Food-Specific IgE and IgG Antibodies in Patients With Chronic Rhinosinusitis With Nasal Polyps: A Case–Control Study

Abstract

EPOS 2012 states that investigation is needed to study a possible role for food allergy in the initiation and perpetuation of chronic rhinosinusitis with nasal polyps (CRSwNP). Our main goal was to compare serum levels of food-specific immunoglobulin G (IgG) and IgE antibodies in patients with CRSwNP and controls. A prospective case–control study with 33 patients with CRSwNP and 31 controls without CRS was carried out. Clinical data were gathered through a systematic interview and blood sample was collected. Enzyme-linked immunosorbent assay tests using OmegaDiagnostics kit with 40 food allergens for detection of specific IgG antibodies were performed and food-specific IgE antibodies were determined by immunoassay using ImmunoCAP. Immunoglobulin classes and IgG subclasses levels were also evaluated. Statistical analysis was performed using SPSS v.23. The overall sum of food IgG antibodies was significantly lower in CRSwNP compared to control group, and this difference was also observed for different specific IgG antibodies (corn, soya, grain legumes, pear and apple, berries, citric fruit). In controls, a positive correlation between IgG1 and the sum of food IgG antibodies was seen, but in CRSwNP group a negative correlation was found. In addition, a significant higher level of IgG1 and lower IgG2 and IgG3 was found among patients with CRSwNP. Levels of serum-specific IgE antibodies against multiallergen food mix (fx5) and against shrimp, strawberry, orange, rye, or egg yolk, as well as the sum of food IgE antibodies, did not differ significantly between the groups. These findings suggest that food allergy does not have an important role in CRSwNP etiopathogenesis, whether it is IgG or IgE mediated. Moreover, the observed suppression of specific IgG antibodies against food allergens, its negative correlation with IgG1 and the IgG1 switching in CRSwNP, can be related to deviated IgG responses against other targets (eg, airborne particles) and warrants future investigation.

International consensus statement on allergy and rhinology: rhinosinusitis 2021

“…Lill et al found a strong association between CRSwNP and milk allergy, 1397 though neither wheat nor overall incidence of food sensitivity differed between diseased and healthy populations. Other studies comparing systemic IgE for food sensitivity between CRSsNP and CRSwNP demonstrated no such relationship, 1398 with Al‐Quodah finding, “no significant differences in the prevalence, type, number of positive food allergens and class level between the 2 groups.” 1399 These studies present conflicting evidence for the role of food allergy in the pathogenesis of CRSwNP disease (Table X‐5).…”

Comparative study of clinical symptoms of chronic rhinosinusitis with nasal polyps patients

“…The impact of allergic reactions on the occurrence and development of CRS w NP is still inconclusive 7,8 . Still, available data support that serum IgE is associated with CRS w NP 9–11 . One of the characteristics of the late reaction phase of an allergic reaction is the large number of eosinophilic granulocytes that infiltrate the tissues and act as effector cells 12 .…”

“…7,8 Still, available data support that serum IgE is associated with CRS w NP. [9][10][11] One of the characteristics of the late reaction phase of an allergic reaction is the large number of eosinophilic granulocytes that infiltrate the tissues and act as effector cells. 12 Eosinophilic chronic rhinosinusitis (ECRS) is a subgroup of CRSwNP and is associated with severe eosinophilic infiltration and Comprehensive treatment based on surgery is required.…”