Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-23T07:37:24.430Z Has data issue: false hasContentIssue false
  • English
  • Français

Role of local allergic inflammation and Staphylococcus aureus enterotoxins in Chinese patients with chronic rhinosinusitis with nasal polyps

Published online by Cambridge University Press:  07 July 2017

K-J Cheng ,
Y-Y Xu ,
M-L Zhou ,
S-H Zhou  and
S-Q Wang
K-J Cheng
Affiliation:
Department of Otolaryngology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
Y-Y Xu
Affiliation:
Department of Otolaryngology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
M-L Zhou
Affiliation:
Department of Otolaryngology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
S-H Zhou
Affiliation:
Department of Otolaryngology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
S-Q Wang*
Affiliation:
Department of Otolaryngology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
*
Address for correspondence: Dr S-Q Wang, Department of Otolaryngology, First Affiliated Hospital, College of Medicine, Zhejiang University, #79 Qingchun Road, Hangzhou, Zhejiang Province, P R China 310003 Fax: +86 571 2886 5247 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To investigate the role of local allergic inflammation and Staphylococcus aureus enterotoxins in chronic rhinosinusitis with nasal polyps.

Methods:

This study included 36 patients with chronic rhinosinusitis with nasal polyps and 18 controls. Total immunoglobulin E, eosinophil cationic protein, staphylococcal enterotoxin types A and B specific immunoglobulin E, staphylococcal enterotoxin types A and B, and myeloperoxidase levels were determined.

Results:

Four patients with chronic rhinosinusitis with nasal polyps had a local allergy. All chronic rhinosinusitis with nasal polyps patients tested negative for staphylococcal enterotoxin types A and B specific immunoglobulin E. The chronic rhinosinusitis with nasal polyps group had significantly elevated staphylococcal enterotoxin types A and B levels in the supernatant. Fourteen patients belonged to the eosinophilic chronic rhinosinusitis with nasal polyps group and the others were characterised as having non-eosinophilic chronic rhinosinusitis with nasal polyps.

Conclusion:

Local allergy may play a role in chronic rhinosinusitis with nasal polyps, independent of staphylococcal enterotoxin superantigens. Staphylococcal enterotoxins may be important in the pathogenesis of chronic rhinosinusitis with nasal polyps; however, their roles as superantigens were not confirmed in this study. In Chinese subjects, chronic rhinosinusitis with nasal polyps usually manifests as a neutrophilic inflammation.

