Serum levels of specific IgE to Staphylococcus aureus enterotoxins in patients with chronic rhinosinusitis

Cui, Xiang; Miao, Jian‐Liang; Han-qiang, LU; Qi, Qin-hong; Chen, Xi; Xu, Juan; Lin, Ziping; Chen, Zhibin; Yin, Min; Cheng, Long

doi:10.3892/etm.2015.2247

Cited by 13 publications

(12 citation statements)

References 25 publications

(27 reference statements)

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“…The prevalence of specific SE-IgE (≥0.10 kU/L) is approximately 40 to 75% in patients with asthma, and SE-IgE levels are associated with high IgE in eosinophilic asthma [30, 31]. Previous studies have suggested the potential involvement of SEB in the pathophysiology of not only eosinophilic asthma but also CRSwNP [32–35]. We occasionally observe patients with eosinophilic asthma who show slight or no response to mepolizumab in clinical practice.…”

Section: Discussionmentioning

confidence: 85%

Efficacy of mepolizumab for patients with severe asthma and eosinophilic chronic rhinosinusitis

et al. 2019

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Background Several major randomized control studies have demonstrated that mepolizumab, an anti-IL-5 monoclonal antibody, is effective for patients with severe eosinophilic asthma who show exacerbation or require systemic corticosteroid maintenance therapy. However, the predictive factors of the response to mepolizumab other than blood eosinophil count are unclear in clinical practice. Objective To elucidate the predictive factors of the response to mepolizumab for patients with severe eosinophilic asthma. Methods From July 2016 to December 2017, 28 patients with severe asthma received mepolizumab in our hospital. To determine the predictive factors, we retrospectively evaluated patient characteristics, comorbidities, biomarkers, pulmonary function, maintenance dose of systemic corticosteroids and number of exacerbations. Results The response rate to mepolizumab treatment was 70% (19/27; one pregnant woman was excluded from analysis). Compared with 11 patients without eosinophilic chronic rhinosinusitis (ECRS), 16 patients with ECRS showed significantly improved systemic corticosteroid-sparing effects [− 71.3 ± 37.0% vs − 10.7 ± 20.1%, P = 0.006], change from baseline FeNO [− 19 ± 57 (%) vs 30 ± 77 (%), P = 0.023] and symptoms [14 patients (88%) vs five patients (45%), P = 0.033]. ECRS was identified as a predictive factor of the response to mepolizumab in a multivariate logistic regression analysis [odds ratio = 22.5, 95% CI (1.5–336), P = 0.024]. Of the eight patients previously administered omalizumab, five responded to mepolizumab. Staphylococcus aureus enterotoxin B IgE results were negative in 80% of responders (P = 0.14). Conclusion Both groups showed improved symptom scores and a decreased number of exacerbations. Mepolizumab substantially improved the clinical variables of patients with eosinophilic asthma complicated with ECRS.

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Section: Discussionmentioning

confidence: 85%

Efficacy of mepolizumab for patients with severe asthma and eosinophilic chronic rhinosinusitis

et al. 2019

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“…Similarly, patients with CRSwNP are also very likely to have frequent Staphylococcus aureus colonization in the nasal passages, which can cross airway epithelial barriers and induce elevated inflammation severity and vascular permeability [39]. Recent literature suggests the elevated presence of specific IgE to SEB in AR and CRSwNP patients, which may amplify mucosal inflammation and initiate a type 2 allergic response [18]. As IgE to SE is common in CSU patients [40], if T2 activity was controlled, complications involving SE and IgE to SEB in the pathogenesis of airway inflammation would be reduced, possibly indirectly leading to a reduction in CSU symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, there are case reports of three different anti-IL5 monoclonal antibodies [ 14 – 16 ] as well as a case series of the anti-IL4 and anti-IL13 monoclonal antibody, dupilumab [ 17 ] improving symptoms of CSU in subjects with severe eosinophilic asthma. Recently, a CSU cohort was found to have IgE against staphylococcal enterotoxin B (SEB), commonly found in subjects with chronic rhinosinusitis with nasal polyposis (CRSwNP) [ 18 ]. SEB IgE level was positively correlated with CSU disease activity, elevated total serum IgE (tIgE) and increased basophil histamine-release.…”

Section: Introductionmentioning

confidence: 99%

Presence of positive skin prick tests to inhalant allergens and markers of T2 inflammation in subjects with chronic spontaneous urticaria (CSU): a systematic literature review

