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Presence of IL-5 protein and IgE antibodies to staphylococcal enterotoxins in nasal polyps is associated with comorbid asthma

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Abstract
Background: Nasal polyps often are associated with asthma. The phenotype of these patients is unknown. Objective: To identify the mucosal factors associated with asthma comorbidity, we analyzed the inflammatory patterns of nasal polyps. Methods: Nasal polyps from 70 Belgian patients, 34% with asthma, were analyzed for type of inflammation, T-cell cytokines, and IgE antibodies to Staphylococcus aureus enterotoxins. The same investigations were repeated in 93 Chinese patients with polyps, a group with a low asthma comorbidity rate (8%). Results: In Belgian patients with polyps, 54% of samples showed eosinophilic inflammation. A classification tree evaluation identified IL-5 as the main positive determinant. Enterotoxin IgE in tissue (37%) was associated with significantly increased total IgE and eosinophil cationic protein concentrations. Expression of enterotoxin IgE, total IgE at greater than 1,442 kU/L, and eosinophil cationic protein at greater than 17,109 mu g/L in samples with a total IgE concentration of greater than 246 kU/L significantly predicted asthma (odds ratio, 5.8-13). Only 7.5% of the samples from Chinese patients with polyps showed eosinophilic inflammation. IL-5 was confirmed as a positive determinant of eosinophilic inflammation, and enterotoxin IgE in tissue (17% of patients) was associated with significantly increased total IgE and eosinophil cationic protein concentrations. The expression of IL-5 or total IgE at greater than 790 kU/L in samples with an IL-5 concentration of greater than 194 pg/mL significantly predicted comorbid asthma (odds ratio, 17.2-96). Conclusion: Mucosal inflammation in nasal polyps orchestrated by T(H)2 cytokines and amplified by S aureus enterotoxins is characterized by an increased eosinophilic inflammation and formation of IgE antibodies. This phenotype is associated with comorbid asthma in white and Asian patients with nasal polyps.
Keywords
nasal polyps, Chronic rhinosinusitis, asthma, T-cell cytokines, Staphylococcus aureus enterotoxins, IgE, SINUS DISEASE, T-CELLS, RHINOSINUSITIS, SUPERANTIGENS, INFLAMMATION

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Chicago
Bachert, Claus, Nan Zhang, Gabriële Holtappels, Lizzy De Lobel, Paul Van Cauwenberge, ShiXi Liu, Ping Lin, Jean Bousquet, and Kristel Van Steen. 2010. “Presence of IL-5 Protein and IgE Antibodies to Staphylococcal Enterotoxins in Nasal Polyps Is Associated with Comorbid Asthma.” Journal of Allergy and Clinical Immunology 126 (5): 962–968.
APA
Bachert, Claus, Zhang, N., Holtappels, G., De Lobel, L., Van Cauwenberge, P., Liu, S., Lin, P., et al. (2010). Presence of IL-5 protein and IgE antibodies to staphylococcal enterotoxins in nasal polyps is associated with comorbid asthma. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 126(5), 962–968.
Vancouver
1.
Bachert C, Zhang N, Holtappels G, De Lobel L, Van Cauwenberge P, Liu S, et al. Presence of IL-5 protein and IgE antibodies to staphylococcal enterotoxins in nasal polyps is associated with comorbid asthma. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. 2010;126(5):962–8.
MLA
Bachert, Claus, Nan Zhang, Gabriële Holtappels, et al. “Presence of IL-5 Protein and IgE Antibodies to Staphylococcal Enterotoxins in Nasal Polyps Is Associated with Comorbid Asthma.” JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY 126.5 (2010): 962–968. Print.
@article{1081031,
  abstract     = {Background: Nasal polyps often are associated with asthma. The phenotype of these patients is unknown.
Objective: To identify the mucosal factors associated with asthma comorbidity, we analyzed the inflammatory patterns of nasal polyps.
Methods: Nasal polyps from 70 Belgian patients, 34\% with asthma, were analyzed for type of inflammation, T-cell cytokines, and IgE antibodies to Staphylococcus aureus enterotoxins. The same investigations were repeated in 93 Chinese patients with polyps, a group with a low asthma comorbidity rate (8\%).
Results: In Belgian patients with polyps, 54\% of samples showed eosinophilic inflammation. A classification tree evaluation identified IL-5 as the main positive determinant. Enterotoxin IgE in tissue (37\%) was associated with significantly increased total IgE and eosinophil cationic protein concentrations. Expression of enterotoxin IgE, total IgE at greater than 1,442 kU/L, and eosinophil cationic protein at greater than 17,109 mu g/L in samples with a total IgE concentration of greater than 246 kU/L significantly predicted asthma (odds ratio, 5.8-13). Only 7.5\% of the samples from Chinese patients with polyps showed eosinophilic inflammation. IL-5 was confirmed as a positive determinant of eosinophilic inflammation, and enterotoxin IgE in tissue (17\% of patients) was associated with significantly increased total IgE and eosinophil cationic protein concentrations. The expression of IL-5 or total IgE at greater than 790 kU/L in samples with an IL-5 concentration of greater than 194 pg/mL significantly predicted comorbid asthma (odds ratio, 17.2-96).
Conclusion: Mucosal inflammation in nasal polyps orchestrated by T(H)2 cytokines and amplified by S aureus enterotoxins is characterized by an increased eosinophilic inflammation and formation of IgE antibodies. This phenotype is associated with comorbid asthma in white and Asian patients with nasal polyps.},
  author       = {Bachert, Claus and Zhang, Nan and Holtappels, Gabri{\"e}le and De Lobel, Lizzy and Van Cauwenberge, Paul and Liu, ShiXi and Lin, Ping and Bousquet, Jean and Van Steen, Kristel},
  issn         = {0091-6749},
  journal      = {JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY},
  keyword      = {nasal polyps,Chronic rhinosinusitis,asthma,T-cell cytokines,Staphylococcus aureus enterotoxins,IgE,SINUS DISEASE,T-CELLS,RHINOSINUSITIS,SUPERANTIGENS,INFLAMMATION},
  language     = {eng},
  number       = {5},
  pages        = {962--968},
  title        = {Presence of IL-5 protein and IgE antibodies to staphylococcal enterotoxins in nasal polyps is associated with comorbid asthma},
  url          = {http://dx.doi.org/10.1016/j.jaci.2010.07.007},
  volume       = {126},
  year         = {2010},
}

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