Staphylococcus aureus Enterotoxins sensitization on the pathophysiology of COPD

<bold>Background:</bold> Sensitization to Staphylococcus aureus enterotoxins (SEs) A (SEA) and B (SEB) is associated with the pathogenesis of asthma and chronic rhinosinusitis, but its role in chronic obstructive pulmonary disease (COPD) remains unclear. <bold>Objective:</bold> To investigate the impact of sensitization to SEs on the pathophysiology of COPD. <bold>Methods:</bold> We prospectively enrolled 68 patients with COPD from June 2018 to January 2020 for post-hoc analysis. Patient characteristics and biomarkers, including total IgE, capsaicin cough reflex sensitivity (C-CS), and SEA-IgE and SEB-IgE, were collected. Total IgE and SEs-IgE levels in individuals with COPD were compared to those of 20 healthy individuals. The correlation between C-CS and IgE levels was evaluated using Pearson’s correlation coefficient. Multivariate analyses were used to analyze the association of SEs sensitization with COPD pathophysiology. <bold>Results:</bold> SEs positivity was higher in patients with COPD (23.5%) than in healthy individuals (0%) (Figure A, P = 0.018). Levels of total IgE was correlated with SEs-IgE in patients with COPD (Figure B). There was a negative correlation between total serum SEB-IgE levels and declined C-CS values (Figure C). Multivariate analysis showed that SEs sensitization contributed to increased total IgE levels, declined C-CS, and acute exacerbation of COPD. <bold>Conclusions:</bold> SEs sensitization might contribute to the pathophysiology of COPD.