SELECTED ARTICLES FROM THE RECENT LITERATURE 2007

December 19, 2007

Superantigens and Nasal Polyps

Summary
These investigators from Ghent in Belgium compared concentrations of IgE, IgG, IgM, IgA, IgG subclasses, and specific IgE to staphylococcal aureus enterotoxins (SAES) in patients with chronic sinusitis and nasal polyps, patients with chronic sinusitis and no nasal polyps, and normal controls. Levels were obtained from tissue homogenates from nasal biopsies and from serum. In addition, tissue cryosections were stained for CD19, CD20, and CD 38. In patients with nasal polyps, IgA, IgG, and IgE concentrations were higher in tissue homogenates than in serum compared with sinusitis patients without nasal polyps, and controls. Nasal polyps demonstrating specific IgE to SAES had higher concentrations of IgG and IgE, and a significantly higher fraction of IgG 4. They also demonstrated a lower fraction of IgG 2 than those without specific IgE production. Nasal polyp tissue also had higher CD19 and plasma cell counts (CD138) than normal controls or patients with sinusitis and no polyps.

The authors interpreted these results as an indication of local immunoglobulin production in nasal polyp tissue. They felt that it was also evidence of a response to a chronic microbial trigger. This response to SAES was associated with an augmentation of the production of IgE and IgG, as well as a shift in IgG subclasses.

Editor's Comments
This article clearly substantiates the previously noted finding of local immunoglobulin production in nasal polyp tissue. It also is evidence for a role of SAES in augmenting this response, thus incriminating local reactivity to superantigens as playing a role in the pathogenesis of sinusitis with nasal polyps.

Reference
Van Zele T, et al. Local immunoglobulin production in nasal polyposis is modulated by superantigens. In: Clinical and Experimental Allergy 2007; 37:1840-1874.

 

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