Staphylococcus aureus superantigens and their role in eosinophilic nasal polyp disease. [Review]

Division of allergy and rhinology, Department of Otolaryngology, Faculty of Medicine Siriraj, Bangkok, Thailand.
Asian Pacific journal of allergy and immunology / launched by the Allergy and Immunology Society of Thailand (Impact Factor: 0.97). 09/2012; 30(3):171-6.
Source: PubMed


Nasal polyposis is a chronic disease of the upper airways which adversely affects the quality of life of patients. Its pathophysiology is still unclear. Recently, several studies have shown different inflammatory pathways which relate to both innate and adaptive immune responses. Moreover, different phenotypes may exist in different ethnic groups of patients. This article will review recent data regarding the type of inflammation, cytokine profiles, involvement of macrophages and dendritic cells, and the impact of various organisms (especially Staphylococcus aureus and its superantigens) and their association with lower airway disease (especially asthma).

Download full-text


Available from: Pongsakorn Tantilipikorn, Jul 08, 2014
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The influence of the microbial community on inflammatory subtype in chronic rhinosinusitis (CRS) has been proposed. Superantigen mechanisms potentially create a T helper 2 (Th-2)/eosinophilic dominated inflammation as a product of local flora rather than an intrinsic mucosal process. The associations between culturable bacteria and the histopathology and clinical features of CRS patients are described. A cross-sectional study involving patients with CRS undergoing surgery was undertaken. Middle meatal swabs were performed at surgery for microbiological evaluation. Mucosal biopsies were taken and a blinded histopathological profile was performed. Disease specific quality of life and nasal symptom scores were recorded. The presence of culturable organisms and particular pathogens were compared with histopathology and clinical outcomes. A total of 95 patients were assessed (48.4% female, mean age 45.6 ± 14.0 years), of which 47.3% had a culturable organism. Tissue eosinophilia (>10/high-power field [HPF]) was found in 46.1% of these patients and 30.3% had neutrophilic infiltrate, with the presence of neither Gram-positive organisms, Gram-negative organisms, nor species correlating to pathology subtype. A culturable pathogen was a predictor of subepithelial fibrosis (χ(2) = 6.36, p = 0.04) and Gram-negative bacteria had the strongest association (χ(2) = 18.82, p < 0.01). There were no other significant associations with other clinical outcomes. The culturable bacterial community has little impact on histopathology in CRS. While more sensitive tests may detect bacteria in the sinuses, the impact of the simple "culturable" bacteria on the underlying pathologic process is limited. Changes, such as subepithelial fibrosis, suggest colonization may lead to undesirable local mucosal damage and remodeling.
    International Forum of Allergy and Rhinology 02/2014; 4(1). DOI:10.1002/alr.21220 · 2.37 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Allergic rhinitis (AR) and chronic rhinosinusitis (CRS) are two widely prevalent inflammatory diseases in the upper airways. T-cell immunity has been suggested to play an important pathogenic role in many chronic inflammatory diseases including inflammatory upper airway diseases. Inappropriate CD4+ T cell responses, especially the dysregulation of the Th1/Th2 balance leading to excessive Th1 or Th2 cell activation, have been associated with allergic rhinitis and chronic rhinosinusitis. Nevertheless, recent studies suggest that IL-17A and IL-17A-producing Th17 cell subset, a distinct pro-inflammatory CD4﹢T cell lineage, may also play an important role in the pathophysiology of inflammatory upper airway diseases. Th17 cells may promote both eosinophilic and neutrophilic inflammation in AR and CRS. In addition, a few, but accumulating evidence shows that the Th17 responses can be tightly regulated by endogenous and exogenous substances in the context of AR and CRS. This review discusses recent advances in our understanding of the expression and function of the Th17 response and its regulation in inflammatory upper airway diseases, and the perspective for future investigation and clinical utility.This article is protected by copyright. All rights reserved.
    Clinical & Experimental Allergy 07/2014; 45(3). DOI:10.1111/cea.12378 · 4.77 Impact Factor