University of Texas Medical School at Houston, Department of Otorhinolaryngology-Head and Neck Surgery and Texas Sinus Institute, Houston, TX 77030, USA.
Int Forum Allergy Rhinol. 2011 Nov-Dec;1(6):445-50. doi: 10.1002/alr.20079. Epub 2011 Jul 18.
Recent data has implicated Staphylococcus aureus (SA) superantigen as a potential disease modifier in patients with chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP). The objective of this work was to compare total serum immunoglobulin E (IgE) and serum eosinophils in patients with CRSwNP and CRS without nasal polyps (CRSsNP) based on culture results of the 3 most commonly isolated bacteria.
Retrospective review at a tertiary rhinology referral center of patients with CRS over a 4-year period.
Bacterial cultures and immunologic data were obtained from 62 patients with CRSwNP and 34 patients with CRSsNP. SA was the most prevalent bacteria in the CRSwNP group, isolated in 19 patients (31%). Patients with elevated total serum IgE (>114 IU/mL) were more likely to have SA on culture (p = 0.04) in this population. The percent serum eosinophil levels in the SA+ group compared with the SA- group was not significant (6.0 vs 5.1, p = 0.17). Lund-Mackay computed tomography (CT) scores, but not Sino-Nasal Outcome Test 20 (SNOT-20) scores were significantly higher in the SA+ vs SA- group (p = 0.03) in patients with CRSwNP. The CRSsNP group demonstrated no difference in IgE or serum eosinophils between different bacterial groups.
Our findings suggest that there is an association between SA sinonasal presence and elevated total serum IgE in patients with CRSwNP. In addition, SA+ patients had higher Lund-Mackay CT scores, indicating a higher objective burden of disease in this group of patients.
最近的数据表明金黄色葡萄球菌（SA）超抗原可能是慢性鼻-鼻窦炎（CRS）伴鼻息肉（CRSwNP）患者潜在的疾病修饰因子。本研究旨在基于最常分离的 3 种细菌的培养结果，比较 CRSwNP 和无鼻息肉的 CRS（CRSsNP）患者的总血清免疫球蛋白 E（IgE）和血清嗜酸性粒细胞。
在一家三级鼻科转诊中心，对 4 年内的 CRS 患者进行回顾性研究。
共获得了 62 例 CRSwNP 患者和 34 例 CRSsNP 患者的细菌培养和免疫数据。SA 是 CRSwNP 组最常见的细菌，19 例（31%）患者分离出 SA。在该人群中，总血清 IgE 升高（>114IU/mL）的患者更有可能在培养物中发现 SA（p=0.04）。与 SA-组相比，SA+组的血清嗜酸性粒细胞百分比无显著差异（6.0%比 5.1%，p=0.17）。在 CRSwNP 患者中，SA+组的 Lund-Mackay 计算机断层扫描（CT）评分高于 SA-组，但 Sino-Nasal Outcome Test 20（SNOT-20）评分无差异（p=0.03）。CRSsNP 组不同细菌组之间的 IgE 或血清嗜酸性粒细胞无差异。
我们的研究结果表明，SA 鼻内存在与 CRSwNP 患者总血清 IgE 升高有关。此外，SA+患者的 Lund-Mackay CT 评分更高，表明该组患者的疾病客观负担更高。
