Korean J Otorhinolaryngol-Head Neck Surg.  2010 Apr;53(4):221-227. 10.3342/kjorl-hns.2010.53.4.221.

Role of Staphylococcus Aureus Exotoxins in Chronic Rhinosinusitis with Nasal Polyp

Affiliations
  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University, School of Medicine, Daejeon, Korea. ksrha@cnu.ac.kr
  • 2Research Institute for Medical Sciences, Chungnam National University, School of Medicine, Daejeon, Korea.

Abstract

BACKGROUND AND OBJECTIVES
Staphylococcal exotoxins (SEs) have been implicated in the pathogenesis of chronic rhinosinusitis with nasal polyp (CRSwNP). In the current study, we determined the prevalence of specific immunoglobulin E (IgE) antibodies to SEs in serum and polyp tissues of patients with CRSwNP and tried to find out whether there is an association between the presence of SEs-IgE antibody and eosinophilic inflammation. SUBJECTS AND METHOD: Blood, nasal polyp and mucosa samples were obtained from 43 patients undergoing endoscopic sinus surgery for CRSwNP and 11 controls undergoing septoplasty without CRS. Specimens were analyzed for the presence of specific IgE antibody to four SEs [staphylococcal enterotoxin A (SEA), staphylococcal enterotoxin B (SEB), staphylococcal enterotoxin C (SEC), toxic shock syndrome toxin 1 (TSST-1)] using ImmunoCAP assay. Eosinophil cationic protein (ECP) in serum and nasal polyp tissue were also analyzed using ImmunoCAP. Eosinophil counts were estimated in polyp tissue.
RESULTS
SEs-specific IgE antibodies were detected in 13 (30.2%) patients of the CRSwNP group. In contrast, only one (9.1%) control patient had IgE to SEs. Serum ECP level was increased significantly in the CRSwNP group compared with controls. However, there were no significant differences in Lund-MacKay score, the ECP level in the serum and polyp tissue, and eosinophil count in the polyp tissue between the SEs-IgE antibody positive [SEs-IgE Ab (+)] group and the SEs-IgE antibody negative [SEs-IgE Ab (-)] group.
CONCLUSION
SEs may play a certain role in the pathogenesis of CRSwNP. However, there is no close correlation between the presence of SEs-IgE antibody and eosinophilic inflammation.

Keyword

Staphylococcal exotoxin; Nasal polyp; Chronic rhinosinusitis
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