Wise Sarah K, Ahn Chadwick N, Lathers Deanne M R, Mulligan Ryan M, Schlosser Rodney J
Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
Am J Rhinol. 2008 Sep-Oct;22(5):451-6. doi: 10.2500/ajr.2008.22.3227.
Local tissue production of antigen-specific immunoglobulin E (IgE) has been shown in patients with allergic rhinitis and in patients with chronic rhinosinusitis (CRS) with nasal polyps. In allergic fungal rhinosinusitis (AFRS), specific IgE has been established in nasal lavage fluid and eosinophilic mucin. In this study, local production of antigen-specific IgE within sinus mucosa of AFRS patients was evaluated.
Sinus mucosa homogenates from 11 AFRS patients, 8 patients with CRS without nasal polyps (CRSsNP), and 9 nonrhinosinusitis control patients were assessed for IgE localization by immunohistochemistry. AFRS and control tissue homogenates were also evaluated for antigen-specific IgE to 14 common antigens by ImmunoCAP testing (Phadia AB, Portage, MI).
There was a significant increase in IgE staining in AFRS sinus epithelium and subepithelium compared with controls and with patients with CRSsNP (p <or= 0.012 for all group differences). AFRS patients showed increased IgE staining in the subepithelium when compared with epithelium (p < 0.001). AFRS sinus tissue had significantly more IgE measured by ImmunoCAP when compared with control sinus tissue for 7 of 14 specific antigens (p < 0.05) and for total IgE (p = 0.004). Antigens with a significant difference on ImmunoCAP included Cladosporium, Aspergillus, Timothy grass, red maple, cockroach, ragweed, and cocklebur.
AFRS patients showed significantly more IgE in sinus mucosa tissue specimens, with increased IgE in subepithelial sites when compared with epithelium. The increased expression of antigen-specific IgE is not limited to fungal antigens. These findings support the role of type I hypersensitivity and local manifestations of allergy in AFRS patients.
变应性鼻炎患者和伴有鼻息肉的慢性鼻-鼻窦炎（CRS）患者已被证实存在局部组织产生抗原特异性免疫球蛋白E（IgE）的情况。在变应性真菌性鼻-鼻窦炎（AFRS）中，已在鼻腔灌洗液和嗜酸性黏液中检测到特异性IgE。本研究评估了AFRS患者鼻窦黏膜内抗原特异性IgE的局部产生情况。
通过免疫组织化学评估11例AFRS患者、8例无鼻息肉的CRS患者（CRSsNP）以及9例非鼻-鼻窦炎对照患者的鼻窦黏膜匀浆中IgE的定位。还通过免疫捕获检测（Phadia AB，密歇根州波蒂奇）评估AFRS和对照组织匀浆中针对14种常见抗原的抗原特异性IgE。
与对照组和CRSsNP患者相比，AFRS鼻窦上皮和上皮下的IgE染色显著增加（所有组间差异p≤0.012）。与上皮相比，AFRS患者上皮下的IgE染色增加（p<0.001）。与对照鼻窦组织相比，AFRS鼻窦组织在14种特异性抗原中的7种（p<0.05）以及总IgE（p=0.004）通过免疫捕获检测测得的IgE显著更多。免疫捕获检测中有显著差异的抗原包括枝孢菌、曲霉菌、梯牧草、红枫、蟑螂、豚草和苍耳。
AFRS患者鼻窦黏膜组织标本中IgE显著更多，与上皮相比上皮下部位的IgE增加。抗原特异性IgE表达的增加不仅限于真菌抗原。这些发现支持了I型超敏反应及过敏局部表现在AFRS患者中的作用。
