A possible link between sinusitis and lower airway hypersensitivity: the role of Staphylococcal enterotoxin B

Tao Liu,Ping-Chang Yang,Bin-Quan Wang

doi:10.1186/1476-7961-4-7

Abstract

Background and aimsThe prevalence of asthma has been keeping arising with unknown etiology. The cumulative evidence indicates that chronic rhinosinusitis (CRS) closely relates to asthma, but the detailed mechanisms remain unclear. The present study aimed to take insight into the role of Staphylococcus enterotoxin B (SEB) in a possible association between CRS and asthma.Methods38 patients with both CRS and asthma underwent functional endoscopic sinus surgery. Serum specific IgE and cytokines, clinical symptoms of CRS and asthma were evaluated before and after the surgery. Peripheral blood mononuclear cells (PBMCs) were separated from the patients and cultured. Th2 response of the cultured PBMCs in the presence or absence of specific antigens and SEB was evaluated.ResultsBesides the improvement of CRS symptoms, amelioration of asthma was also observed in the patients with both CRS and asthma after the sinus surgery. The preoperatively elevated Th2 cytokines, IL-4 and IL-5, normalized postoperatively. Th2 response was generated with separated PBMCs in the presence of specific antigens. SEB was required for maintaining Th2 response in these separated PBMCs.ConclusionThe present results indicate that a possible link exists between CRS and lower airway hypersensitivity. Sinusitis derived SEB may play a role in sustaining Th2 responses in the low airway hypersensitivity related to sinusitis.

Highlights

Background and aimsThe prevalence of asthma has been keeping arising with unknown etiology
With a group patient suffering from both chronic rhinosinusitis (CRS) and allergic asthma, their CRS was treated with functional sinus endoscopic surgery (FESS), we aimed to observe: (i) amelioration of clinical symptom of asthma; (ii) regulation of Th2 response and (iii) the role of Staphylococcus enterotoxin B (SEB) in the maintenance of the skewed Th2 polarization in separated peripheral blood mononuclear cell (PBMC)
Staphylococcus aureus and SEB are identified in the sinuses of CRS patients The surgical removed sinus tissues were subjected to S. aureus culture and the sinus (or nasal) wash fluids (SWF) samples were used to evaluate levels of SEB. 94.7% (36/38) CRS-asthma and 32% (8/25) CRS patients had S. aureus growth in the surgical removed tissues (χ2 test: p < 0.05)

Summary

Introduction

The prevalence of asthma has been keeping arising with unknown etiology. The cumulative evidence indicates that chronic rhinosinusitis (CRS) closely relates to asthma, but the detailed mechanisms remain unclear. The present study aimed to take insight into the role of Staphylococcus enterotoxin B (SEB) in a possible association between CRS and asthma. Asthma is a chronic respiratory disease characterized by episodes or attacks of inflammation and narrowing of small airways in response to exposure to environmental stimuli [1]. Asthma has been a significant health problem in the world, with an ever-increasing morbidity and mortality, and economic impact through both direct and indirect costs over the last 20 years [2]. The cummulative evidence suggests that CD4+ T-helper (Th) lymphocytes play a crucial role in the pathogenesis of asthma. Significant correlation has been identified between high levels of interleukin (IL)-4 and IL-5 and (page number not for citation purposes)

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