Local increase in IgE and class switch recombination to IgE in nasal polyps in chronic rhinosinusitis

Baba, Satoru; Kondo, Kenji; Toma-Hirano, Makiko; Kanaya, Kaori; Suzukawa, Keigo; Ushio, Munetaka; Suzukawa, Maho; Ohta, Ken; Yamasoba, Tatsuya

doi:10.1111/cea.12287

Cited by 57 publications

(39 citation statements)

References 34 publications

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“…34 Baba et.al., demonstrated local increase in total IgE, as well as class switch recombination to IgE in nasal polyps in chronic rhinosinusitis. The Th2 inflammatory pathway, and increased concentrations of IL-5 and total IgE, are proposed to play a role in the pathogenesis of CRSwNP 35 That increased IgE levels are reported in CRSwNP, coupled with the current findings that cells with cytoplasmic IgG are also elevated in this population, suggests mature B cells may migrate and localize to polyp tissue. Factors that govern class-switch recombination and further tissue specific differentiation of plasma cells warrant further investigation.…”

Section: Discussionmentioning

confidence: 65%

Expression of immunoglobulin D is increased in chronic rhinosinusitis

Sokoya

Ramakrishnan

Frank

et al. 2017

Annals of Allergy, Asthma & Immunology

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Section: Discussionmentioning

confidence: 65%

Expression of immunoglobulin D is increased in chronic rhinosinusitis

Sokoya

Ramakrishnan

Frank

et al. 2017

Annals of Allergy, Asthma & Immunology

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“…6 Several groups also found B cell clusters and B cell follicle-like structures in NPs. 121–124 However, unlike the germinal center, the structure of these local follicles was not well organized (Fig. 2I).…”

Section: B-lineage Cellsmentioning

confidence: 99%

“…123 Interestingly, Cao et al and Baba et al reported that local IgE production and IgE class switch recombination were found only in eosinophilic NPs but not in non-eosinophilic NPs in China and Japan. 97,124 …”

Section: B-lineage Cellsmentioning

confidence: 99%

Immunopathology of chronic rhinosinusitis

Kato

2015

Allergology International

228

205

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Chronic rhinosinusitis (CRS) is a heterogeneous disease characterized by local inflammation of the upper airways and sinuses which persists for at least 12 weeks. CRS can be divided into two phenotypes dependent on the presence of nasal polyps (NPs); CRS with NPs (CRSwNP) and CRS without NPs (CRSsNP). Immunological patterns in the two diseases are known to be different. Inflammation in CRSsNP is rarely investigated and limited studies show that CRSsNP is characterized by type 1 inflammation. Inflammation in CRSwNP is well investigated and CRSwNP in Western countries shows type 2 inflammation and eosinophilia in NPs. In contrast, mixed inflammatory patterns are found in CRSwNP in Asia and the ratio of eosinophilic NPs and non-eosinophilic NPs is almost 50:50 in these countries. Inflammation in eosinophilic NPs is mainly controlled by type 2 cytokines, IL-5 and IL-13, which can be produced from several immune cells including Th2 cells, mast cells and group 2 innate lymphoid cells (ILC2s) that are all elevated in eosinophilic NPs. IL-5 strongly induces eosinophilia. IL-13 activates macrophages, B cells and epithelial cells to induce recruitment of eosinophils and Th2 cells, IgE mediated reactions and remodeling. Epithelial derived cytokines, TSLP, IL-33 and IL-1 can directly and indirectly control type 2 cytokine production from these cells in eosinophilic NPs. Recent clinical trials showed the beneficial effect on eosinophilic NPs and/or asthma by monoclonal antibodies against IL-5, IL-4Rα, IgE and TSLP suggesting that they can be therapeutic targets for eosinophilic CRSwNP.

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“…Local, rather than systemic IgE, is thought to be responsible for the inflammatory process in CRSwNP and eCRS. Total IgE and the number of IgE‐positive cells in tissue have been shown to be elevated in the nasal polyp tissue in patients with eCRS compared with non‐eCRS . Additionally, raised total IgE in nasal polyps is significantly associated with elevated interleukin 5 (IL‐5) and eosinophil cationic protein levels, implying a correlation between IgE and eosinophilic inflammation.…”

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confidence: 99%

Atopy in chronic rhinosinusitis: impact on quality of life outcomes

Alvarado

Rimmer

et al. 2019

Int Forum Allergy Rhinol

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Background: Chronic rhinosinusitis (CRS), in particular with nasal polyps (CRSwNP), has been linked with skewed T-helper 2 and immunoglobulin E (IgE)-mediated allergic responses. The role of atopy in CRS, however, remains unclear. Correlations between immunological allergic markers and patient-reported outcomes measures (PROMs) were investigated. Methods:A cross-sectional study of adult patients with CRS undergoing endoscopic sinus surgery was conducted. Immunological allergic markers included automated immunoassay testing for serum-specific IgE to common allergens (house dust mite, grass, mold, animal epithelia) and total IgE. PROMs were assessed using the 22-item Sino-Nasal Outcome Test (SNOT-22). Patients were defined as atopic based on either a positive specific IgE or elevated total IgE (>160 kU/L). Results:A total of 446 patients (45.7% female, age 49.05 ± 14.96 years) were recruited, of which 42.8% had asthma, 51.6% had CRSwNP, and 63.0% had eosinophilic CRS. Positive allergen sensitization was detected in 52.9% patients. Total IgE levels were elevated in 28.0% with mean IgE level of 161 ± 269 kU/L. Atopy was associated with younger age at the time of surgery, CRSwNP, asthma, and eosinophilic CRS (eCRS). Atopy was also associated with increased severity in nasal symptom score (13.1 ± 6.4 vs 11.9 ± 6.0, p = 0.04), as well as worse scores in the loss of smell/taste (χ 2 (1) = 5.97, p = 0.02) and need to blow nose (χ 2 (1) = 4.26, p = 0.04) questions in the CRS population. In the CRSwNP population, there was no significant association between atopy and PROMs. Conclusion:Comorbid atopy in CRS is associated with additional symptom burden, reflected mainly within the nasal symptom quality of life markers. Atopy assessment in CRS is important to ensure appropriate and successful treatment of the disease. C 2018 ARS-AAOA, LLC.

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Local increase in IgE and class switch recombination to IgE in nasal polyps in chronic rhinosinusitis

Cited by 57 publications

References 34 publications

Expression of immunoglobulin D is increased in chronic rhinosinusitis

Expression of immunoglobulin D is increased in chronic rhinosinusitis

Immunopathology of chronic rhinosinusitis

Atopy in chronic rhinosinusitis: impact on quality of life outcomes

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