Abstract
The aim of this study was to determine the prevalence of Staphylococcus aureus enterotoxins (SEs) in the serum from patients with chronic rhinosinusitis (CRS) and its involvement in the condition. Thirty CRS patients without nasal polyps (CRSsNP), 40 CRS patients with nasal polyps (CRSwNP), and 30 healthy controls were enrolled in this study. Peripheral blood was obtained and analyzed to measure the serum levels of total IgE, specific IgE to SEA, SEB and SEC, and eosinophil cationic protein (ECP) using ImmunoCAP assays. The positive rate and level of serum specific IgE to SEB, but not to SEA or SEC, were significantly higher in CRSwNP patients compared with the controls (P=0.027 and P=0.021, respectively). No significant differences were found between CRSsNP patients and controls, or between CRSsNP and CRSwNP patients. Serum total IgE was significantly elevated and positively correlated with SEB-specific IgE in the CRSsNP (P<0.001; r=0.393, P=0.032) and CRSwNP (P<0.001; r=0.581, P<0.001) groups. ECP was also significantly increased in the CRSsNP (P=0.002) and CRSwNP (P<0.001) groups, but not correlated with specific IgE to SEs in either CRS group. The results suggest that SEB may play a role in the pathogenesis of CRSwNP.
Highlights
Chronic rhinosinusitis (CRS) is characterized by mucosal inflammation of the nose and paranasal sinuses and often taken as an umbrella term for a heterogeneous group of sinus diseases
The Staphylococcus aureus enterotoxins (SEs) have been described as superantigens due to their ability to bridge major histocompatibility (MHC) class II
The serum specific IgE antibodies against three common staphylococcal superantigens (SEA, SEB and SEC) were detected in patients with CRS patients without nasal polyps (CRSsNP) and CRS patients with nasal polyps (CRSwNP), and healthy controls
Summary
Chronic rhinosinusitis (CRS) is characterized by mucosal inflammation of the nose and paranasal sinuses and often taken as an umbrella term for a heterogeneous group of sinus diseases. Of the multiple etiological hypotheses, including bacterial, fungal, microbial biofilm, superantigen and immune barrier hypotheses [4,5,6], an exogenous pathogen is probably essential for the development and persistence of mucosal inflammation. Staphylococcus aureus enterotoxins (SEs), secreted by Staphylococcus aureus (S. aureus), the most common colonizer of nasal passages and sinuses, are broadly classified as superantigens [7]. It has been speculated that SEs may aggravate inflammation severity in airway diseases, such as CRS, asthma and allergic rhinitis [8,9,10]
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