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特定 IgE 在葡萄球菌肠毒素 B 与慢性鼻-鼻窦炎严重程度中的作用。

Role of specific IgE on staphylococcal enterotoxin B in chronic rhinosinusitis severity.

机构信息

Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea.

Otolaryngology-Head and Neck Surgery, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.

出版信息

Clin Otolaryngol. 2021 Mar;46(2):304-310. doi: 10.1111/coa.13666. Epub 2020 Nov 25.

Abstract

OBJECTIVE

To investigate the clinical significance of specific IgE-staphylococcal enterotoxin B (IgE-SEB) in CRS (chronic rhinosinusitis).

DESIGN

Retrospective analysis of patients who were positive for specific IgE-staphylococcal enterotoxin B.

SETTING

Tertiary rhinology clinic.

PARTICIPANTS

A total of 965 patients who were tested for specific IgE-staphylococcal enterotoxin B from December 2016 to December 2017.

MAIN OUTCOME MEASURES

We retrospectively reviewed the records of 965 patients who were tested for specific IgE-staphylococcal enterotoxin B from December 2016 to December 2017. Patient demographics, titre-specific IgE to staphylococcal enterotoxin B levels, MAST, serologic test and medical records were reviewed.

RESULTS

IgE-SEB (KU/L) was higher in CRS patients than non-CRS patients (0.13 ± 0.37 vs 0.08 ± 0.22, respectively; P-value: .044), and the IgE-SEB (+, ≥0.35) rate was also higher (10.06% vs 4.46%, respectively; P-value: .030). IgE-SEB (KU/L) was higher in the CRS group than in the fungal sinusitis group (0.13 ± 0.37 vs 0.03 ± 0.05, respectively; P-value: <.001), and the IgE-SEB (+, ≥0.35) rate was also higher (10.06% vs 0%, respectively; P-value: .015). Between the CRSsNP (chronic rhinosinusitis without nasal polyps) and CRSwNP (chronic rhinosinusitis with nasal polyps) groups, there were no differences in IgE-SEB (KU/L) or IgE-SEB (+) rates. IgE-SEB positivity was not associated with the presence of polyps, concomitant asthma or postoperative recurrence. As the values of IgE-SEB (KU/L) and the IgE-SEB (+, >0.1) rate increased, the CRS severity also increased.

CONCLUSIONS

IgE-SEB showed a positive correlation with Lund-Mackay CT severity score, but not with postoperative recurrence or nasal polyps. Further studies are needed to obtain clear evidence that IgE-SEB can be considered as an independent CRS endotype.

摘要

目的

探讨特异性 IgE-葡萄球菌肠毒素 B(IgE-SEB)在慢性鼻-鼻窦炎(CRS)中的临床意义。

设计

对特异性 IgE-葡萄球菌肠毒素 B 阳性患者进行回顾性分析。

地点

三级鼻科诊所。

参与者

2016 年 12 月至 2017 年 12 月间共 965 例接受特异性 IgE-葡萄球菌肠毒素 B 检测的患者。

主要观察指标

回顾性分析 2016 年 12 月至 2017 年 12 月间 965 例接受特异性 IgE-葡萄球菌肠毒素 B 检测的患者的记录。患者的人口统计学资料、葡萄球菌肠毒素 B 特异性 IgE 滴度、MAST、血清学检测和病历均进行了评估。

结果

葡萄球菌肠毒素 B(KU/L)在 CRS 患者中高于非 CRS 患者(0.13±0.37 比 0.08±0.22,P 值:.044),且葡萄球菌肠毒素 B(IgE-SEB,≥0.35)的阳性率也更高(10.06%比 4.46%,P 值:.030)。葡萄球菌肠毒素 B(KU/L)在 CRS 组中高于真菌性鼻窦炎组(0.13±0.37 比 0.03±0.05,P 值:<0.001),且葡萄球菌肠毒素 B(IgE-SEB,≥0.35)的阳性率也更高(10.06%比 0%,P 值:.015)。在 CRSsNP(无鼻息肉的慢性鼻-鼻窦炎)和 CRSwNP(有鼻息肉的慢性鼻-鼻窦炎)组之间,葡萄球菌肠毒素 B(KU/L)或葡萄球菌肠毒素 B(IgE-SEB,≥0.1)的阳性率均无差异。葡萄球菌肠毒素 B 阳性与息肉的存在、并存的哮喘或术后复发无关。随着葡萄球菌肠毒素 B(KU/L)值和葡萄球菌肠毒素 B(IgE-SEB,>0.1)阳性率的升高,CRS 的严重程度也随之升高。

结论

葡萄球菌肠毒素 B 与 Lund-Mackay CT 严重程度评分呈正相关,但与术后复发或鼻息肉无关。需要进一步的研究来获得明确的证据,表明葡萄球菌肠毒素 B 可以被视为一个独立的 CRS 表型。

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