Wong

Keith

2020

Allergy Asthma Clin Immunol

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Background: Current guidelines do not recommend performing aeroallergen skin prick testing (SPT) in chronic spontaneous urticaria (CSU). Objective: The objective of this review was to investigate the presence of aeroallergen sensitization and markers of T2 inflammation in subjects with CSU. Methods: Systematic literature reviews to identify all studies that evaluated the presence of T2 markers of allergic inflammation in CSU subjects were performed. Results: In 16 studies that assessed the prevalence of positive SPT to multiple aeroallergens in CSU, 38.5% of CSU subjects had positive SPT. In three controlled studies, 34.2% of CSU subjects had positive SPT to multiple aeroallergens, compared to 13.6% of controls (p = 0.047). In 18 studies that assessed the prevalence of house dust mite (HDM) positive SPT in CSU, 27.5% of CSU subjects had positive SPT. In three controlled studies, 27.5% of CSU subjects had positive SPT to HDM, compared to 2.1% of controls (p = 0.047). Overall, CSU subjects were 3.1 times more likely to be aeroallergen-sensitized (95% CI 1.7-5.8, p = 0.0002) and 6.1 times more likely to be HDM-sensitized (95% CI 3.7-9.9, p < 0.00001) than controls. Mean total serum IgE (tIgE) levels were 238 kU/L and median tIgE levels were 164 kU/L, which was greater than the upper 90 th percentile of normal (< 137 kU/L). Compared to healthy controls, CSU subjects were 6.5 times more likely to have IgG autoantibody against FcεR1α (p = 0.001), 2.4 times more likely to have IgG anti-IgE antibody (p = 0.03) and 5 times more likely to have anti-thyroid peroxidase (anti-TPO) antibody (p = 0.02). When corticosteroids were withheld for ≥ 28 days, mean blood eosinophil percentage was elevated at 5.9% (normal < 4%), but other studies reporting absolute count found the mean was in the normal range, 239 ×10 6 / L (normal < 400 ×10 6 /L). Conclusion: Increased aeroallergen sensitization, tIgE, autoantibodies and blood eosinophil percentage in the CSU subjects indicates the possible importance of T2 inflammation in the pathogenesis of CSU. Further studies may

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“…However, clinical colonization by superantigen-producing S. aureus is often linked to type 2 responses such as allergic sinusitis and atopic dermatitis (37)(38)(39). Under these conditions, IL-4-dependent IgE responses to superantigens can be detected (40)(41)(42). It is difficult to explain these discrepant observations given that Th1 and Th2 responses negatively cross-regulate each other.…”

Section: Discussionmentioning

confidence: 99%

Staphylococcus aureusDownregulates IP-10 Production and Prevents Th1 Cell Recruitment

Levast

Madrenas

2017

The Journal of Immunology

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Staphylococcal superantigens cause toxic shock syndrome, which is characterized by massive T cell activation and a predominant Th1 profile of cytokine production. However, superantigen-producing strains are often part of the human nasal microbiome, and this carrier state has often been associated with some type 2 immune responses such as chronic sinusitis with polyps and atopic dermatitis. We have previously reported that the cell wall downregulates the human T cell response to superantigens through a TLR2-dependent, IL-10-mediated mechanism. In this study, we show that also regulates the profile of superantigen-induced T cell recruitment. The staphylococcal superantigen SEE induced the production of Th1 cell-recruiting chemokines, including IP-10, through an IFN-γ-dependent mechanism. Such an induction was suppressed by the concomitant presence of The downregulation of IP-10 by was mediated by components of its cell wall, but was not due to peptidoglycan-induced IL-10 production. Instead, triggered activation of MAPKs p38 and ERK, as well as inhibition of STAT1 signaling in monocytes, altogether contributing to the downregulation of IP-10 and other Th1 cell-recruiting chemokines (e.g., CXCL9 and CXCL11). These effects translated into inhibition of superantigen-induced Th1 cell recruitment. Taken together, our data may explain why colonization of superantigen-producing can induce, under some circumstances, mucosal type 2 immune responses.

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Serum levels of specific IgE to Staphylococcus aureus enterotoxins in patients with chronic rhinosinusitis

Cited by 13 publications

References 25 publications

Efficacy of mepolizumab for patients with severe asthma and eosinophilic chronic rhinosinusitis

Efficacy of mepolizumab for patients with severe asthma and eosinophilic chronic rhinosinusitis

Presence of positive skin prick tests to inhalant allergens and markers of T2 inflammation in subjects with chronic spontaneous urticaria (CSU): a systematic literature review

Staphylococcus aureusDownregulates IP-10 Production and Prevents Th1 Cell Recruitment

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