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Patients Selleck EGFR inhibitor with SRA had not only lower respiratory function parameters (FEV1) reflecting obstruction of large airways, but in addition their mean mid expiratory flow rate (MEFR 25�C75%), which is thought to reflect involvement of small airways (Endonuclease suggesting that pathophysiological associations between serum total IgE levels and reversible airway obstruction exist, particularly among most patients with severe asthma (25). The mechanisms underlying difficult to treat asthma are complex and have not been fully elucidated (1, 6). Although genetic predisposition to severe asthma phenotype seems to be important, influence of environmental and infectious (viruses and bacteria) factors may have crucial impact in the degree of asthma severity. Staphylococcus aureus-derived enterotoxins (SEs) are a group of molecules with superantigenic activity and potent stimulatory effect on T-cell, eosinophils, neutrophils and other inflammatory cells involved in asthmatic inflammation (9). Presence of specific IgE to SEs has been originally associated this website with the development of eosinophilic inflammation in nasal polyps but also with allergic rhinitis and atopic dermatitis (26�C28). Specific IgE antibodies to SEs may be present in sera of apparently healthy subjects; however, both colonization rates and antibody titres are significantly increased in patients with chronic upper airway inflammatory diseases (rhinosinusitis, nasal polyposis and allergic rhinitis) and are related to other markers of eosinophilic inflammation (ECP, IL-5 and eotaxin) (8, 12).