Rationale In patients with chronic rhinosinusitis with nasal polyps (CRSwNP) there is evidence that Staphylococcus aureus enterotoxins (SEs) contribute to the immune inflammatory response that characterizes the disease. CRSwNP occurs in cystic fibrosis (CF) patients who are frequently colonized with S. aureus, but the cellular infiltrate of the inflammatory response differs from CRSwNP non CF patients. We investigated the role of SEs in CF patients with CRSwNP and characterized the polypoid tissue inflammatory responses and each patient's atopic status. Methods Blood was collected from 8 CF patients at the time of polypectomy. Antibody levels were determined by ImmunoCAP 100 and included IgE anti-SEA, -SEB, -SEC, -SED, -TSST-1, -Aspergillus, -Alternaria, -oak, -D. pteronyssinus, -ragweed, & -Kentucky blue grass, total IgE, and IgG anti-Alternaria. Culture and histopathology were performed on tissue specimens. Results Six of eight patients were colonized with S. aureus, but none had IgE against SEA, SEB, SEC, SED, or TSST-l. Inflammation was graded as moderate in 4 patients and marked in 4; lymphocytes and plasma cells represented the bulk of the inflammatory infiltrates with only rare or occasional neutrophils and eosinophils. Fungi were absent in both cultures and tissue sections. Total IgE ranged from 2-91 kU/L; 3 patients had IgE sensitivities: 1 to oak and Alternaria, 1 to Aspergillus and 1 to Alternaria. Seven of eight patients had low or undectable IgG anti-Alternaria.. Conclusions It appears that SEs do not elicit an IgE response in CF patients with CRSwNP, and thus do not contribute to the pathophysiology of the immune response.
Full conference title:
2008 American Academy of Allergy, Asthma, and Immunology Annual Meeting
- AAAAI 2008 (64th)