The prevalence of antibody responses against Staphylococcus aureus Staphylococcus aureus antigens in patients with atopic dermatitis: a systematic review and meta‐analysis

摘要

Summary Background 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.Objectives To provide an overview of the varying prevalences and odds of antibody responses againstS. aureus antigens in patients withAD .Methods 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 withAD . Prevalences and odds ratios (OR s) of IgE, IgG, IgM and IgA againstS. aureus in patients withAD vs. healthy controls were pooled using the randomeffects model. We calculatedI 2 statistics to assess heterogeneity and rated study quality using the NewcastleOttawa Scale.Results Twentysix articles (2369 patients) were included, of which 10 were controlled studies. Study quality was fair to poor. Patients withAD had higher prevalences of IgE against staphylococcal enterotoxin (SE )A (OR 8?7, 95% confidence interval 2?323?2) andSEB (OR 9?4, 95% confidence interval 3?424?3) compared with controls. Prevalences of antistaphylococcal IgE were 33% forSEA , 35% forSEB and 16% for toxic shock syndrome toxin1. 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.Conclusions Patients withAD more often show an IgE antibody response directed againstS. aureus superantigens than healthy controls, supporting a role forS. aureus inAD pathogenesis.