Clinical Symptoms, Free Histamine and IgE in Patients with Nasal Polyposis

Drake-Lee, Adrian; Mclaughlan, P.

doi:10.1159/000233182

Cited by 65 publications

(37 citation statements)

References 6 publications

(8 reference statements)

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“…31 There is evidence that the changes may extend into the nasal mucosa of the inferior turbinate in some patients, indicating the existence of a more widespread inflammation of the airway mucosa 32. The total histamine content of polyps is much higher than other tissues, and large quantities of free histamine can be measured in the oedema fluid33 which fits in with the ultrastructural findings. Arachidonic acid generated mediators are also found in polyp fluid 34.…”

Section: Inflammation In Nasal Polypssupporting

confidence: 82%

Nasal polyposis, eosinophil dominated inflammation, and allergy

Mygind

2000

Thorax

143

124

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A polyp is an oedematous mucous membrane which forms a pedunculating process with a slim or broad stalk or base. Nasal polyps originate in the upper part of the nose around the openings to the ethmoidal sinuses. The polyps extend into the nasal cavity from the middle meatus, resulting in nasal blockage and restricted airflow to the olfactory region. The polyp stroma is highly oedematous with a varying density of inflammatory cells. Nasal polyposis, consisting of recurrent, multiple polyps, is part of an inflammatory reaction involving the mucous membrane of the nose, paranasal sinuses, and often the lower airways. The polyps are easily accessible for immunological and histological studies and an increasing number of publications have appeared in recent years, including two monographs. Nasal polyps have long been associated with rhinitis and asthma. However, the role of allergy in the aetiology and pathogenesis of nasal polyps is a controversial issue. It has been postulated that allergy is an aetiological factor for nasal polyposis. If this is so, then it can be expected that allergic patients will have polyps more often than a control population and that patients with polyps have an increased occurrence of positive allergy testing.In this paper we will describe the possible connection between nasal polyposis and allergy, based on an analysis of (1) the occurrence of polyps and of allergy, (2) the anatomy and histology of nasal polyps, (3) the inflammation in nasal polyps, (4) the occurrence of positive allergy tests in patients with polyps, (5) the eVect of allergen exposure on nasal symptoms in patients with polyps, and (6) the response to treatment.

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Section: Inflammation In Nasal Polypssupporting

confidence: 82%

Nasal polyposis, eosinophil dominated inflammation, and allergy

Mygind

2000

Thorax

143

124

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“…Although elevated total IgE was found in polyp fluid, there was no difference between polyps from allergic and nonallergic subjects [31]. However, it was noted that total IgE was higher in polyp fluid than the corresponding sera in both allergic and nonallergic polyp subjects.…”

Section: Pathomechanism Of Nasal Polypsmentioning

confidence: 75%

Superantigens and nasal polyps

Bachert

Zele

Gevaert

et al. 2003

Curr Allergy Asthma Rep

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Nasal polyps represent an often severe T-cell-orchestrated eosinophilic upper airway disease with currently unknown pathogenesis, often associated with lower airway disease, such as asthma. Superantigens, predominantly derived from Staphylococcus aureus, are potent activators of T cells, induce the synthesis of IgE in B cells, and have direct effects on pro-inflammatory cells, such as eosinophils. IgE antibodies to S. aureus enterotoxins have been described in polyp tissue, linked to a local polyclonal IgE production and an aggravation of eosinophilic inflammation. Furthermore, such IgE antibodies have also been described in the sera of patients with asthma, and linked to severity of disease and steroid insensitivity. This review summarizes our current understanding of the possible role of S. aureus enterotoxins in chronic severe airway disease, such as nasal polyposis.

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“…Bachert et al [43•] have recently demonstrated a lack of concordance between skin prick tests to inhalant allergens and local IgE levels in polyp homogenates. Local IgE levels in polyp homogenates has also been examined by Drake-Lee and McLaughlan [44], who reported no difference in these levels in allergic and nonallergic patients. It has also been demonstrated, in contrast with studies discussed earlier, that local levels of ECP, IL-4, and IL-5 in polyps, along with IgE, do not differ in allergic versus nonallergic patients [23••].…”

Section: Common Inflammatory Responsementioning

confidence: 99%

The Impact of allergic and nonallergic rhinitis on pediatric sinusitis

Smart

2006

Curr Allergy Asthma Rep

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There is a great deal of published evidence that there is a relationship between both allergic and nonallergic rhinitis and sinusitis in both pediatric and adult patients. The relationship between rhinitis and sinusitis may involve inflammation in one compartment leading to secondary inflammation in the other compartment, such as in the case of rhinitis leading to obstruction of the osteomeatal complex. The relationship may also involve individual manifestations of a shared process, such as allergic disease. A better understanding of the relationship between rhinitis and sinusitis may significantly influence the treatment of these common and important conditions.

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Clinical Symptoms, Free Histamine and IgE in Patients with Nasal Polyposis

Cited by 65 publications

References 6 publications

Nasal polyposis, eosinophil dominated inflammation, and allergy

Nasal polyposis, eosinophil dominated inflammation, and allergy

Superantigens and nasal polyps

The Impact of allergic and nonallergic rhinitis on pediatric sinusitis

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