Superantigens and Chronic Rhinosinusitis II: Analysis of T-Cell Receptor Vβ Domains in Nasal Polyps

Abstract

The current results indicate that polyp lymphocytes exhibit significant oligoclonal expansion of specific V beta-domains. These data are considered diagnostic of a SAg effect. The corresponding blood profile is much less, suggesting that the nose is the primary source of stimulus. Although the trigger(s) for this expansion are unknown, these data are consistent with the hypothesis that staphylococcal toxins are central to the development of CRSwNP.

Efficient characterization of the TCR repertoire in lymph nodes by flow cytometry

“…However, it is well known that circulating lymphocytes do not exactly reflect the situation in tissues where pathologic lesions occur (6,17,23,33,37). Of note, investigations in sites other than peripheral blood have infrequently been conducted using flow cytometry (13,17,20,21,24,(32)(33)(34). As regards lymph nodes, only six studies primarily addressed this question, and these included few patients or used few anti-Vb mAbs (13,23,34,(36)(37)(38).…”

“…The TCR repertoire has been frequently studied in various diseases, but mainly in blood samples (6,14,15,19,(21)(22)(23)37,39), and more rarely in injured organs (3)(4)(5)(6)(7)(8)(9)(10)17,20,21,24,(32)(33)(34). However, it is well known that circulating lymphocytes do not exactly reflect the situation in tissues where pathologic lesions occur (6,17,23,33,37).…”

“…Such an approach by flow cytometry proved to be efficient in detecting skewing of the TCR-repertoire in blood samples. Indeed, oligoclonal expansions or restrictions of some families have been demonstrated in allergy (14), autoimmune disease (15)(16)(17)(18)(19), infection (20)(21)(22)(23), cancer (24,25), and immunodeficiency (26,27). In addition, homogeneous expansions have been characterized in T-cell lymphoproliferative disorders (11,(28)(29)(30)(31).…”

“…So, there was no argument in favor of stimulation by a preferential antigen, in RH, HD, or B-NHL of the present series. In the literature, indication of activation by superantigenic toxins from Staphylococcus aureus has been reported in nasal polyposis (20,21), and Haemophilus parainfluenzae activated Vb6 T-cells have been described in tonsils of patients with IgA nephropathy (18). In other pathologies, recurrent expansion or restriction of specific Vb families have occasionally been reported (6,19), but the putative common antigen has not been identified.…”

Chronic sinusitis pathophysiology: The role of allergy

“…8,45 These bacteria can drive the recurrent acute infections that plague CS patients, when they transform into their planktonic state and emerge from the biofilm. However, even in their indolent biofilm-associated state, these bacteria are not innocuous and can be a robust source of superantigens, [45][46][47][48][49] immune adjuvants, and of allergenic (IgE inducing) proteins (Fig. 2).…”