The objective of a population cohort study by A. Semic-Jusufagic et al. (Great Britain), was a study of the role of exotoxins produced by Staphylococcus aureus in the development of allergic diseases in early childhood.

The work included data from 510 children followed from birth to 5 years of age. During the study, the questionnaires were filled out again, specific IgEs for respiratory and food allergens were detected in children, lung function was assessed by spirometry and plethysmography, the reactivity of the respiratory tract was determined. and specific IgEs, considered as markers of allergic pathology, have been identified for a certain number of exotoxins (staphylococcal exotoxin A, staphylococcal exotoxin C, toxic shock syndrome toxin 1) using the immunofluorescence method.

According to the results obtained, no relationship was found between the development of allergic rhinitis and sensitization to staphylococcal exotoxins. At the same time, in children suffering from eczema, awareness of these exotoxins was noted more often compared to healthy children (17.4% vs 8.3%; p = 0, 02). The increase in the severity of the eczematous process was accompanied by a significant increase in the frequency of sensitization (8.3% in healthy children, 14.8% in children with mild eczema and 42, 9% in children of moderate severity and severe eczema; p = 0.003), and awareness itself remained an independent predisposing factor for the development of eczema in the multivariate model after correction taking into account the concentration total IgE (adjusted odds ratio 2.19; 95% confidence interval (CI) 1.05-4.56; p = 0.04).

In the univariate but not multivariate model, the relationship between sensitization to staphylococcal exotoxins and the development of respiratory disorders (shortness of breath, wheezing) was also shown, and sensitization was significantly more common in children with persistent disorders (8, 5% in the absence of respiratory disorders, 3.8% - for transient violations, 7.7% - for late onset of violations and 17.6% - for persistent violations; p = 0.05). In addition, significantly higher reactivity of the respiratory tract was detected in sensitized children compared to non-sensitized children (average variation of FOV1 -59 ml, 95% CI -121 - 3 vs 19, 95% CI -10.2 - 48.9; p = 0.04).

The presence of IgE antibodies against staphylococcal exotoxins in 5-year-old children with allergic skin and respiratory lesions, unlike healthy children, enabled the authors to draw a conclusion on the modifying effect of staphylococcal exotoxins on the development of allergic diseases in early childhood.