Staphylococcal enterotoxin specific IgE and asthma: a systematic review and meta-analysis

Abstract

Background: Recent literature suggests that Staphylococcal enterotoxin specific IgE may be a risk factor for asthma.

Objective: To investigate the associations between Staphylococcal enterotoxin sensitization and asthma.

Methods: A systematic review and meta-analysis was performed for relevant case-control or population-based studies, published in the peer-reviewed journals until February 2013. Data were extracted on study designs, subjects, definitions and the prevalence of Staphylococcal enterotoxin sensitization.

Results: A total of 683 studies were initially identified, of which 7 studies finally met the inclusion criteria (5 case-control and 2 population-based studies). All the included studies reported higher prevalence of the sensitization in asthmatics than in controls, despite clinical and methodological heterogeneity. In a meta-analysis, the pooled odds ratio of the sensitization for asthma was 2.95 (95% confidence intervals 2.28-3.82).

Conclusion: Staphylococcal enterotoxin sensitization was significantly associated with asthma. The mechanisms of associations warrant further elucidation.

Keywords: Asthma; Meta-analysis; Staphylococcus.

Fig. 1

Flowchart for the identification of relevant studies.

Fig. 2

Forest plots of studies comparing the frequency of Staphylococcal enterotoxin sensitization in asthmatics and controls. Green squares represent individual studies, and the size of squares is proportional to the number of subjects in the study. Horizontal lines indicate 95% confidence interval ranges. Vertical dotted lines and diamond shapes represent pooled summary estimates for the analysis (the width of the diamond represents the 95% CI). OR, odds ratio; 95% CI, 95% confidence interval; M-H, Mantel-Haenzel test; D+L, DerSimonian and Laird method.