin-1，TSST-1）为 16%。然而，在解释结果时，应考虑到研究的异质性和不精确性。有关 IgG、IgM 和 IgA 以及其他抗原的数据有限。
AD 患者比健康对照者更常出现针对金黄色葡萄球菌超抗原的 IgE 抗体反应，这支持金黄色葡萄球菌在 AD 发病机制中的作用。
