Allergic conversion of protective mucosal immunity against nasal bacteria in patients with chronic rhinosinusitis with nasal polyposis

Takeda, Kazuya; Sakakibara, Shuhei; Yamashita, Kazuo; Motooka, Daisuke; Nakamura, Shota; Hussien, Marwa Ali El; Katayama, Jun’ichi; Maeda, Yukihiro; Nakata, Masao; Hamada, Shigeyuki; Standley, Daron M.; Hayama, Masaki; Shikina, Takashi; Inohara, Hidenori; Kikutani, Hitoshi

doi:10.1016/j.jaci.2018.07.006

Cited by 48 publications

(34 citation statements)

References 53 publications

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“…16 Local IgE class switching by B cells and IgE production is well documented in tissue from patients with CRSwNP. [17][18][19] Within the sinonasal mucosa, Staphylococcal enterotoxin-specific IgE and polyclonal IgE for inhalant allergens, as well as colonization by microbial agents including Staphylococcus aureus, are associated with CRSwNP irrespective of atopic status. 20 Locally produced IgE appears to be functional and involved in regulating chronic inflammation.…”

mentioning

confidence: 99%

Efficacy and safety of omalizumab in nasal polyposis: 2 randomized phase 3 trials

Gevaert

Omachi²,

Corren

et al. 2020

Journal of Allergy and Clinical Immunology

490

438

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mentioning

confidence: 99%

Efficacy and safety of omalizumab in nasal polyposis: 2 randomized phase 3 trials

Gevaert

Omachi²,

Corren

et al. 2020

Journal of Allergy and Clinical Immunology

490

438

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“…However, previous studies only detected the immunoreaction to Staphylococcus aureus in a small portion of Chinese patients with CRSwNP, even in eosinophilic type, disfavoring a role of Staphylococcus aureus in inducing IgE in Chinese patients (8,17,18) . Very recently, IgE antibodies against Streptococcus pyogenes and Haemophilus influenzae were detected and reported in Japanese patients with eosinophilic CRSwNP (19) . Therefore, the role of bacteria or common aeroallergens in the change of local IgE in NPs deserves further studies.…”

Section: Discussionmentioning

confidence: 99%

A retrospective study of changes of histopathology of nasal polyps in adult Chinese in central China

Jiang

Cao

et al. 2019

Rhin

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Background: The factors contributing to the eosinophilic inflammation in chronic rhinosinusitis with nasal polyps (CRSwNP) remain elusive. This study was designed to investigate the inflammatory patterns and tissue remodeling of CRSwNP in patients from central China at two time points over 14 years apart and the influence of age. Methods: One hundred and eight CRSwNP patients enrolled in 2000 and 2001 (group A), and 134 CRSwNP patients enrolled in 2014 and 2015 (group B) were retrospectively studied. Hematoxylin-eosin stained tissue sections were used to study characteristics of inflammation and tissue remodeling. Immunohistochemistry was used to further evaluate the cells positive for eosinophil cationic protein (ECP), IL-5, IgE, tryptase or myeloperoxidase (MPO). Time-and age-related difference was analyzed. Results: The number of eosinophils and proportion of eosinophilic CRSwNP were increased, whereas the numbers of total inflammatory cells and lymphocytes were decreased in group B as compared with group A. Group B had severer epithelial squamous metaplasia and basement membrane thickening, and a lower number of mucosal glands than group A. Higher numbers of ECP + , IL-5 + and IgE + cells were detected in group B than those in group A. The elderly (≥ 60 yrs) and non-elderly (< 60 yrs) had a comparable number of eosinophils and ratio of eosinophilic CRSwNP. Conclusion: Eosinophilic inflammation has been significantly augmented over time, which is associated with increased Th2 response and IgE production, and accompanied by exaggerated epithelium remodeling in CRSwNP patients from central China. Age has no significant influence on eosinophilic inflammation.

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“…32,39 Increased mucosal infiltration of B cells, particularly germinal center B cells, and the presence of markers of class-switch recombination to IgE including epsilon germinal gene transcripts and epsilon circle transcripts in nasal polyps, strongly suggest local class-switch recombination to IgE in patients with eosinophilic CRSwNP. 39–41 Tfh cells classically locate in germinal centers in secondary lymphoid tissues and play a crucial role in regulating B-cell responses. A recent study by Song et al demonstrated that the formation of ectopic lymphoid tissues was more frequently observed in nasal polyps and Tfh cells resided in these structures in polyps (Fig 1).…”

Section: Immune Polarization In Crsmentioning

confidence: 99%

“…39 Recently, by characterizing single cell-derived monoclonal antibodies, Takeda et al discovered that about 20% of isolated IgE antibodies recognized nasal bacteria such as Staphylococcus aureus , Streptococcus pyogenes , and Haemophilus influenza . 41 …”

Section: Immune Polarization In Crsmentioning

confidence: 99%

Pathophysiologic mechanisms of chronic rhinosinusitis and their roles in emerging disease endotypes

Cao

Wang

Schleimer

et al. 2019

Annals of Allergy, Asthma & Immunology

103

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Objective: Chronic rhinosinusitis (CRS) is a heterogeneous disorder with distinct pathophysiologic mechanisms. Based on the transcription factor expression and cytokine production patterns in different types of innate lymphoid cells (ILCs), in parallel with those of adaptive CD4+ T helper (Th) cells and CD8+ cytotoxic T (Tc) cells, new perspectives on endotypes of patients are emerging around the immune response deviation into type 1 (orchestrated by ILC1s, Tc1 and Th1 cells), type 2 (characterized by ILC2s, Tc2 and Th2 cells), and type 3 (mediated by ILC3s, Tc17 and Th17 cells) responses. Additionally, cluster analysis has been applied to the endotyping of CRS in recent years, which has provided additional novel insights into the CRS pathogenesis. This article aims to review pathological mechanisms of CRS on the basis of type 1, type 2, and type 3 immune responses and how they inform us to begin to understand CRS endotypes. This article also reviews the recent cluster analysis studies of CRS endotypes. Finally, the impact of endotype on therapeutic management of CRS is summarized. Data Sources: Review of published literature. Study Selections: Relevant literature concerning CRS endotypes and the possible underlying mechanisms were obtained from a PubMed search and summarized here. Results and Conclusion: Both CRSwNP and CRSsNP are comprised of distinct endotypes with distinct deviated immune responses, pathogenic mechanisms, and different responses to medical and surgical treatment. An endotype of CRS with prominent type 2 immune responses is the most well studied endotype, and generally can benefit from treatment with steroids and specific type 2 disrupting biologics.

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Allergic conversion of protective mucosal immunity against nasal bacteria in patients with chronic rhinosinusitis with nasal polyposis

Abstract: In patients with CRSwNP, nasal bacteria-reactive B cells differentiate into IgE-producing B cells through IgG/IgA-IgE class switching, suggesting that allergic conversion of the mucosal response against nasal bacteria underlies disease pathogenesis.

Cited by 48 publications

References 53 publications

Efficacy and safety of omalizumab in nasal polyposis: 2 randomized phase 3 trials

Efficacy and safety of omalizumab in nasal polyposis: 2 randomized phase 3 trials

A retrospective study of changes of histopathology of nasal polyps in adult Chinese in central China

Pathophysiologic mechanisms of chronic rhinosinusitis and their roles in emerging disease endotypes

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