| Chronic sinusitis with nasal polyps: staphylococcal exotoxin immunoglobulin E and cellular inflammation. | |
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MedLine Citation:
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PMID: 15586797 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The etiology of chronic sinusitis with nasal polyposis (CS/NP) remains enigmatic. Frequently, Staphylococcus aureus is present in the nose of CS/NP patients, although the significance is unclear. Recent reports have suggested the hypothesis that these bacteria may secrete exotoxins triggering the inflammatory mucosal changes seen in CS/NP. This mechanism of immunopathology has been established in other diseases associated with Staphylococcus colonization and exotoxin secretion such as atopic dermatitis. In atopic dermatitis, the exotoxins incite a local superantigen response in which clonal T-cell activation and massive cytokine release occur in the affected skin. Second, these exotoxins can act as traditional allergens, stimulating a typical immunoglobulin E (IgE) response in the serum, which has been correlated with disease severity. This study is designed to begin the assessment of the hypothesis that a similar mechanism takes place in CS/NP. METHODS: Serum was drawn from patients with CS/NP undergoing endoscopic sinus surgery as well as 13 atopic and nonatopic control subjects without sinusitis. IgE levels to S. aureus exotoxins A (SEA), SE exotoxins B (SEB), and toxic shock syndrome toxin 1 were measured using enzyme-linked immunosorbent assay. Tissue eosinophilia and the presence of lymphocytes on hemotoxylin and eosin-stained sections of polyps were scored by a blinded pathologist and correlated to presence of toxin IgE in the serum. RESULTS: Staphylococcal exotoxin (SE)-specific IgE was found in the serum of 5/10 (50%) of the patients with CS/NP. In contrast, 0/13 control patients had IgE to the exotoxins (p = 0.031). Polyp eosinophil, lymphocyte, and mononuclear cell counts were compared in IgE exotoxin-positive and -negative subjects. A trend toward increased eosinophil counts in patients with SE IgE (SE IgE+) was present, but not statistically significant. CONCLUSION: These results indicate that a high percentage of CS/NP patients show a systemic IgE response to S. aureus exotoxins in comparison with controls without CS/NP. Although these results are consistent with the actions of Staphylococcus toxins in other diseases, additional work is necessary to establish a local superantigen response in the nasal mucosa of CS/NP patients. |
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Authors:
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David B Conley; Anju Tripathi; Anne M Ditto; Kathryn Reid; Leslie C Grammer; Robert C Kern |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: American journal of rhinology Volume: 18 ISSN: 1050-6586 ISO Abbreviation: Am J Rhinol Publication Date: 2004 Sep-Oct |
Date Detail:
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Created Date: 2004-12-09 Completed Date: 2005-02-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8807268 Medline TA: Am J Rhinol Country: United States |
Other Details:
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Languages: eng Pagination: 273-8 Citation Subset: IM |
Affiliation:
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Department of Otolaryngology--Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Chronic Disease Exotoxins / immunology* Humans Immunoglobulin E / immunology* Leukocytes, Mononuclear / immunology Lymphocytes / immunology Middle Aged Nasal Polyps / immunology* Sinusitis / immunology* Staphylococcus aureus / immunology* |
| Chemical | |
Reg. No./Substance:
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0/Exotoxins; 37341-29-0/Immunoglobulin E |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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