Immunoglobulin E antibodies against Staphylococcus aureus cell walls in the sera of patients with hyperimmunoglobulinemia E and recurrent staphylococcal infection.

The specificity of antistaphylococcal antibodies of the IgE class in five patients with hyperimmunoglobulinemia E and recurrent staphylococcal infection has been investigated. Purified cell walls were prepared from various staphylococcal strains, and serum immunoglobulin E binding was measured by using a solid-phase radioimmunoassay. Immunoglobulin E binding occurred only with cell walls from Staphylococcus aureus strains, including walls from a teichoic acid-deficient mutant. Immunoglobulin E did not bind to cell wall preparations from the coagulase-negative species S. capitis, S. sciuri subsp. lentus, S. simulans, S. xylosus, staphylococcal strains RB-11 and Armour, and from a group A streptococcus strain CS44. Since the glycan backbone and the tetrapeptide (pentapeptide) subunit of the peptidoglycan of all staphylococcal strains tested are believed to be identical, it is suggested that IgE binding is related to either the peptidoglycan interpeptide bridge or an unknown antigenic structure within the cell wall of S. aureus. The pathophysiological significance of antistaphylococcal immunoglobulin E antibodies in the disorder studied is at present unknown. The formation of immunoglobulin E antibodies to S. aureus cell wall components may be a manifestation of an aberrant immunological response to S. aureus related to the undue susceptibility to staphylococcal infections in these patients.