Keywords

SinusitisNasal PolypsAllergyStaphylococcus AureusEosinophil Cationic ProteinMyeloperoxidase
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 131 , Issue 8 , August 2017 , pp. 707 - 713
Copyright
Copyright © JLO (1984) Limited 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Bachert, C, Zhang, N, van Zele, T, Gevaert, P. Chronic rhinosinusitis: from one disease to different phenotypes. Pediatr Allergy Immunol 2012;23(suppl 22):2–4 CrossRefGoogle ScholarPubMed
2 Akdis, CA, Bachert, C, Cingi, C, Dykewicz, MS, Hellings, PW, Naclerio, RM et al. Endotypes and phenotypes of chronic rhinosinusitis: a PRACTALL document of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma & Immunology. J Allergy Clin Immunol 2013;13:1479–90Google Scholar
3 Muñoz-Del-Castillo, F, Jurado-Ramos, A, Soler, R, Fernández-Conde, BL, Barasona, MJ, Cantillo, E et al. Fungal sensitization in nasal polyposis. J Investig Allergol Clin Immunol 2009;19:6–12 Google Scholar
4 Kennedy, JL, Borish, L. Chronic sinusitis pathophysiology: the role of allergy. Am J Rhinol Allergy 2013;27:367–71Google Scholar
5 Asero, R, Bottazzi, G. Nasal polyposis: a study of its association with airborne allergen hypersensitivity. Ann Allergy Asthma Immunol 2001;86:283–5Google Scholar
6 Erbek, SS, Erbek, S, Topal, O, Cakmak, O. The role of allergy in the severity of nasal polyposis. Am J Rhinol 2007;21:686–90CrossRefGoogle ScholarPubMed
7 Collins, MM, Loughran, S, Davidson, P, Wilson, JA. Nasal polyposis: prevalence of positive food and inhalant skin tests. Otolaryngol Head Neck Surg 2006;135:680–3Google Scholar
8 Rondón, C, Romero, JJ, López, S, Antúnez, C, Martín-Casañez, E, Torres, MJ et al. Local IgE production and positive nasal provocation test in patients with persistent nonallergic rhinitis. J Allergy Clin Immunol 2007;119:899–905 Google Scholar
9 Wierzbicki, DA, Majmundar, AR, Schull, DE, Khan, DA. Multiallergen nasal challenges in nonallergic rhinitis. Ann Allergy Asthma Immunol 2008;100:533–7Google Scholar
10 Rondón, C, Canto, G, Blanca, M. Local allergic rhinitis: a new entity, characterization and further studies. Curr Opin Allergy Clin Immunol 2010;10:1–7 Google Scholar
11 Cheng, KJ, Xu, YY, Liu, HY, Wang, SQ. Serum eosinophil cationic protein level in Chinese subjects with nonallergic and local allergic rhinitis and its relation to the severity of disease. Am J Rhinol Allergy 2013;27:8–12 Google Scholar
12 el-Fiky, LM, Khamis, N, Mostafa Bel, D, Adly, AM. Staphylococcal infection and toxin production in chronic rhinosinusitis. Am J Rhinol Allergy 2009;23:264–7Google Scholar
13 Ikeda, K, Shiozawa, A, Ono, N, Kusunoki, T, Hirotsu, M, Homma, H. Subclassification of chronic rhinosinusitis with nasal polyp based on eosinophil and neutrophil. Laryngoscope 2013;123:E1–9 CrossRefGoogle ScholarPubMed
14 Fokkens, WJ, Lund, VJ, Mullol, J, Bachert, C, Alobid, I, Baroody, F et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology 2012;50:1–12 Google Scholar
15 Lund, VJ, Kennedy, DW. Staging for rhinosinusitis. Otolaryngol Head Neck Surg 1997;117(3 Pt 2):S35–40 Google Scholar
16 Zhang, N, Van Zele, T, Perez-Novo, C, Van Bruaene, N, Holtappels, G, DeRuyck, N et al. Different types of T-effector cells orchestrate mucosal inflammation in chronic sinus disease. J Allergy Clin Immunol 2008;122:961–8Google Scholar
17 Bernstein, JM, Kansal, R. Superantigen hypothesis for the early development of chronic hyperplastic sinusitis with massive nasal polyposis. Curr Opin Otolaryngol Head Neck Surg 2005;13:39–44 CrossRefGoogle ScholarPubMed
18 Tomassen, P, Jarvis, D, Newson, R, Van Ree, R, Forsberg, B, Howarth, P et al. Staphylococcus aureus enterotoxin-specific IgE is associated with asthma in the general population: a GA(2)LEN study. Allergy 2013;68:1289–97CrossRefGoogle Scholar
