Pérez-Novo Claudina A, Kowalski Marek L, Kuna Piotr, Ptasinska Anetta, Holtappels Gabriele, van Cauwenberge Paul, Gevaert Philippe, Johannson Sgo, Bachert Claus
Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium.
Int Arch Allergy Immunol. 2004 Mar;133(3):255-60. doi: 10.1159/000076832. Epub 2004 Feb 17.
Nasal polyposis is a multifactorial disease characterized by a chronic eosinophilic inflammation of the sinus mucosa, often associated with asthma and aspirin sensitivity. We have recently shown that the presence of IgE antibodies to Staphylococcus aureus enterotoxins (SAEs) was related to the severity of eosinophilic inflammation in nasal polyp tissue. In this study, we therefore aimed to determine, whether aspirin sensitivity was related to an immune response to SAEs, and how both criteria would be related to eosinophilic inflammation.
40 subjects with nasal polyposis (NP) were classified as aspirin-sensitive (n=13, ASNP) or aspirin-tolerant (n=27, ATNP) based on a bronchial aspirin challenge test. Homogenates prepared from nasal polyp tissue and inferior nasal turbinates from healthy subjects (n=12) were analyzed for concentrations of IL-5 by enzyme immunoassay and for ECP, total and IgE to a mix of SAEs (A, C, TSST-1) using the ImmunoCAP system.
Concentrations of IL-5, ECP, total IgE, and IgE to an SAE mix were significantly increased in ASNP compared with ATNP patients and controls. In addition, a subgroup analysis showed an increase in eosinophilic markers in ATNP-SAE(+) compared to ATNP-SAE(-). This relationship, however, was not found in ATNP-SAE(+) and ATNP-SAE(-) subjects, indicating that SAE immune response is overlapped or not relevant in this condition.
Aspirin sensitivity was associated with increased concentrations of eosinophil-related mediators, as well as IgE antibodies to SAEs in nasal polyp tissue. However, a direct impact of S. aureus could not be established. It seems that aspirin sensitivity and immune reactions to SAEs are independently related to eosinophilic inflammation.
鼻息肉病是一种多因素疾病，其特征为鼻窦黏膜的慢性嗜酸性粒细胞炎症，常与哮喘和阿司匹林敏感性相关。我们最近发现，针对金黄色葡萄球菌肠毒素（SAEs）的IgE抗体的存在与鼻息肉组织中嗜酸性粒细胞炎症的严重程度有关。因此，在本研究中，我们旨在确定阿司匹林敏感性是否与对SAEs的免疫反应相关，以及这两个标准如何与嗜酸性粒细胞炎症相关。
根据支气管阿司匹林激发试验，将40例鼻息肉病（NP）患者分为阿司匹林敏感组（n = 13，ASNP）或阿司匹林耐受组（n = 27，ATNP）。采用酶免疫测定法分析从鼻息肉组织和健康受试者（n = 12）的下鼻甲制备的匀浆中IL-5的浓度，并使用免疫捕获系统分析嗜酸性粒细胞阳离子蛋白（ECP）、针对SAEs混合物（A、C、TSST-1）的总IgE和IgE。
与ATNP患者和对照组相比，ASNP患者中IL-5、ECP、总IgE以及针对SAEs混合物的IgE浓度显著升高。此外，亚组分析显示，与ATNP-SAE（-）相比，ATNP-SAE（+）中嗜酸性粒细胞标志物增加。然而，在ATNP-SAE（+）和ATNP-SAE（-）受试者中未发现这种关系，表明SAE免疫反应在这种情况下重叠或不相关。
阿司匹林敏感性与鼻息肉组织中嗜酸性粒细胞相关介质浓度升高以及针对SAEs的IgE抗体增加有关。然而，无法确定金黄色葡萄球菌的直接影响。似乎阿司匹林敏感性和对SAEs的免疫反应与嗜酸性粒细胞炎症独立相关。
