Local immunoglobulin production in nasal polyposis is modulated by superantigens

• Published in: Clinical and experimental allergy Vol. 37; no. 12; pp. 1840 - 1847
• Main Authors: Van Zele, T., Gevaert, P., Holtappels, G., Van Cauwenberge, P., Bachert, C.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.12.2007; Blackwell
• Subjects: Adult; Aged; Allergic diseases; Biological and medical sciences; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; immunoglobulin; Immunoglobulins - biosynthesis; Immunoglobulins - classification; Immunoglobulins - immunology; Immunohistochemistry; Immunopathology; Male; Medical sciences; Middle Aged; nasal polyps; Nasal Polyps - classification; Nasal Polyps - immunology; Nasal Polyps - metabolism; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Staphylococcus aureus; superantigen; Superantigens - immunology; Allergy; Immunopathology; Nose disease; Immunoglobulins; Nasal polyp; Upper respiratory tract; immunoglobulin; Biosynthesis; Immunology; Nasal polyposis; Superantigen; nasal polyps; ENT disease
• ISSN: 0954-7894; 1365-2222; 1365-2222
• DOI: 10.1111/j.1365-2222.2007.02838.x

Summary Background Chronic rhinosinusitis (CRS) with nasal polyps (NP) represents a persistent inflammation often characterized by local hyper‐immunoglobulinaemia and the presence of specific IgE to Staphylococcus aureus enterotoxins (SAEs). We aimed to study the systemic and local production of Igs in relation to plasma cells, B cells and specific IgE to SAEs. Methods Concentrations of IgE, IgG, IgM, IgA, IgG subclasses and specific IgE to SAE were determined on tissue homogenates and serum from 15 CRS patients with NP, 15 CRS without NP and 10 control patients. Tissue cryo‐sections were stained for CD19, CD20 and CD138 to demonstrate B and plasma cells. Results IgA, IgG and IgE concentrations were significantly higher in tissue homogenates, but not in serum, of NP compared with CRS and control subjects. NP with specific IgE to SAEs had significantly higher concentrations of IgG and IgE, and also showed a significantly higher fraction of IgG4 (P=0.003) and a lower fraction of IgG2 (P=0.04) than those without specific IgE production. Furthermore, naïve CD19+ B cell and plasma cell counts (CD138+) were significantly higher in NP tissue compared with controls or CRS. Conclusions The difference in IgE, IgG and IgA expression between NP tissue and serum, supported by increased numbers of plasma cells, suggests a local production of these Igs in NP in response to a chronic microbial trigger. The local immune response to SAE is associated with a further increased production of IgE and IgG, and a shift in IgG subclasses.