The Role of IgE Production in the Pathophysiology of Rhinitis and Rhinosinusitis

Abstract

A multitude of potential etiologies exist for rhinitis and rhinosinusitis. These sinonasal disorders are heterogeneous entities that are best understood by evaluating the causative factors in each individual patient. More precise diagnosis permits accurate and effective treatment. The association of allergy with sinonasal symptoms has been described for decades; however, the specific relationship between allergy, rhinitis, and rhinosinusitis is complex. Considering allergy in terms of a systemic atopic disorder, along with a local inflammatory process mediated by IgE production in sinonasal tissues, is helpful in unveiling the complex connection between allergy, rhinitis, and rhinosinusitis. This article reviews recent literature regarding local IgE and sinonasal inflammatory conditions.

Is chronic rhinosinusitis related to allergic rhinitis in adults and children? Applying epidemiological guidelines for causation

“…These findings are similar to the effect of allergy on other parts of the respiratory tract (11). Nevertheless, the presence of IgE, mast cells, eosinophils, and 'TH2 cytokines' and clinical evidence of hyper-reactivity (40,41) are not synonymous with and not specific to IgE-mediated hypersensitivity. In other words, IgE might play a role in nonallergic inflammation.…”

Recent advances in understanding chronic rhinosinusitis endotypes

“…T helper cell responses in CRS are highly variable, and a combination of Th1, Th2, Th17, and likely other T helper subsets drives the production of specific cytokines and results in a persistent inflammatory state 21– 23 . Furthermore, CRSwNP is frequently associated with infiltration by plasma cells and increased local production of immunoglobulin E (IgE) antibodies 24– 26 . Differential tissue infiltration by eosinophils or neutrophils (or both) is typical in CRS and governed by T cell-mediated immune responses and the resulting cytokine milieu.…”