19 Pezato, R, Świerczyńska-Krępa, M, Niżankowska-Mogilnicka, E, Derycke, L, Bachert, C, Pérez-Novo, CA. Role of imbalance of eicosanoid pathways and staphylococcal superantigens in chronic rhinosinusitis. Allergy 2012;67:1347–56Google Scholar
20 Pérez-Novo, CA, Claeys, C, Van Zele, T, Holtapples, G, Van Cauwenberge, P, Bachert, C. Eicosanoid metabolism and eosinophilic inflammation in nasal polyp patients with immune response to Staphylococcus aureus enterotoxins. Am J Rhinol 2006;20:456–60Google Scholar
21 Bachert, C, Zhang, N, Holtappels, G, De Lobel, L, van Cauwenberge, P, Liu, S et al. Presence of IL-5 protein and IgE antibodies to staphylococcal enterotoxins in nasal polyps is associated with comorbid asthma. J Allergy Clin Immunol 2010;126:962–8Google Scholar
22 Zhang, N, Holtappels, G, Claeys, C, Huang, G, van Cauwenberge, P, Bachert, C. Pattern of inflammation and impact of Staphylococcus aureus enterotoxins in nasal polyps from southern China. Am J Rhinol 2006;20:445–50CrossRefGoogle Scholar
23 Heymans, F, Fischer, A, Stow, NW, Girard, M, Vourexakis, Z, Des Courtis, A et al. Screening for staphylococcal superantigen genes shows no correlation with the presence or the severity of chronic rhinosinusitis and nasal polyposis. PLoS One 2010;5:e9525 CrossRefGoogle ScholarPubMed
24 Chakhtoura, M, Hadi, U, Rameh, C, Nassar, J, Abdelnoor, AM. Identification of bacteria isolated from nasal polyps and their ability to produce superantigens and biofilms in Lebanese patients. Ear Nose Throat J 2011;90:E6 Google Scholar
25 Rondón, C, Canto, G, Blanca, M. Local allergic rhinitis: a new entity, characterization and further studies. Curr Opin Allergy Clin Immunol 2010;10:1–7 CrossRefGoogle ScholarPubMed
26 Wise, SK, Ahn, CN, Schlosser, RJ. Localized immunoglobulin E expression in allergic rhinitis and nasal polyposis. Curr Opin Otolaryngol Head Neck Surg 2009;17:216–22Google Scholar
27 Sheahan, P, Ahn, CN, Harvey, RJ, Wise, SK, Mulligan, RM, Lathers, DM et al. Local IgE production in nonatopic nasal polyposis. J Otolaryngol Head Neck Surg 2010;39:45–51 Google ScholarPubMed
28 Van Zele, T, Gevaert, P, Holtappels, G, van Cauwenberge, P, Bachert, C. Local immunoglobulin production in nasal polyposis is modulated by superantigens. Clin Exp Allergy 2007;37:1840–7Google Scholar
29 Bachert, C, Gevaert, P, Holtappels, G, Johansson, SG, van Cauwenberge, P. Total and specific IgE in nasal polyps is related to local eosinophilic inflammation. J Allergy Clin Immunol 2001;107:607–14Google Scholar
30 Zhang, N, Holtappels, G, Gevaert, P, Patou, J, Dhaliwal, B, Gould, H et al. Mucosal tissue polyclonal IgE is functional in response to allergen and SEB. Allergy 2011;66:141–8Google Scholar
31 Cao, PP, Zhang, YN, Liao, B, Ma, J, Wang, BF, Wang, H et al. Increased local IgE production induced by common aeroallergens and phenotypic alteration of mast cells in Chinese eosinophilic, but not non-eosinophilic, chronic rhinosinusitis with nasal polyps. Clin Exp Allery 2014;44:690–700 CrossRefGoogle Scholar
32 Bernstein, JM, Allen, C, Rich, G, Dryja, D, Bina, P, Reiser, R et al. Further observations on the role of Staphylococcus aureus exotoxins and IgE in the pathogenesis of nasal polyposis. Laryngoscope 2011;121:647–55CrossRefGoogle ScholarPubMed
33 Hu, Y, Cao, PP, Liang, GT, Cui, YH, Liu, Z. Diagnostic significance of blood eosinophil count in eosinophilic chronic rhinosinusitis with nasal polyps in Chinese adults. Laryngoscope 2012;122:498–503 Google Scholar
34 Kim, SY, Park, JH, Rhee, CS, Chung, JH, Kim, JW. Does eosinophilic inflammation affect the outcome of endoscopic sinus surgery in chronic rhinosinusitis in Koreans? Am J Rhinol Allergy 2013;27:e166–9 CrossRefGoogle ScholarPubMed