Fan Yun-Ping, Xu Gen, Zuo Ke-Jun, Xu Rui, Jiang Hong-Yan, Lin Zhi-Bin, Shi Jian-Bo
Hospital of Otorhinolaryngology, First Affiliated Hospital of Sun Yat-Sen University, Otorhinolaryngology Institute of Sun Yat-Sen University, Guangzhou 510080, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2006 Nov;41(11):825-9.
To search the evidence for the presence of superantigen of Staphylococcus aureus enterotoxin (SE) in the pathogenesis of nasal polyposis.
In a cohort of population composed of 42 cases who belonged to three groups: nasal polyposis, simple chronic rhinosinusitis (CRS), and control group without any rhinopathy, detecting the specific IgE against SE-A and B (SEA and SEB), total IgE (TIgE), eosinophilic cationic protein (ECP) of the local mucosa by means of FRAST (UniCAP system), as well as the serum TIgE, and serum anti-SEA and SEB SIgE (only in 8 cases); meanwhile the secretion culture was performed for aerobic bacteria from the middle meatus.
There was no evidence to support that SE played as a superantigen in all mucosa samples (42 cases) and 8 cases serum samples out of the 42 patients. The range of TIgE in mucosa was 4.59 -70.21 kIU/2 mg tissue protein, the mean was (17.85 +/- 14.31) kIU/2 mg tissue protein; in serum the total IgE was 7.44 - 344.00 kIU/L, the mean was (88.65 +/- 80.03) kIU/L The positive culture of Staphylococcus aureus was obtained from only 3 cases from secretion of middle meatus (1 from nasal polyps, 2 from CRS). There was no significance statistically among the three groups on the tissue fluorescence value of SIgE for SE, the means of tissue TIgE and ECP.
No evidence was found to support the role of SE acting as a superantigen among our cases who did not have persistent asthma. It is suggested that further study and investigation is required to prove the superantigen Hypothesis in the pathogenesis of NPs.
探寻金黄色葡萄球菌肠毒素(SE)超抗原在鼻息肉病发病机制中存在的证据。
选取42例患者组成队列,分为三组:鼻息肉病组、单纯慢性鼻-鼻窦炎(CRS)组和无任何鼻病的对照组,采用荧光酶免疫分析法(UniCAP系统)检测局部黏膜针对SE-A和B(SEA和SEB)的特异性IgE、总IgE(TIgE)、嗜酸性粒细胞阳离子蛋白(ECP),以及血清TIgE和血清抗SEA及SEB特异性IgE(仅8例);同时对中鼻道需氧菌进行分泌物培养。
在所有黏膜样本(42例)及42例患者中的8例血清样本中,均无证据支持SE作为超抗原发挥作用。黏膜中TIgE范围为4.59 - 70.21 kIU/2 mg组织蛋白,均值为(17.85 ± 14.31)kIU/2 mg组织蛋白;血清中总IgE为7.44 - 344.00 kIU/L,均值为(88.65 ± 80.03)kIU/L。仅3例中鼻道分泌物培养出金黄色葡萄球菌(1例来自鼻息肉,2例来自CRS)。三组间针对SE的特异性IgE组织荧光值、组织TIgE均值和ECP均值无统计学意义。
在我们未患持续性哮喘的病例中,未发现证据支持SE作为超抗原发挥作用。提示需进一步研究和调查以证实超抗原假说在鼻息肉病发病机制中的作用。